More Doctor Check-ups Means Earlier Dental Check-ups in Toddlers
February 13, 2013

By Nancy Volkers
InteliHealth News Service

INTELIHEALTH - Children on Medicaid with more well-child visits between ages 1 and 3 are more likely to have a dental check-up earlier in life, a new study finds.

The American Academy of Pediatric Dentistry and the American Academy of Pediatrics recommend that all children visit a dentist by their first birthday. Fewer than 5% of children meet this goal. But nearly all children visit a physician multiple times for well-baby visits.

The authors of the study said well-baby visits could provide a chance to talk about early preventive dental care.

Researchers at the University of Washington, Seattle, and the University of Iowa did the study. They reviewed Iowa Medicaid data from the years 2000 to 2008.

Children in the study had to be enrolled in Medicaid for at least 41 months in a row, starting at birth. This allowed researchers to see if they had all 10 of the well-baby visits recommended during that time. Those who first visited a dentist for treatment, rather than a check-up, were excluded from the study.

The final results included 6,322 children. Of these, 76.6% were white. All children had at least one well-baby visit.

Five well-baby visits are recommended before age 1. In that first year, 55.1% of children had 4 or 5 visits. Only 2% of children visited a dentist.

By 41 months, 30% of children had not visited the dentist. But nearly all of them had at least 2 well-baby visits.

The study found:

• Children who had more well-baby visits during the first year were not more likely to have an earlier first dental visit.
• Children with more well-baby visits between ages 1 and 2 were nearly 3 times as likely to have an earlier first dental visit, compared with children who had fewer well-baby visits.
• Children with more well-baby visits between ages 2 and 3 were about 25% more likely to have an earlier first dental visit, compared with children who had fewer well-baby visits.

The authors present three possible reasons for these results:

• Baby molars start coming in at about age 1. Physicians might begin talking to parents then about the need for dental exams.
• Caregivers may be more interested in a child having a dental exam after the child has more teeth.
• Tooth decay takes time to develop. Physicians may start noticing possible decay after age 1 and referring the child to a dentist.

Three other factors also were related to earlier first dental visits:

• Non-white children were 14% more likely than white children to have an earlier first dental visit. The authors say this may be because non-white children are more likely to have early tooth decay.
• Children who saw different medical professionals for well-baby visits were 90% less likely to have an earlier first dental visit than children who saw the same person every time. The authors say that seeing the same person may help reinforce messages to parents.
• Children whose mothers used preventive dental care while they were pregnant were 40% more likely to have an earlier dental visit than children whose mothers did not.

The study appears in the February issue of the American Journal of Public Health.