Community Dentistry, Case Western Reserve University, Cleveland, OH, USA.
Population and Quantitative Health Sciences, Case Western Reserve University, Cleveland, OH, USA.
J Public Health Dent. 2021 Jun;81(2):131-142. doi: 10.1111/jphd.12423. Epub 2020 Nov 2.
The objectives of this study are to determine the overall and racial differences in the extent of caries experience and to examine the association between child and parent/caregiver characteristics and caries among 3-6-year-old Medicaid-enrolled children.
This study reports baseline cross-sectional data from a larger pragmatic clinical trial in pediatric primary care practices. Child-level clinical dental exams included decayed and filled teeth (dft) using ICDAS criteria and parent/caregiver questionnaire collected information on socio-demographics, child oral health behaviors, oral health related quality of life (OHQoL), and food environment.
A total of 1,024 parent/caregiver-child dyads participated in the study. The overall caries experience (dft) was 49 percent and untreated decay was 42 percent. Children who were Black had 1.3 and 1.2 times significantly higher frequency of untreated primary decay and caries experience compared to non-Black children. An overall logistic regression model predicted that race, increased age, receiving dental care in the past 12 months for a cavity/toothache, and lower caregiver OHQoL was significantly associated with increased odds of the child having caries. Non-Black caregivers with less education, whose child was older, and lower child OHQoL had increased odds of having a child with caries, but these same variables were not predictive for the Black children.
Racial disparities exist with respect to caries experience and untreated decay within a Medicaid-enrolled population of young children attending well-child visits. Pediatric primary care offices are well-positioned to provide dental surveillance and preventive care and could play an important role in decreasing oral health inequities.
本研究旨在确定龋齿经历的总体和种族差异，并探讨儿童和家长/照顾者特征与 3-6 岁参加医疗补助计划的儿童龋齿之间的关系。
本研究报告了一项大型实用临床研究在儿科初级保健实践中的基线横断面数据。儿童口腔临床检查包括使用 ICDAS 标准的龋齿和填充牙（dft），以及家长/照顾者问卷收集社会人口统计学、儿童口腔健康行为、口腔健康相关生活质量（OHQoL）和食物环境信息。
共有 1024 对家长/照顾者-儿童参与了研究。总体龋齿经历（dft）为 49%，未治疗的龋齿为 42%。与非黑人儿童相比，黑人儿童的未治疗原发性乳牙龋齿和龋齿经历的频率分别高出 1.3 倍和 1.2 倍。总体逻辑回归模型预测，种族、年龄增长、过去 12 个月内因龋齿或牙痛接受牙科护理以及照顾者 OHQoL 降低与儿童患龋齿的几率增加显著相关。受教育程度较低的非黑人照顾者，其孩子年龄较大，儿童 OHQoL 较低，其孩子患龋齿的几率增加，但这些相同的变量对黑人儿童没有预测作用。
在参加常规儿童健康检查的医疗补助计划的年轻儿童中，存在与龋齿经历和未治疗龋齿有关的种族差异。儿科初级保健办公室非常适合提供牙科监测和预防保健，并可以在减少口腔健康不平等方面发挥重要作用。
