Psychosocial Risk Exposure Limits Routine Pediatric Oral Health Care

HIGHLIGHTS

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  Early childhood caries is a complex, multifactorial oral disease.

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  About half of U.S. children do not receive regular oral health care.

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  Parental depression and COVID-19 were associated with increased cancelations and failed dental appointments.

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  Canceled or no-show appointments were associated with increased reported alcohol use and low social support.

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  Pediatric routine dental appointments and pediatric study visits were observed over a 2-year period.

Abstract

Introduction

This study aimed to identify social, psychological, and contextual factors that influenced attendance at routine oral health visits in a cohort of 189 preschool children who were followed over a 2-year period.

Methods

Generalized estimating equation was used to examine the association between clinic attendance and the predictors. ORs and 95% CIs were reported in the multiple logistic regression models. The study was conducted in Rochester, New York, between February 2016 and February 2021.

Results

Prior to the COVID-19 pandemic declaration, the rate of canceled and no-show appointments was greater for routine clinic visits (20% and 24%, respectively) than for research visits (14% and 9%, respectively) for the same participants; these rates increased during the pandemic. After adjusting for sociodemographic factors, the likelihood of a canceled or no-show appointment was associated with parental depression (OR=1.06, CI=1.03, 1.09), regardless of the type or occurrence of the visit.

Conclusions

Findings from this study demonstrate that attendance to oral health care in young children is reliably reduced with parental depression and that this may provide one mechanism for early emerging health inequalities of oral health.

Graphical Abstract