Influence of Caregivers and Children's Entry Into the Dental Care System
Influence of Caregivers and Children's Entry Into the Dental Care System
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DOI：
10.1542/peds.2013-2932
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发表时间：
2014-05-01
期刊：
影响因子：
8
通讯作者：
Vann, William F., Jr.
中科院分区：
文献类型：
--
作者：
Divaris, Kimon;Lee, Jessica Y.;Vann, William F., Jr.
注意事项：早期预防性牙科检查对改善儿童的口腔健康至关重要，特别是龋齿高危儿童。然而，关于这些儿童如何进入牙科保健系统的信息很少。我们的目标如下：（1）描述一个以人口为基础的队列的年轻医疗注册儿童进入牙科保健;（2）调查的影响，照顾者的特点对他们的孩子的牙科保健寻求patterns.METHODS：我们依靠医疗补助的索赔和访谈数据的成年人儿童二人组谁参加了卡罗莱纳口腔健康素养研究在2007-2008年。分析队列包括1000名儿童，他们在入组前没有牙科就诊。收集了有关社会人口特征、口腔健康状况、健康素养、牙科忽视和获得护理障碍的其他信息。我们的分析依赖于描述性、双变量和多变量方法。结果：在25个月的中位随访期内，39%的儿童（平均基线年龄：16个月）进入牙科护理系统，其中13%的儿童第一次就诊是为了紧急护理。照顾者的牙齿忽视成为一个显着的预测nonenterprise。报告的口腔健康问题的儿童在基线更有可能进入牙科保健系统相比，儿童口腔健康状况更好，但他们也更有可能需要紧急护理。结论：照顾者有一个关键的作用，在儿童的口腔健康和护理。旨在改善儿童口腔健康的干预措施应包括社区外展，以便在儿童为婴儿或幼儿时以文化上适当的方式让护理人员参与。
OBJECTIVES:Early preventive dental visits are essential in improving children's oral health, especially young children at high risk for dental caries. However, there is scant information on how these children enter the dental care system. Our objectives were as follows: (1) to describe how a population-based cohort of young Medicaid-enrolled children entered dental care; and (2) to investigate the influence of caregiver characteristics on their children's dental care-seeking patterns.METHODS:We relied on Medicaid claims and interview data of caregiver-child dyads who were enrolled in the Carolina Oral Health Literacy study during 2007-2008. The analytical cohort comprised 1000 children who had no dental visits before enrollment. Additional information was collected on sociodemographic characteristics, oral health status, health literacy, dental neglect, and access to care barriers. Our analyses relied on descriptive, bivariate, and multivariate methods.RESULTS:During the 25-month median follow-up period, 39% of the children (mean baseline age: 16 months) entered the dental care system, and 13% of their first encounters were for emergency care. Caregivers' dental neglect emerged as a significant predictor of nonentrance. Children with reported oral health problems at baseline were more likely to enter the dental care system compared with children with better oral health, but they were also more likely to require emergency care.CONCLUSIONS:Caregivers have a pivotal role in children's oral health and care. Interventions aimed at improving children's oral health should involve community outreach to engage caregivers in a culturally appropriate manner when their children are infants or toddlers.