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Agency for Healthcare Research Quality

Child/Adolescent Health

Children from lower income families are not as likely to visit a dentist after a care provider's referral

When care providers recommended that children see a dentist, lower income children weren't as likely as higher income children to comply with that recommendation, a new study finds. May Chu, B.S., and Richard J. Manski, D.D.S., M.B.A., Ph.D., with the Agency for Healthcare Research and Quality, and fellow researchers looked at Medical Expenditure Panel Survey data from 2003 to determine the role of nondentist providers in referring children aged 2 to 17 to dentists for care. Of the 8,983 children in the survey, 51 percent had a dental checkup in 2003. Sixty percent of the children were from middle- or high-income families and 38 percent came from poor, near-poor, or low-income families.

About 50 percent of nondentist providers, such as pediatricians, recommended that children in any income category see a dentist. However, the likelihood of that advice translating into a child's seeing a dentist depended on several factors, such as income and education level. Children of families who made more than 200 percent of the Federal poverty guidelines in 2003 (which would have been $36,800 for a family of four) were more likely to have seen a dentist than children living in lower income families.

Income alone did not determine which children visited the dentist. Children whose parents graduated high school were more likely to visit a dentist than children whose parents who did not earn a diploma.

The researchers suggest that high school graduates may have a keener sense of what constitutes good health and how to maintain it. Also, raising awareness of the importance of dental health through education may prove beneficial for getting children from lower income households to regular dental visits.

See "The dental care of U.S. children: Access, use and referrals by nondentist providers, 2003," by Ms. Chu, Luciana E. Sweis, D.D.S., Albert H. Guay, D.M.D., and Dr. Manski in the October 2007 Journal of the American Dental Association 138, pp. 1324-1331.

Reprints (AHRQ Publication No. 08-R036) are available from the AHRQ Publications Clearinghouse.

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