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World Health Organization invites the nations to progress towards universal health care coverage. This study evaluated preventive and curative dental services utilization among children aged 12 years and younger in Tehran, Iran, based on the Andersen behavioral model using a generalized structural equation modeling. A phone-based cross-sectional study was conducted in Tehran, Iran, on 886 children in 2023. Information on curative and preventive/consultation dental service utilization and associated factors was collected by a standard questionnaire. We used a generalized structural equation model (GSEM) to build a model based on Andersen’s behavioral model. Of 886 children, 22.1% used curative dental services, and 19.9% used preventive/consultation services in the past year. Among children aged 6 years and younger, age (OR = 1.87, p-value <0.001) and parent-perceived oral health need (OR = 54.77, p-value <0.001) predicted curative services utilization and age (OR = 1.45, p-value <0.001), knowledge (OR = 1.36, p-value <0.001), dental visit before the age of one (OR = 6.05, p-value = 0.04), and socioeconomic status (OR = 1.65, p-value = 0.03) predicted preventive/consultation services utilization. Regarding children aged 7 to 12, knowledge (OR = 1.28, p-value = 0.03), dental visit before the age of one (OR = 11.12, p-value = 0.02), socioeconomic status (OR = 2.53, p-value = 0.01), dental insurance (OR = 4.17, p-value <0.001), and parent-perceived oral health need (OR = 19.48, p-value <0.001) associated with curative dental services utilization, and dental visit before the age of one (OR = 10.05, p-value = 0.02), oral health behavior (OR = 1.25, p-value = 0.04), socioeconomic status (OR = 3.74, p-value <0.001), and parent-perceived oral health need (OR = 4.62, p-value <0.001) related to preventive/consultation services utilization. The findings of this study underscore the significant influence of predisposing, enabling, and need factors on dental services utilization among children aged 12 years and younger. These results provide a valuable perspective for policymakers, highlighting the modifiable determinants that could be targeted to improve dental services utilization in this age group.

Objective This study aimed to examine the factors that affect treatment delay in early childhood caries (ECC), guided by a modern medical model. This study attempted to analyze the pathways influenced by these factors and provide a theoretical foundation for designing targeted intervention programs. Methods Data were collected from young children who visited the department of stomatology at a tertiary hospital from January to December 2023. Data were collected via a general information survey questionnaire, the Scale of Oral Health Outcomes for 5-year-old Children (SOHO-5), the Children’s Fear Survey Schedule-Dental Subscale-Chinese (CFSS-DS-C), the Parental Caregiver Perceptions Questionnaire-8 (P-CPQ-8), the Family Impact Scale (FIS-8), and the Perceived Barriers to Health Care-Seeking Decision-Chinese (PBHSD-C). The data in this study were analyzed using a variety of statistical tests, including the Kruskal-Wallis and Mann-Whitney tests, correlation analysis, multiple stepwise regression analysis, and structural equation modeling (SEM). Results The treatment delay score of early childhood caries was 36.77 ± 10.11, indicating that the state of early childhood caries was currently at a moderate level of delay. The SOHO-5 score was 6.41 ± 1.78, the CFSS-DS-C score was 23.60 ± 6.91, the P-CPQ-8 score was 18.43 ± 4.33, and the FIS-8 score was 18.66 ± 4.28. Multi-factor analysis revealed key factors affecting treatment delay, including permanent residence, medical insurance type, oral health habits, reasons for visit, first symptoms, the time of first discovery of oral problems, brushing teeth before bedtime every day, a genetic history of dental caries and the staging of dental caries. A positive correlation existed between oral health, children’s dental fear and treatment delay, whereas social support was negatively correlated with treatment delay. The SEM, which is based on the modern medical model, revealed that children’s dental fear plays a mediating role in the relationships among social support, oral health, and treatment delay. Conclusion The present study developed a novel model to study the ECC treatment delay, elucidated the causal links between the identified variables, and proposed potential intervention strategies to enhance oral health awareness, knowledge, and skills among young children and their parents. These strategies can help improve children’s dental visiting behavior and reduce treatment delay.

ObjectivesThe aim of this study was to examine the association between Medicaid dental benefits for pregnant people and dental care use among very young children in Medicaid. We hypothesized that children living in states with more generous dental benefits for Medicaid-enrolled pregnant people would be more likely to have a recent dental visit.MethodsThis national cross-sectional study used pooled 2017–2019 data from the National Survey of Children’s Health, as well as state Medicaid policy data. The study sample included children aged 0–2 enrolled in Medicaid. Multivariable logistic regression models estimated the association between Medicaid dental benefit generosity for pregnant people and the child having a dental visit in the past year.ResultsChildren in states with emergency-only dental coverage for pregnant people were 2.5 times as likely to have had a dental visit than children in states with extensive coverage (OR 2.48, 95% CI 1.35–4.53). In supplemental analyses excluding children living in Texas, there was no longer an association between dental coverage for pregnant people and dental utilization among young children (OR 1.52, 95% CI 0.82–2.83).Conclusions for practiceYoung children in states that provided emergency-only dental benefits for pregnant people in Medicaid had significantly higher odds of dental utilization than young children in states with more generous dental benefits for pregnant people. This relationship disappeared after excluding the state Texas, which had the highest rate of child dental utilization in the country and provided emergency-only dental benefits for pregnant people in Medicaid.SignificanceIn previous research, dental benefit generosity for Medicaid-enrolled pregnant people has been found to be related to utilization of dental care for pregnant people, and dental benefit generosity for adults has been found to have spillover effects on children’s dental care use. This is the first study to examine the relationship between Medicaid dental benefit generosity for pregnant people and dental care use among very young children.

Objectives. To assess the relation between Medicaid reimbursement rates and access to dental care services in the context of dentist density and dentist participation in Medicaid in each state. Methods. Data were from Early and Periodic Screening, Diagnostic, and Treatment reports for 2014, Medicaid reimbursement rate in 2013, dentist density in 2014, and dentist participation in Medicaid in 2014. We assessed patterns of mediation or moderation. Results. Reimbursement rates and access to dental care were directly related at the state level, but no evidence indicated that higher reimbursement rates resulted in overuse of dental services for those who had access. The relation between reimbursement rates and access to care was moderated by dentist density and dentist participation in Medicaid. We estimate that more than 1.8 million additional children would have had access to dental care if reimbursement rates were higher in states with low rates. Conclusions. Children who access the dental care system receive care, but reimbursement may significantly affect access. States with low dentist density and low dentist participation in Medicaid may be able to improve access to dental services significantly by increasing reimbursement rates.

Mail-in pilot-tested questionnaires were sent to a stratified random sample of 1,500 families from the North Carolina Autism Registry. Multivariate logistic regression analysis was used to determine the significance of unmet dental needs and other predictors. Of 568 surveys returned (Response Rate = 38%), 555 were complete and usable. Sixty-five (12%) children had unmet dental needs. Of 516 children (93%) who had been to a dentist, 11% still reported unmet needs. The main barriers were child’s behavior, cost, and lack of insurance. The significant predictor variables of unmet needs were child’s behavior ( p  = 0.01), child’s dental health ( p  < 0.001), and caregiver’s last dental visit greater than 6 months ( p  = 0.002). Type of ASD did not have an effect on having unmet dental needs.

Objectives Children in out-of-home care (OHC) are at greater risk of ill health than other children in the community. The aim of this registry-based cohort study was to compare the oral health and dental care needs of children in OHC with those of other children in Sweden, by merging data from different Swedish registries. A further aim was to analyse whether children in OHC received more dental examinations after 2017, following implementation of a law requiring mandatory health evaluations prior to placement. Methods We identified an exposed cohort of Swedish children and young people, 0–19 years old, who had been placed in OHC 2010–2018 ( N  = 50,878), and an unexposed cohort, five times larger, matched for age, sex and county of residence ( N  = 254,380). During the study period, children in OHC received relatively fewer regular, scheduled dental examinations (4.21 vs. 4.88; p  < 0.0001). More children entering OHC in 2018 received dental examinations (81.7%) compared with 2016 (76.6%) ( p  < 0.0001), but this was still lower than the proportion of controls. Moreover, during the study period, dental caries affected more teeth in children in OHC than in the controls (dft 6-year-olds 1.56 vs. 0.74; p  < 0.0001, and DFT 12-year-olds 1.18 vs. 0.65; p  < 0.0001), and they had more extractions and more emergency dental appointments than children who had never been in OHC. Conclusion Not only do children in OHC have poorer oral health than other children, they also receive less support from the dental health services. It seems that society has failed in its mission to ensure that children in OHC are not disadvantaged with respect to health and access to comprehensive healthcare. Thus, there is an urgent need for reappraisal of guidelines, legislation, and organizational models for providing dental care to children and adolescents in OHC.

Background The Child Dental Care Reform introduced in Israel in 2010 aimed to provide universal dental coverage for children, addressing high caries morbidity and inequalities in access to care. The reform initially covered ages 0–8 and expanded to include all children up to age 18 by 2019. This study examines age-related patterns of dental service utilization during the first decade of its implementation. Methods This retrospective study analyzed anonymized dental service data from 2011 to 2022, submitted by the four Health Maintenance Organizations to the Israeli Ministry of Health. The data included the number of children treated, categorized by age group, and the types of treatments provided. Results Service utilization showed distinct age-related patterns, with rates peaking at age 8 (48%) and gradually declining through adolescence ( p  < 0.001). Restorative care consistently outnumbered preventive care across all age groups ( p  < 0.001), with children aged 3–5 receiving the most restorative procedures per child. Preventive treatments increased with age, from 1.0 per patient in young children to 1.5 in teenagers, transitioning from mainly dental examinations in younger children to hygienist visits in adolescents. Restorative treatments included dental restorations (peaking at 50% at ages 8–9), extractions (25% at ages 10–11), and pulp treatments (25% at ages 6–8). Emergency dental visits were most common in infants and increased by 83% over the course of a decade ( p  < 0.001). General anesthesia utilization increased significantly in the younger age groups, with the 4–5 age group showing the most dramatic increase (2.39-fold increase, p  < 0.001). Conclusion This study highlights distinct age-related patterns in dental service utilization among children in Israel, emphasizing the need for targeted prevention strategies and policy reforms to address current challenges disparities, including the increasing rate of treatment under general anesthesia. Preventive interventions, such as community water fluoridation and early childhood programs, alongside improved access to specialized dental care, are essential for fostering better long-term oral health outcomes. Integrating quality indicators will facilitate better incorporation of dental services into the national health system, ensuring comprehensive and equitable oral care.

Background Dental health and care among children and adolescents are a major neglected area of public health, leading to both physical and mental health consequences in the long term. Several demographics, economic, and social factors influence dental service utilization, with Socio-Economic Status (SES) being a significant determinant. SES plays an important role in the utilization of dental services for children and adolescents. This systematic review and meta-analysis aim to explore the association between SES and dental service utilization in this population. Methods Using the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines, we searched PubMed, Web of Science, and Scopus for relevant articles published between January 2000 and September 2024. We selected global studies that examined the association between SES and dental service utilization among children and adolescents. Different subgroup analysis based on socioeconomic indicators (household income, parental educational level and/ or occupational level, household assets, SES index, and annual household consumption expenditure), economic classification of the country (high, upper-middle, or lower-middle), nature of the dental insurance system and type of outcome measure. Pooled Odd Ratio (OR) and 95% confidence intervals (CIs) were calculated for the outcome using a random-effects model. Furthermore, meta-regression and sensitivity analysis were conducted to identify the sources for heterogeneity. Results A total of 48 studies met the inclusion criteria for this review. The meta-analysis revealed that children and adolescents from higher SES were about twice as likely to utilize dental services (OR = 2.10, 95% CI: 1.32–2.89) compared to those from lower SES backgrounds. The subgroup analysis indicated that various factors influenced the association between SES and dental service utilization among children and adolescents. These included specific SES indicators—household income (OR = 1.65, 95% CI: 1.37–1.94), parental occupation and/or education level (OR = 3.30, 95% CI: 1.12–5.47), and household assets (OR = 1.47, 95% CI: 1.15–1.78)—as well as the economic classification of the country, with higher-income countries (OR = 2.57, 95% CI: 1.24–3.90) and upper-middle-income countries (OR = 1.52, 95% CI: 1.26–1.78) showing stronger associations. The type of dental insurance system also influenced the outcomes, with significant associations found in countries with universal coverage (OR = 1.73, 95% CI: 1.19–2.26), means-tested systems (OR = 1.70, 95% CI: 1.40–2.00), and mixed public-private systems (OR = 1.47, 95% CI: 1.09–1.85). Additionally, the type of outcome measure also played a role, with recent dental service use (OR = 2.21, 95% CI: 1.18–3.23) and preventive dental service use (OR = 2.01, 95% CI: 1.19–2.84) demonstrating significant effects. Conclusion The findings provide evidence that children and adolescents with low SES are associated with lower utilization of dental services. Interventions focused on these groups targeting specific barriers to care are needed to improve equitable dental service utilization.

Introduction: Dental caries is the most common chronic disease of childhood that interferes with normal nutrition intake, speech, and daily routine activities. Dental caries is a lifetime disease, and the highest priority risk group is school children. Aim: To assess the prevalence of dental caries and treatment needs among school going children of Chandigarh. Materials and Methods: A cross-sectional study was done among school going children of Chandigarh in the age group of 3-17 years. The subjects were selected from four randomly selected schools. All the children from the selected schools were examined. A total of 4493 subjects formed the sample size. Dentition status was assessed using dft index by Gruebbel for primary dentition and DMFT index by Klein, Palmer, Knutson for permanent dentition, respectively. Chi-square test was used to find an association between the study variables. Independent t-test and one-way ANOVA were used to compare the mean difference. Results: Among the 4493 study subjects, caries prevalence was found to be 47.3%. Mean dft and DMFT score of the population was 1.06 ± 1.995 and 0.41 ± 1.022, respectively. When analyzing the treatment needs among various age groups 42.6% of the study subjects required oral prophylaxis and 45% required restorative procedures. Conclusion: Based on the findings, it can be concluded that high prevalence of caries was found in primary dentition than permanent dentition and most of the decayed teeth were untreated. This study emphasize the need for treating dental caries at its earliest possible stage and parents should be made aware of caries preventive measures for their children.

Background Oral health is crucial for caries prevention. Research reported variations in oral health practices among countries and individuals. Therefore, this study aims to examine and compare oral hygiene practices among children aged 3 to 11 years old across five areas of Saudi Arabia. Methods This cross-sectional study includes healthy children aged 3 to 11 from five areas/regions of Saudi Arabia. A self-administered, validated parental questionnaire was constructed according to the WHO Oral Health Questionnaire for children, which inquires about the child’s socio-demographic factors, oral health evaluation, and oral hygiene practice. Results Out of the 1516 parents who participated, 21.2% reported their children brushing twice a day. Regression analysis found that the first-born children and those who visited a dentist displayed a significantly higher adjusted odds ratio (AOR) for parents reporting that their child practices oral health care compared to only children (AOR: 2.837; P  = 0.016) and to those who did not visit a dentist in the last 12 months (AOR: 2.989; P  < 0.001). Conclusion This study highlights that only 21.2% of parents reported their children practicing excellent oral hygiene by brushing twice a day. This underscores the importance of early dental visits, customized interventions, and prevention programs that account for regional and demographic factors, such as birth order, to effectively promote oral health.