Background
Early childhood caries (ECC) remains the most common, preventable infectious disease
among children in the United States. Screening is recommended after the eruption of
the first tooth, but it is unclear how the age at first dental examination is associated
with eventual restorative treatment needs. The authors of this study sought to determine
how provider type and age at first dental examination are associated longitudinally
with caries experience among children in the United States.
Methods
Deidentified claims data were included for 706,636 privately insured children aged
0 through 6 years as part of the nationwide IBM Watson Health Market Scan (2012-2017).
The authors used Kaplan-Meier survival analysis to describe the association between
the age of first visit and restorative treatment needs.
Results
A total of 21% of this population required restorative treatment, and the average
age at first dental examination was 3.6 years. A multivariable Cox proportional hazards
model showed increased hazard for restorative treatment with age at first dental visit
at 3 years (hazard ratio, 2.05; 95% CI, 1.97 to 2.13) and 4 years (hazard ratio, 3.99;
95% CI, 3.84 to 4.16).
Conclusion
The high proportion of children requiring restorative treatment and late age at first
dental screening show needed investments in educating general dentists, medical students,
and pediatricians about oral health guidelines for pediatric patients.
Practical Implications
Communicating the importance of children establishing a dental home by age 1 year
to parents and health care professionals may help reduce disease burden in children
younger than 6 years.
