Shervin Churchill, MPH1, Karen Lissy, MPH2, Chris Delecki, DDS3, Bryan Williams, DDS, MEd4, and Nanci Villareale, RN, MSN1. (1) Children's Hospital and Regional Medical Center, Center for Children with Special Needs, POB 50020 MS S219, Seattle, WA 98145-5020, (206) 987-5312, firstname.lastname@example.org, (2) Children's Hospital and Regional Medical Center, PO Box 50020, M/S: S-219, Seattle, WA 98145-5020, (3) Odessa Brown Childrens Clinic, Childrens Hospital and Regional Medical Center, PO Box 50020 / MS: OBCC, Seattle, WA 98145-5020, (4) Dept of Dental Medicine, Childrens Hospital and Regional Medical Center, PO Box 50020, M/S: 4E-2, Seattle, WA 98105
Dental disease is preventable and yet widespread in children, disproportionately so by family income. Recent interventions addressing disparities aim to improve access to dental care for children by integrating oral health (OH) into well-child visits. Washington State’s Healthy Smiles Project sought to assess differences in OH risks of children with Medicaid & private insurance to determine impact on program efficacy. Approximately 1,200 families with children 0 to 7 years old who presented at well-child visits at select primary care clinics participated in a survey of oral hygiene, nutrition, knowledge & access to dental care. Families received OH screening, counseling, preventive treatment, and/or referrals if indicated. Based on family dental history, 58% of children with Medicaid were identified as at-risk, compared to 46% of children in non-Medicaid (NM) families (p<0.001). Patterns of toothbrush use were similar; but 3 to 5 year-old children with Medicaid were 70% less likely to use toothpaste than their NM counterparts (p=0.01). Snacking patterns for children with Medicaid showed increased caries risk. Children with Medicaid had sweet drinks more often (2.1 servings per day, 1.5 for NM children, p<0.001), & consumed fewer servings of fruit and vegetables. Medicaid families reported lack of dental insurance & having a family dentist more often than NM families. Pervasive disparities in family dental history, nutrition and access to dental care result in more negative OH outcomes in children with Medicaid. Implications of these findings for early-intervention programs will be discussed.
Keywords: Oral Health, Children
Presenting author's disclosure statement:
I do not have any significant financial interest/arrangement or affiliation with any organization/institution whose products or services are being discussed in this session.
The 132nd Annual Meeting (November 6-10, 2004) of APHA