Influence of Social Capital on US Children's Oral Health and Use of Dental Care

Objective: Children living in low-income households have poorer oral health and access to dental care than children in more affluent households. However, little is known about how social capital influences these outcomes. The purpose of this study is to determine the influence of parents' self-perceived neighborhood social capital on oral health status and use of dental care in US children. Methods: Data were analyzed for 91,642 children <18 years in the 2007 National Survey of Children's Health. Parents' perceived social capital was measured with a 4-items index (SCI) that included cohesion, trust, support and safety. Dependent variables were parent-perceived ratings of their child's oral health, unmet dental care needs (delayed or unable to receive care) and the lack of a dental visit in the past 12 months. Bivariate and multivariable logistic regression analyses were performed for each outcome. Results: The SCI exhibited a dose-response relationship to oral health outcomes. Children with the lowest support were 56% and 93% more likely to have poorer oral health and unmet dental care needs than children with the highest support (SCI=+11 vs. 4; p<.05). Low support (SCI = 8-10) was associated with lack of dental visits in the past 12 months (AOR 1.38; 95% CI: 1.16-1.63) after controlling for child- and family-level characteristics. Conclusion: Parents' social capital independently affects children's oral health outcomes. A better understanding of the effects of social support systems on children's oral health risks might help address disparities.