Oral health of infants and toddlers and associated health outcomes: Are best practices falling short?

Background: The American Academy of Pediatric Dentistry (AAPD) recommends that children have their first dental visit by age one. The prevalence of early childhood caries (ECC) is increasing in poor US children under age 5. Poor oral health and ECC left untreated may lead to subsequent adverse health outcomes. Objective: Examine associations between oral health status & health outcomes among children 1-4 years old. Methods: 2,489 low-income mothers of publicly insured children from 5 US urban medical centers were interviewed as part of the ongoing Children's HealthWatch study. Children were weighed and mothers responded to questions on household demographics, and the child's health, development and oral health status. Multivariable logistic regression models examined associations between children's oral-health status and underweight (weight-for-age < 5th%) and Parent's Evaluation of Developmental Status (PEDS). Results: 65% of children had never seen a dental provider. 8% had fair/poor oral health. After controlling for potential confounders, children with fair/poor oral-health had increased adjusted odds of underweight (AOR 2.15, 95% CI: 1.35-3.42) and significant concerns on the PEDS (AOR 1.50, 95% CI: 1.02-2.19). Conclusion: Despite AAPD and other recommendations, the majority of young children in this sample had not seen a dental provider. We found associations between young children's poor oral health and adverse health and development outcomes. Targeted strategies to provide oral health care to this demographic and education on the importance of early access to oral health care is a key public health objective.