Research Update: A Spotlight on Children’s Oral Health

This week, I am reading the latest research on children’s oral health. Some of the notable findings include: poorer children’s oral health leads to worse academic performance, there continue to be disparities in access to child preventive oral health services, and providing dental benefits to parents may have a positive impact on children’s use of dental services.

The Journal of Pediatrics’ Children’s Oral Health and Academic Performance: Evidence of a Persisting Relationship Over the Last Decade in the US 

This study from researchers at the National Bureau of Economic Research, Universidad Nacional de Colombia, University of College London, and the University of Iowa uses data from the National Survey of Children’s Health (NSCH) from 2016-2017 to assess the relationship between children’s oral health and academic performance.

What it finds

  • There were significant associations across all oral health measures, such as reported rating of child’s current dental health, and whether or not the child had problems with toothache, decayed teeth, cavities, bleeding gums; and academic performance measures, such as reported child problems at school and the number of school days missed due to health.
  • Children with oral health problems were more likely to have problems at school, and were more likely to miss at least one day of school and miss more than three or six days of school.
  • There was a consistent relationship between poor oral health and worse academic performance across age, sex, household income, and health insurance types.

Why it matters

  • Findings continue to demonstrate a link between children’s oral health and academic performance outcomes.
  • Such results emphasize the need for integrated approaches to promote the healthy development of children that encourages child oral health and supports academic performance.

The Journal of the American Dental Association’s Preventative Oral Health Care Use and Oral Health status among US children: 2016 National Survey of Children’s Health 

This study from researchers at the US Department of Health and Human Services uses data from the 2016 National Survey of Children’s Health (NSCH) to estimate child use of preventive oral health services (according to parent/caregiver-reported measures) as well as to track child oral health. The study also sought to investigate any further associations (i.e. between child & family oral health). Finally, researchers explored any gaps in preventive oral health care among subpopulations of children in the United States.

What it finds

  • Among the children ages 2-17 years old, eight out of ten (80%) children had a preventive dental visit in the past year.
  • However, the rate of receipt of specific preventive dental services was lower: 75% received prophylaxis, 46% fluoride, 44% instructions, 21% sealants, and 12% has carious teeth or caries.
  • Results indicate that 6% of all children sampled had a fair or poor condition of their teeth.
  • There was a decreased likelihood of receiving a preventive dental visit among children without health insurance, younger children (ages 2-5 years old), and children from lower-income and lower-educated families.
  • There was a large increase in prevalence (97%) of fair or poor condition of teeth for children from non-English speaking households in comparison to children from English-speaking households.
  • There was an increased likelihood of a child receiving a preventive dental visit when the child also had preventive health visits and a primary physician or nurse monitoring their overall health.

Why it matters

  • Children without health insurance were less likely to receive preventive dental care.
  • There are oral health disparities in preventive dental care visits among children in lower-income families, those with lesser educational attainment, and those in non-English speaking households.

Munich Personal RePEc Archive (MPRA) for Research in Economics’ Adult Medicaid Benefit Generosity and Receipt of Recommended Health Services among Low Income Children: The Spillover Effects of Medicaid Adult Dental Coverage Expansions 

This study from a researcher at San Diego State University’s School of Public Health uses a restricted version of the National Health Interview Survey (NHIS) that is linked with Medicaid adult dental coverage policies from 2000 to 2013. The sample included children ages 1-17 and parents aged between 22-64 years old. The majority of children in the sample included were enrolled in Medicaid or CHIP (94%). The study sought to explore possible “spillover effects” of public health insurance expansions for adults and how such policies impact the whole family.

What it finds

  • There are overall income-based differences among children with regards to receiving recommended health services, with low-income children less likely to receive services when compared to high-income children.
  • But there was a larger gap in receipt of dental visits between low-income and high-income children (by about 23 percentage points) in states that did not offer Medicaid dental coverage to adults.
  • Results suggest that parents having access to adult dental benefits through Medicaid increases use of dental care among parents, and that having dental coverage is associated with a 5%-point increase in dental visits for children (dental visits in the past 6-months) as well, which is strongest among children under 12 years old.  (Other research shows that if parents have health insurance, there is greater utilization of needed care among their children.)

Why it matters

  • Results suggest that providing Medicaid dental health coverage to parents may have a positive impact on children on Medicaid and CHIP receiving recommended dental care.