Dissertation/Thesis Abstract

An Investigation of the Relationship between Child, Family, and Community Factors and Early Childhood Oral Health and the Utilization of Dental Health Services
by Holt, Nicole M., Dr.P.H., East Tennessee State University, 2017, 188; 13830128
Abstract (Summary)

Background / Objective: Children under the age of 5 years bear a disproportionate burden of oral disease. The aim of this study is to investigate how child, family, and community determinants impact dental care utilization, and parental report of child’s oral health.

Methods: Data for this study came from the 2011/2012 National Survey of Children’s Health for children aged 1 to 5 years old. Dependent variables evaluated were if the child had an oral health problem, been to a dentist in the past year, and parents description of the child’s teeth. Independent variables were selected from child, family, and community levels. Binary logistic methods were applied to each outcome and predictor variable. Stepwise logistic regression models were constructed for child, family, and community variables. Additionally the mediating effect of oral health services utilization in the association between child, family and community factors and parental perception of child’s oral health was evaluated. National results and Health Resource Service Area (HRSA) region IV results were compared.

Results: In the national (n=24,875) and HRSA region IV sample (n=4,017) 9.7% and 10.2% of caregivers, reported that the child had an oral health problem in the past 12 months. Fewer than half (46.7%) of caregivers reported that their child had visited a dentist in the past 12 months. Absence of neighborhood cohesion, neighborhood amenities, and residence in metropolitan statistical area all had positive significant effects on children seeing a dentist. There was a mediating effect by utilization of oral health services between child with special health care needs (p=0.005), number of children (p=0.045) and adults (p=0.046) in the household, and tobacco use (p=0.018) and parents perception of oral health in the HRSA region IV population.

Conclusion: This study identified several factors as correlates of poor oral health outcomes. Our results expand our knowledge of early childhood oral health by studying how oral health is impacted not only by child factors but also the family and community at large. Our results begin identifying the unique constellation of risk factors that contribute to early childhood oral health.

Indexing (document details)
Advisor: Alamian, Arsham
Commitee: Alamian, Arsham, Slawson, Deborah, Zheng, Shimin
School: East Tennessee State University
Department: Biostatistics and Epidemiology
School Location: United States -- Tennessee
Source: DAI-B 80/06(E), Dissertation Abstracts International
Subjects: Public health, Epidemiology
Keywords: Community risk factors, Dental health services, Early childhood, Family risk factors, Oral health
Publication Number: 13830128
ISBN: 978-0-438-79060-5
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