The Journal of the American Dental Association
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J Am Dent Assoc, Vol 136, No 4, 524-533.
© 2005 American Dental Association

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TRENDS

Dental visits and access to dental care among Maryland schoolchildren



MARK D. MACEK, D.D.S., Dr.P.H., MARK L. WAGNER, D.M.D., HAROLD S. GOODMAN, D.M.D., M.P.H., MICHAEL C. MANZ, D.D.S., M.P.H. and ILISE D. MARRAZZO, M.P.H.

Background. Regular dental visits afford an opportunity for dentists to provide preventive services and to diagnose and treat disease. Not all children, however, have equal access to these services.

Methods. The authors conducted this study to describe access to and utilization of oral health care services for Maryland schoolchildren in kindergarten and third grade. They obtained data from a questionnaire filled out by parents or guardians participating in the Survey of the Oral Health Status of Maryland School Children, 2000–2001 (N = 2,642). Outcome variables included having a dental visit in the last year, prophylaxis in the last year, usual source of medical care and usual source of dental care. Descriptor variables included region, grade, race/ethnicity, eligibility for free or reduced-fee meals, parents’ or guardians’ education and dental insurance status.

Results. Overall, general dental visit and dental prophylaxis visit rates were similar (74.1 and 71.3 percent, respectively). Schoolchildren, however, were more likely to have had a usual source of medical care than of dental care (96.0 and 82.9 percent, respectively). Third graders, those ineligible for free or reduced-fee meals and those with some dental insurance coverage were more likely to have received a prophylaxis in the last year and were more likely to have a usual source of dental care. Non-Hispanic white and non-Hispanic black schoolchildren also were more likely to have had a usual source of dental care than were Hispanics.

Conclusions. Schoolchildren most likely to have received regular preventive dental care were those who had parents or guardians with financial resources. Medicaid and State Children’s Health Insurance Program (SCHIP) provide safety nets, but these programs could be improved.

Practice Implications. Dentistry’s challenge is to determine which characteristics are unique to those who visit the dentist regularly and use this information to help meet the needs of the underserved.

Key Words: Schoolchildren; epidemiology; health services accessibility; health survey; Maryland




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