Racial and ethnic differences in a regular source of dental care and the oral health, behaviors, beliefs and services of low-income mothers
ABSTRACT In a racial/ethnically-diverse sample of low-income mothers of children aged 3-6, we determine: (1) whether a regular source of dental care (RSDC), self-rated oral health, beliefs and behaviors differ by racial/ethnic group; (2) estimate whether a RSDC is associated with oral health, beliefs and behaviors, and whether these associations differ by racial/ethnic group; and (3) examine these relationships for mothers' dental utilization.
Cross-sectional survey. Participants From a population of 108,151 Medicaid children aged 3-6 in Washington state, U.S., 10,909 eligible children were sampled stratified by racial/ethnic group. Eligible mothers completed a mixed-mode survey in the following groups: Black (n=818), Hispanic (n=1310), or White (n=1382).
Measures were mothers' RSDC, personal characteristics, self-rated dental health, appearance of teeth, dental problems, brushing duration, flossing frequency, use of toothpicks or whiteners, belief that cleaning prevents cavities or loose teeth, and self-reported services at last dental visit.
About 38-40% of mothers had a RSDC. For Black, Hispanic and White mothers, having a RSDC was associated consistently with better oral health, greater likelihood of a dental cleaning and less likelihood of tooth extraction. RSDC was not associated generally with oral health beliefs and behaviors. Oral health behaviors differ by racial/ethnic group.
Relationships between RSDC and self-reported oral health, health behaviors, beliefs and dental services are similar for Black, Hispanic and White low-income mothers of young children. Oral health behaviors differ across racial/ethnic groups, which may have implications for mother and child oral health.
- SourceAvailable from: Janice M. Williams
[Show abstract] [Hide abstract]
- "In the United States (US), Hispanic children and other racial/ethnic minorities and those who live in poverty are at highest risk for poor oral health, caries, oral disease, and poor access to dental care (Dietrich et al. 2008; Dye et al. 2012; Grembowski et al. 2009; Kopycka-Kedzierawski and Billings 2011). These disparities result from low access to dental care, lack of dental insurance, and incorrect knowledge about oral health self-care (Fisher-Owens et al. 2012; Hilton et al. 2007; National Institute of Dental and Craniofacial Research 2011). "
ABSTRACT: OBJECTIVES: A community-based intervention is described that targets oral health self-care practices among Hispanic children in the United States and is being tested in an ongoing trial. Descriptive results of baseline oral health variables are presented. METHODS: As of January 2013, 284 Hispanic children of ages 5-7 enrolled in the Healthy Families Study in Nashville, TN, USA. Families are randomized to one of two culturally appropriate interventions. RESULTS: At baseline, 69.6 % of children brushed at least twice daily, and 40.6 % brushed before bed daily. One-third of parents did not know if their children's toothpaste contained fluoride. CONCLUSIONS: This intervention fills the need for community-based interventions to improve oral health self-care practices that are culturally appropriate in Hispanic families.International Journal of Public Health 04/2013; 59(1). DOI:10.1007/s00038-013-0470-5 · 2.70 Impact Factor
- [Show abstract] [Hide abstract]
ABSTRACT: The authors examined whether low-income mothers, who have a regular source of dental care (RSDC), rate the dental health of their young children higher than mothers without an RSDC. From a population of 108,151 children enrolled in Medicaid aged 3 to 6 years and their low-income mothers in Washington state, a disproportionate stratified random sample of 11,305 children aged 3 to 6 years was selected from enrollment records in four racial/ethnic groups: 3791 Black; 2806 Hispanic; 1902 White; and 2806 other racial/ethnic groups. A mixed-mode survey was conducted to measure mother RSDC and mother ratings of child's dental health and pain. The unadjusted response rate was 44%, yielding the following eligible mothers: 816 Black, 1309 Hispanic, 1379 White, 237 Asian, and 133 American-Indian. Separate regression models for Black, Hispanic, and White mothers estimated associations between the mothers having an RSDC and ratings of child dental health. Across racial/ethnic groups, mothers with an RSDC consistently rated their children's dental health 0.15 higher on a 1-to-5 scale (where '1' means 'poor' and '5' means 'excellent') than mothers without an RSDC, controlling for child and mother characteristics and the mothers' propensity to have an RSDC. This difference can be interpreted as a net movement of one level up the scale by 15% of the population. Across racial/ethnic groups, low-income mothers who have a regular source of dental care rate the dental health of their young children higher than mothers without an RSDC.Community Dentistry And Oral Epidemiology 08/2009; 37(5):381-90. DOI:10.1111/j.1600-0528.2009.00486.x · 1.94 Impact Factor
- [Show abstract] [Hide abstract]
ABSTRACT: The objective of this study is to assess follow-up dental care received by children given baseline screening and referrals as part of an ongoing clinical trial. A retrospective study with two cohorts of kindergarten children who had baseline and follow-up (9 months later) dental exams was used. The parents/caregivers of children with routine restorative or urgent needs at baseline received a referral letter and telephone reminders to seek care for their child. Children with referrals were evaluated at follow-up exam for the receipt of care. A baseline caregiver questionnaire provided information on the individual and family characteristics of the children. A total of 303 children had dental exams at both time periods. At baseline, 42 percent (126/303) received referrals and among the referred group19 percent (24/126) received follow-up care. A greater proportion with urgent referrals (10/30, 33 percent) received care than those with routine referrals (14/96, 15 percent). Baseline dmft decayed, missing, filled primary teeth and DMFT decayed, missing, filled permanent teeth was similar between children who did/did not receive follow-up care (P = 0.178 and 0.491, respectively). Children receiving referrals had caregivers with less education, higher Medicaid participation, fewer routine care visits, poorer self-rating of teeth, and a higher proportion of children reporting tooth pain. Children without receipt of follow-up care had caregivers who were more likely to report not visiting a dentist within the last 5 years and a greater number of missed days from work because of tooth problems. The rate of dental utilization was low even with school screening, referral and parental reminders among poor, largely minority inner-city kindergarten children.Journal of Public Health Dentistry 10/2011; 72(1):45-52. DOI:10.1111/j.1752-7325.2011.00282.x · 1.64 Impact Factor