Association Between First Oral Examination Characteristics and Dental Treatment Needs in Privately Insured Children: A Claims Data Analysis

Background: Early Childhood Caries (ECC) remain the most common, preventable infectious disease among children in the United States. Screening is recommended after the eruption of the first tooth, but it is unclear how the age at first dental examination is associated with eventual treatment needs. The current study seeks to determine how provider type and age at first dental examination are associated longitudinally with dental caries experience among children in the United States.

Methods: Deidentified claims data were included for 706,636 privately insured children between the ages of 0 and 6 years old as part of the nation-wide IBM Watson Health Market Scan (2012-2017). Kaplan-Meier Survival analysis was used to describe the association between the age of first visit and dental treatment needs.

Results: 21% of this population required dental treatment, and the average age at first dental examination was 3.6 years. A multivariable Cox proportional hazards model demonstrated increased hazard for dental treatment with age at first dental visit at 3 years old (HR: 2.05, 95% CI: 1.97-2.13) and 4 years old (HR: 3.99, 95% CI: 3.84-4.16).

Conclusion: The high proportion of children requiring dental treatment and late age at first dental screening demonstrate needed investments in educating general dentists, medical students, and pediatricians about oral health guidelines for pediatric patients. Communicating the importance of children establishing a dental-home by age 1 to parents and healthcare professionals may help reduce disease burden in children under the age of 6.