Skip to main content
Key Specialties
Cardiology Diabetology Endocrinology Gastroenterology Geriatrics and Gerontology Gynecology and Obstetrics Hematology Infectious Disease Internal Medicine Nephrology Neurology Oncology Pediatrics Respiratory Medicine Rheumatology Surgery
Congress Coverage
2024 ACC Congress 2023 ESMO Congress 2023 EASD Congress 2023 ERS Congress 2023 ESC Congress 2023 EHA Congress 2023 ASCO Annual Meeting
Clinical Collections
Advances in Alzheimer’s

At a glance: The ONWARDS insulin icodec trials

A round-up of the ONWARDS phase 3 clinical trials evaluating the novel weekly insulin icodec in people with diabetes.
ADVANCED SEARCH
Log in
Top
BMC Oral Health
Published in: BMC Oral Health 1/2013

Open Access 01-12-2013 | Research article

Developmental delays and dental caries in low-income preschoolers in the USA: a pilot cross-sectional study and preliminary explanatory model

Authors: Donald L Chi, Katharine C Rossitch, Elizabeth M Beeles

Published in: BMC Oral Health | Issue 1/2013

Login to get access

Abstract

Background

Anecdotal evidence suggests that low-income preschoolers with developmental delays are at increased risk for dental caries and poor oral health, but there are no published studies based on empirical data. The purpose of this pilot study was two-fold: to examine the relationship between developmental delays and dental caries in low-income preschoolers and to present a preliminary explanatory model on the determinants of caries for enrollees in Head Start, a U.S. school readiness program for low-income preschool-aged children.

Methods

Data were collected on preschoolers ages 3–5 years at two Head Start centers in Washington, USA (N = 115). The predictor variable was developmental delay status (no/yes). The outcome variable was the prevalence of decayed, missing, and filled surfaces (dmfs) on primary teeth. We used multiple variable Poisson regression models to test the hypothesis that within a population of low-income preschoolers, those with developmental delays would have increased dmfs prevalence than those without developmental delays.

Results

Seventeen percent of preschoolers had a developmental delay and 51.3% of preschoolers had ≥1 dmfs. Preschoolers with developmental delays had a dmfs prevalence ratio that was 1.26 times as high as preschoolers without developmental delays (95% CI: 1.01, 1.58; P < .04). Other factors associated with increased dmfs prevalence ratios included: not having a dental home (P = .01); low caregiver education (P < .001); and living in a non-fluoridated community (P < .001).

Conclusions

Our pilot data suggest that developmental delays among low-income preschoolers are associated with increased primary tooth dmfs. Additional research is needed to further examine this relationship. Future interventions and policies should focus on caries prevention strategies within settings like Head Start classrooms that serve low-income preschool-aged children with additional targeted home- and community-based interventions for those with developmental delays.
Appendix
Available only for authorised users
Literature
1.
U.S. Department of Health and Human Services: Oral Health in America: A Report of the Surgeon General. 2000, Rockville, MD: US Department of Health and Human Services, National Institute of Dental and Craniofacial Research, National Institute of Health
2.
Dye BA, Tan S, Smith V, Lewis BG, Barker LK, Thornton-Evans G, Eke PI, Beltrán-Aguilar ED, Horowitz AM, Li CH: Trends in oral health status: United States, 1988–1994 and 1999–2004. Vital Health Stat. 2007, 11: 1-92.
3.
4.
5.
Ramos-Gomez FJ, Weintraub JA, Gansky SA, Hoover CI, Featherstone JD: Bacterial, behavioral and environmental factors associated with early childhood caries. J Clin Pediatr Dent. 2002, 26: 165-173.CrossRefPubMed
6.
Dye BA, Arevalo O, Vargas CM: Trends in paediatric dental caries by poverty status in the United States, 1988–1994 and 1999–2004. Int J Paediatr Dent. 2010, 20: 132-143.CrossRefPubMed
7.
Da Fonseca MA: The effects of poverty on children’s development and oral health. Pediatr Dent. 2012, 34: 32-38.PubMed
8.
9.
Jackson SL, Vann WF, Kotch JB, Pahel BT, Lee JY: Impact of poor oral health on children’s school attendance and performance. Am J Public Health. 2011, 101: 1900-1906.CrossRefPubMedPubMedCentral
10.
Casamassimo PS, Thikkurissy S, Edelstein BL, Maiorini E: Beyond the dmft: the human and economic cost of early childhood caries. J Am Dent Assoc. 2009, 140: 650-657.CrossRefPubMed
11.
Nicolau B, Thomson WM, Steele JG, Allison PJ: Life-course epidemiology: concepts and theoretical models and its relevance to chronic oral conditions. Community Dent Oral Epidemiol. 2007, 35: 241-249.CrossRefPubMed
12.
13.
Fiscella K, Kitzman H: Disparities in academic achievement and health: the intersection of child education and health policy. Pediatrics. 2009, 123: 1073-1080.CrossRefPubMed
14.
15.
16.
17.
Siegal MD, Detty AM: Targeting school-based dental sealant programs: who is at “higher risk”?. J Public Health Dent. 2010, 70: 140-147.CrossRefPubMed
18.
Goldberg E, Lewis P, Ferguson F: Oral health status and access-to-care concerns of Suffolk County Head Start children. NY State Dent J. 2011, 77: 20-22.
19.
Vargas CM, Monajemy N, Khurana P, Tinanoff N: Oral health status of preschool children attending Head Start in Maryland, 2000. Pediatr Dent. 2002, 24: 257-263.PubMed
20.
Montero MJ, Douglass JM, Mathieu GM: Prevalence of dental caries and enamel defects in Connecticut Head Start children. Pediatr Dent. 2003, 25: 235-239.PubMed
21.
Siegal MD, Yeager MS, Davis AM: Oral health status and access to dental care for ohio head start children. Pediatr Dent. 2004, 26: 519-525.PubMed
22.
Autio-Gold JT, Tomar SL: Prevalence of noncavitated and cavitated carious lesions in 5-year-old head start schoolchildren in Alachua County, Florida. Pediatr Dent. 2005, 27: 54-60.PubMed
23.
Anderson L, Martin NR, Burdick A, Flynn RT, Blaney DD: Oral health status of New Hampshire Head Start children, 2007–2008. J Public Health Dent. 2010, 70: 245-248.CrossRefPubMed
24.
25.
Patrick DL, Lee RS, Nucci M, Grembowski D, Jolles CZ, Milgrom P: Reducing oral health disparities: a focus on social and cultural determinants. BMC Oral Health. 2006, 15 (6 Suppl 1): S4-CrossRef
26.
27.
Warren JJ, Weber-Gasparoni K, Marshall TA, Drake DR, Dehkordi-Vakil F, Dawson DV, Tharp KM: A longitudinal study of dental caries risk among very young low SES children. Community Dent Oral Epidemiol. 2009, 37: 116-122.CrossRefPubMed
28.
World Health Organization: Oral Health Survey, Basic Methods. 1997, Geneva, Switzerland: WHO, 4
29.
Barton LR, Spiker D, Williamson C: Characterizing disability in Head Start programs: not so clearcut. Early Child Res Q. 2012, 27: 596-612.CrossRef
30.
Shiboski CH, Gansky SA, Ramos-Gomez F, Ngo L, Isman R, Pollick HF: The association of early childhood caries and race/ethnicity among California preschool children. J Public Health Dent. 2003, 63: 38-46.CrossRefPubMed
31.
Ismail AI, Lim S, Sohn W, Willem JM: Determinants of early childhood caries in low-income African American young children. Pediatr Dent. 2008, 30: 289-296.PubMed
32.
Bricker DD, Squires J, Mounts L, Squires J: Ages & Stages Questionnaires: A Parent-Completed, Child-Monitoring System. 1999, Paul H. Brookes: Baltimore, MD, 2
33.
Plutzer K, Keirse MJ: Influence of first-time mothers’ early employment on severe early childhood caries in their child. Int J Pediatr. 2012, Epub 2012 Oct 11
34.
Plutzer K, Keirse MJ: Incidence and prevention of early childhood caries in one- and two-parent families. Child Care Health Dev. 2011, 37: 5-10.CrossRefPubMed
35.
Shenkin JD, Broffitt B, Levy SM, Warren JJ: The association between environmental tobacco smoke and primary tooth caries. J Public Health Dent. 2004, 64: 184-186.CrossRefPubMed
36.
Gillcrist JA, Brumley DE, Blackford JU: Community fluoridation status and caries experience in children. J Public Health Dent. 2001, 61: 168-171.CrossRefPubMed
37.
38.
Chi DL, McManus BM, Carle AC: Caregiver burden and preventive dental care use for US children with special health care needs: a stratified analysis based on functional limitation. Matern Child Health J. 2013, Epub 2013 Jun 23
39.
Quinonez R, Santos RG, Wilson S, Cross H: The relationship between child temperament and early childhood caries. Pediatr Dent. 2001, 23: 5-10.PubMed
40.
Spitz AS, Weber-Gasparoni K, Kanellis MJ, Qian F: Child temperament and risk factors for early childhood caries. J Dent Child (Chic). 2006, 73: 98-104.
41.
Milgrom P, Sutherland M, Shirtcliff RM, Ludwig S, Smolen D: Children’s tooth decay in a public health program to encourage low-income pregnant women to utilize dental care. BMC Public Health. 2010, 18 (10): 76-CrossRef
42.
Kagihara LE, Huebner CE, Mouradian WE, Milgrom P, Anderson BA: Parents’ perspectives on a dental home for children with special health care needs. Spec Care Dentist. 2011, 31: 170-177.CrossRefPubMed
43.
American Academy of Pediatric Dentistry: Policy on the dental home. Pediatr Dent. 2012–2013, 34: 24-25.
44.
Psoter WJ, Pendrys DG, Morse DE, Zhang H, Mayne ST: Associations of ethnicity/race and socioeconomic status with early childhood caries patterns. J Public Health Dent. 2006, 66: 23-29.CrossRefPubMed
45.
Vann WF, Lee JY, Baker D, Divaris K: Oral health literacy among female caregivers: impact on oral health outcomes in early childhood. J Dent Res. 2010, 89: 1395-1400.CrossRefPubMedPubMedCentral
46.
Skeie MS, Espelid I, Riordan PJ, Klock KS: Caries increment in children aged 3–5 years in relation to parents’ dental attitudes: Oslo, Norway 2002 to 2004. Community Dent Oral Epidemiol. 2008, 36: 441-450.CrossRefPubMed
47.
48.
Commission on Social Determinants of Health: Closing the Gap in a Generation: Health Equity through Action on the Social Determinants of Health. Final Report of the Commission on Social Determinants of Health. 2008, Geneva: World Health Organization
49.
Halpern DF: How time-flexible work policies can reduce stress, improve health, and save money. Stress Health. 2005, 21: 157-168.CrossRef
50.
McDonagh MS, Whiting PF, Wilson PM, Sutton AJ, Chestnutt I, Cooper J, Misso K, Bradley M, Treasure E, Kleijnen J: Systematic review of water fluoridation. BMJ. 2000, 7 (321): 855-859.CrossRef
51.
Parnell C, Whelton H, O’Mullane D: Water fluoridation. Eur Arch Paediatr Dent. 2009, 10: 141-148.CrossRefPubMed
52.
Armfield JM, Akers HF: Community water fluoridation support and opposition in Australia. Community Dent Health. 2011, 28: 40-46.PubMed
53.
Williams SA, Kwan SY, Parsons S: Parental smoking practices and caries experience in pre-school children. Caries Res. 2000, 34: 117-122.CrossRefPubMed
54.
Hanioka T, Nakamura E, Ojima M, Tanaka K, Aoyama H: Dental caries in 3-year-old children and smoking status of parents. Paediatr Perinat Epidemiol. 2008, 22: 546-550.CrossRefPubMed
55.
Tanaka K, Miyake Y, Sasaki S: The effect of maternal smoking during pregnancy and postnatal household smoking on dental caries in young children. J Pediatr. 2009, 155: 410-415.CrossRefPubMed
56.
Gorber SC, Schofield-Hurwitz S, Hardt J, Levasseur G, Tremblay M: The accuracy of self-reported smoking: a systematic review of the relationship between self-reported and cotinine-assessed smoking status. Nicotine Tob Res. 2009, 11: 12-24.CrossRef
57.
Nunn ME, Dietrich T, Singh HK, Henshaw MM, Kressin NR: Prevalence of early childhood caries among very young urban Boston children compared with US children. J Public Health Dent. 2009, 69: 156-162.CrossRefPubMedPubMedCentral
58.
Chi DL: Reducing Alaska Native pediatric oral health disparities: a systematic review of oral health interventions and a case study on multilevel strategies to reduce sugar sweetened beverage intake. Int J Circumpolar Health. 2013, 72: 21066-CrossRefPubMed
59.
Milgrom P, Chi DL: Prevention-centered caries management strategies during critical periods in early childhood. J Calif Dent Assoc. 2011, 39: 735-741.PubMed
60.
Agrawal T, Hoffman JA, Ahl M, Bhaumik U, Healey C, Carter S, Dickerson D, Nethersole S, Griffin D, Castaneda-Sceppa C: Collaborating for impact: a multilevel early childhood obesity prevention initiative. Fam Community Health. 2012, 35: 192-202.CrossRefPubMed
61.
Kanellis MJ: Caries risk assessment and prevention: strategies for Head Start, Early Head Start, and WIC. J Public Health Dent. 2000, 60: 210-217.CrossRefPubMed
62.
Milgrom P, Weinstein P, Huebner C, Graves J, Tut O: Empowering Head Start to improve access to good oral health for children from low income families. Matern Child Health J. 2011, 15: 876-882.CrossRefPubMed
63.
Chi DL, Tut O, Milgrom P: Cluster-randomized xylitol toothpaste trial for early childhood caries prevention. J Dent Child. In Press
64.
Stokes E, Ashcroft A, Burnside G, Mohindra T, Pine CM: Randomised controlled trial of the efficacy of a high-fluoride gel self-applied by toothbrushing in children at high caries risk. Caries Res. 2011, 45: 475-485.CrossRefPubMed
65.
Autio JT, Courts FJ: Acceptance of the xylitol chewing gum regimen by preschool children and teachers in a Head Start program: a pilot study. Pediatr Dent. 2001, 23: 71-74.PubMed
66.
Chinn CH: Effectiveness of an oral health program in improving the knowledge and competencies of head start staff. Pediatr Dent. 2011, 33: 403-408.PubMed
67.
Kranz AM, Rozier RG, Zeldin LP, Preisser JS: Oral health activities of early head start teachers directed toward children and parents. J Public Health Dent. 2011, 71: 161-169.CrossRefPubMedPubMedCentral
68.
Miller AP, Kameka M, Young-Whiting C: The effects of an oral health intervention on caregivers of Head Start children. J Natl Black Nurses Assoc. 2012, 23: 52-58.PubMed
69.
Ismail AI, Ondersma S, Jedele JM, Little RJ, Lepkowski JM: Evaluation of a brief tailored motivational intervention to prevent early childhood caries. Community Dent Oral Epidemiol. 2011, 39: 433-448.CrossRefPubMedPubMedCentral
70.
Plonka KA, Pukallus ML, Barnett A, Holcombe TF, Walsh LJ, Seow WK: A controlled, longitudinal study of home visits compared to telephone contacts to prevent early childhood caries. Int J Paediatr Dent. 2013, 23: 23-31.CrossRefPubMed
71.
Reisine S, Litt M, Tinanoff N: A biopsychosocial model to predict caries in preschool children. Pediatr Dent. 1994, 16: 413-418.PubMed
Metadata
Title
Developmental delays and dental caries in low-income preschoolers in the USA: a pilot cross-sectional study and preliminary explanatory model
Authors
Donald L Chi
Katharine C Rossitch
Elizabeth M Beeles
Publication date
01-12-2013
Publisher
BioMed Central
Published in
BMC Oral Health / Issue 1/2013
Electronic ISSN: 1472-6831
DOI
https://doi.org/10.1186/1472-6831-13-53

Other articles of this Issue 1/2013

BMC Oral Health 1/2013 Go to the issue

Research article

Perception of toothache in adults from state capitals and interior cities within the Brazilian geographic regions

Research article

A cross sectional study examining social desirability bias in caregiver reporting of children’s oral health behaviors

Research article

Evaluating performance of dental caries detection methods among third-year dental students

Research article

Investigating the biological properties of carbohydrate derived fulvic acid (CHD-FA) as a potential novel therapy for the management of oral biofilm infections

Research article

Relationships between self-rated oral health, subjective symptoms, oral health behavior and clinical conditions in Japanese university students: a cross-sectional survey at Okayama University

Research article

Clinical and histological characterization of oral pemphigus lesions in patients with skin diseases: a cross sectional study from Sudan