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Am J Public Health. 2014 Oct;104(10):1979-85. doi: 10.2105/AJPH.2013.301325. Epub 2013 Oct 17.

Effects of early dental office visits on dental caries experience.

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At the time of the study, Heather Beil was with the School of Nursing, R. Gary Rozier, Sally C. Stearns, and Jessica Y. Lee were with the Department of Health Policy and Management, and John S. Preisser was with the Department of Biostatistics, Gillings School of Global Public Health, University of North Carolina, Chapel Hill. Jessica Y. Lee was also with the Department of Pediatric Dentistry, School of Dentistry, University of North Carolina.



We determined the association between timing of a first dentist office visit before age 5 years and dental disease in kindergarten.


We used North Carolina Medicaid claims (1999-2006) linked to state oral health surveillance data to compare caries experience for kindergarten students (2005-2006) who had a visit before age 60 months (n=11,394) to derive overall exposure effects from a zero-inflated negative binomial regression model. We repeated the analysis separately for children who had preventive and tertiary visits.


Children who had a visit at age 37 to 48 and 49 to 60 months had significantly less disease than children with a visit by age 24 months (incidence rate ratio [IRR]=0.88; 95% confidence interval [CI]=0.81, 0.95; IRR=0.75; 95% CI=0.69, 0.82, respectively). Disease status did not differ between children who had a tertiary visit by age 24 months and other children.


Medicaid-enrolled children in our study followed an urgent care type of utilization, and access to dental care was limited. Children at high risk for dental disease should be given priority for a preventive dental visit before age 3 years.

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