75 percent of parents miss key milestone of bringing children to dentist by age 1

A new survey from Western University of Health Sciences’ College of Dental Medicine found parents in the general population bring their children to the dentist for the first time at the average age of 2.5, while parents who fall under the U.S. poverty threshold bring their children to the dentist for the first time at approximately 3.5 years old.

The American Academy of Pediatric Dentistry (AAPD) recommends parents take children to the dentist by age 1, although the survey found 75 percent do not do so.

“The ‘dental visit for children by 1 year of age’ is a new concept for people that may take several more years for the general public to be familiar and aware of this practice,” said Timothy S. Martinez, DMD, College of Dental Medicine associate dean of Community Partnerships and Access to Care, and the lead author of the survey report. “Despite the fact that there is a joint policy from the American Academy of Pediatrics, the American Academy of Pediatric Dentistry, the American Dental Association and the American Association of Public Health Dentistry, who all recommend a dental visit for children by 1 year of age, policy implementation into a practice behavior takes time.

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The survey, released today, assesses patients’ attitudes, knowledge and beliefs about dental care for themselves and their children. The paper, titled “Survey Analysis of Parental Awareness and Behaviors Regarding Children’s Dental Care and Dental Infection Control,” is available for download at supportcleandentistry.com.

The survey was conducted in the United States among 304 adults, ages 18 to 65, in the general population, and 75 adults, ages 18 to 65, who fell below the poverty threshold.

“In addition to an overall lack of awareness, there still seems to be a perception that early dental care is not as imperative as other medical care – 61 percent of people did not seek dental care for their children simply because they didn’t feel it was necessary,” Martinez said. “Although not implicitly stated, there is a perception that infants at age 1 do not have teeth, and also that the 'baby teeth' are not important because they eventually fall out. Dental professionals – and all health care professionals – need to impart the role of oral health care in one’s overall health.”

The second most common reason parents do not take their child to the dentist prior to age 1 is the child’s pediatrician or doctor said it wasn’t necessary, according to the survey. Many of these health professionals may not be aware of the recommendation, Martinez says.

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The reasons parents don't take their children to the dentist diverge among low-income respondents, with 22 percent worrying they can’t afford dental care or that insurance won’t cover it.

Both private and public insurers recognize that if a child visits the dentist by age 1, the child is more likely to use and receive dental services, Martinez says.

“In public (non-Medicaid), Medicaid and private plans, dental care for infants is an important component of primary care, and these plans typically provide dental care for children this young,” he says. “Unfortunately, the survey shows that some low-income respondents are not fully aware if their health care plans cover dental. Thirteen percent of the respondents that fall under the poverty line reported that they did not think their insurance would cover dental benefits, and an additional 9 percent of the respondents said they could not afford the dental visits for their child (when most likely those individuals have plans that cover dental care for their infants and young children).”

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Although compliance for 1-year-old dental visits was very low, 88 percent of parents took advice from their dental professional and had sealants applied when recommended.

“Sealants have been proven to prevent dental caries,” Martinez said. “The most expensive tooth that requires treatment from both the insurance company’s perspective and patient’s is the permanent first molars. The most common area of decay occurs on the tops of these teeth (occlusal surfaces). By placing sealants on the occlusal surfaces of these teeth, decay can be prevented. At-risk children for dental caries should have dental sealants placed on their permanent molars.”

There are no risks associated taking an infant or child to the dentist before age 1, according to Martinez. There are benefits, however, to early visits. Introducing children to the process of visiting the dentist early in life may mitigate fears of going to the dentist in later years, plus early visits translate into early detection of disease, he said. In addition, if dental problems are noted, they will be less difficult to treat because the extent of decay is small.

“Early visits are necessary for screening, prevention, anticipatory guidance and early detection of caries,” Martinez says. “In addition, teeth usually erupt around six months of age. The first dental visit should coincide with the eruption of their first teeth; hence, prior to age 1.”

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Martinez recommends parents take their children to a dental home or dental visit by age 1, make sure their children get sealants on their teeth and send their child to a dental office that has a safe and clean environment. He also recommends dentists educate their patients on the importance of early dentist visits and coordinate, communicate, collaborate and cooperate with pediatric primary health care professionals as well as community representatives.

“The lack of knowledge parents have, and the lack of urgency of taking their children to the dentist by age one, is very concerning to me,” Martinez said. “Age 1 is a perfect time to get a child into the dental office and begin preventative dental care that will minimize decay and early childhood caries.”

The survey also found recent dental infection control breaches covered in the news media have influenced patient attitudes about cleanliness at the dentist. Of the people who recalled seeing or hearing these news stories (107 people), more than half of them said they have changed their outlook on going to the dentist:

• 41 percent report they are now more attentive to the cleanliness in the dental office.

• 21 percent also claimed to be more nervous about visiting the dentist.

• 14 percent say they now ask their dental professionals more questions about how they clean the dental equipment and office.

• 46 percent report that the news stories did not change their outlook.

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For the most part, patients are confident their dental practitioners are doing everything they can to create a clean environment and provide sterile equipment.

“Dentists must adhere to the Center for Disease Control and Prevention, “Guidelines for Infection Control in Dental Health-Care Settings,” 2003, MMWR, December 19^th, 2003:52(RR-17),” Martinez said. “Furthermore, dental office personnel must participate in annual infection control training, which is usually articulated in the state dental board regulations.”

To help assist dentists in adhere to the CDC infection control guidelines, dental trade companies manufacture dental disposable supplies that reduce the risk of cross-contamination, Martinez said. For example, syringe tips that are used for water and air in the dental operatories are available as a disposable item, as well as eye protective wear and other items, such as bib holders.

“The last thing the dental profession wants is for people to perceive infection control practices as a barrier to visiting a dentist,” Martinez said. “Patients can request disposable products if they are concerned about infection control practices in a dental office. Using disposable supplies prevents the transfer of germs from previous patients or dental professionals.”

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