Background. Healthy People 2010 and the U.S. Surgeon General's report, Oral Health in America, indicate that caries is a severe oral health problem among low-income, minority preschool children that is compounded by low access to dental care. Potential solutions to this problem may exist in the linkage between mother and child access to dental care. If low-income mothers have a regular source of dental care (RSDC), oral health benefits may accrue to both mother and child through biological and dental care mechanisms, but little is known about these associations.
Aims. Among children aged three-to-six years old and enrolled in Medicaid dental insurance in Washington state (N=115,853), study aims are: 1) to measure the percentage of mothers with a RSDC and identify the determinants of mothers having a RSDC; 2) among mothers, to determine whether having a RSDC is associated with greater dental knowledge, oral health behaviors, dental satisfaction, better self-reported oral health, and less reparative treatment and work loss due to dental care; 3) among children, to determine whether having a mother with a RSDC is associated with greater utilization of dental care and better oral health; and 4) among children, to determine whether children with mothers losing dental coverage have less dental utilization than other children. Methods.
Aims will be achieved through a prospective cohort study design composed of a baseline survey of mothers and one-year follow-up of children's dental utilization from Medicaid dental claims. Disproportionate stratified random sampling will select Medicaid households with children aged three-to-six years in four racial/ethnic strata (White non-Hispanic (n=3,050), Hispanic (n=4,511), African-American (n=6,100), and other race/ethnic groups (n=4,518). At least 780 sampled mothers will complete a baseline telephone or mail survey. One year later, Medicaid dental claims for one-year pre/post-survey will be extracted for sampled children. Separate regression analyses will be conducted for each racial/ethnic stratum.
Aim 1 analyses will identify factors associated with mothers having a RSDC.
Aim 2 analyses of mothers will determine the association between having a RSDC and knowledge and attitudes about dental care, oral health behaviors, and dental utilization.
Aim 3 analyses of children will determine whether having a mother with a RSDC is associated with greater dental utilization in the prospective year.
Aim 4 analyses of children will determine whether mothers' loss of dental insurance results in fewer children dental utilization.
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| Grembowski, D; Spiekerman, C; Milgrom, P (2009) Racial and ethnic differences in a regular source of dental care and the oral health, behaviors, beliefs and services of low-income mothers. Community Dent Health 26:69-76 |
| Grembowski, David; Spiekerman, Charles; Milgrom, Peter (2009) Linking mother access to dental care and child oral health. Community Dent Oral Epidemiol 37:381-90 |
| Grembowski, David; Spiekerman, Charles; Milgrom, Peter (2008) Linking mother and child access to dental care. Pediatrics 122:e805-14 |
| Milgrom, Peter; Spiekerman, Charles; Grembowski, David (2008) Dissatisfaction with dental care among mothers of Medicaid-enrolled children. Community Dent Oral Epidemiol 36:451-8 |
| Grembowski, David; Spiekerman, Charles; Milgrom, Peter (2007) Disparities in regular source of dental care among mothers of medicaid-enrolled preschool children. J Health Care Poor Underserved 18:789-813 |
