The impact of poor oral health on school performance for children in North Carolina

Purpose: To examine the difference in missed school days related to routine dental care versus dental pain/infection and to determine the relationship between children's oral health status (OHS) and school attendance and performance. Methods: We relied upon the 2008 North Carolina (NC) Child Health Assessment and Monitoring Program, a statewide telephone survey. Variables included outcome--school absence and performance; explanatory--OHS; control--parental education, insurance, race, and sex. We used logistic regression models and mediation analysis. Results: The final sample included 2,183 schoolchildren, weighted to reflect the state's census. Children with poorer OHS were nearly 3 times more likely (OR=2.89, 95% CI 1.96, 7.75) to miss school for dental pain. Absence for pain was associated with poorer performance (P<.05) but absence for routine care was not. Mediation analysis revealed that OHS was significantly associated with performance, independent of absence for pain. Conclusions: Children with poorer OHS were more likely to experience dental pain and miss school and more likely to have poorer school performance. These findings suggest that improvement of children's OHS may be a vehicle to improve their educational experience