Dental Service Utilization Among Children in the Child Welfare System

OBJECTIVE:To examine predisposing, enabling, and need-related factors associated with dental utilization by children involved with the child welfare system (CWS). METHODS:Data were analyzed from the National Survey of Child and Adolescent Well-Being (NSCAW; Wave II), a national probability sample of children (2-17 years) following a welfare assessment during 2008-2009 (n = 2806). Caregiver-reported child receipt of dental services in the past year was the outcome in weighted logistic regression models. RESULTS:Two-thirds of children had a recent dental visit. Older children (OR 2.95, 95% CI 2.06,4.21 for ages 6-11; OR 2.47, CI 1.82, 3.37 for ages 12-17, compared to ages 2-5) were more likely to have visited the dentist, as were children of more educated caregivers (OR 1.68; CI 1.20, 2.36 for high school, OR 2.45; CI 1.71, 3.52 for more than high school). Children without a usual source of care (OR 0.50; CI 0.27, 0.94) and those living with non-biological parents had lower odds of a recent visit (OR 0.64; CI 0.43, 0.97). Children with dental problems were twice as likely to have a recent visit (OR 2.02; CI 1.21, 3.38), while children with unmet needs who could not afford care had lower odds of utilizing services (OR 0.28; CI 0.16, 0.46). CONCLUSIONS FOR PRACTICE:Many children in the CWS, especially younger children (ages 2-5), did not have a reported dental visit in the past year. Cost was a barrier, and caregiver status was associated with the likelihood of obtaining dental care. Health and social service providers should refer these children for dental care