Abstract
BackgroundDental problems are the most prevalent chronic disease worldwide, with up to half of all kindergarten children having tooth decay. However, there is a lack of evidence of whether unaddressed dental needs (UDNs) are associated with children’s developmental health, a concept reflecting holistic child development - encompassing physical, emotional, and cognitive development. The objective of the current study was to evaluate the relationship between UDNs and developmental health among kindergarten children using the Early Development Instrument (EDI).MethodsWe examined associations between teacher reported UDNs and developmental vulnerability on the EDI. Children were included in the study if they were enrolled in kindergarten in publicly-funded schools in Canada between 2010 and 2015, had been in the classroom for at least one month, and had no more than 25% of missing items on the questionnaire.ResultsAmong 576,264 children who met inclusion criteria (95.4% of eligible children), 2465 (0.4%) were identified as having UDNs by their teachers. Children with UDNs had 4.58 to 8.27 times higher odds of being vulnerable on any of the five developmental domains (physical health and well-being, social competence, emotional maturity, language and cognitive development, communication skills and general knowledge), compared to children without UDNs.ConclusionIn this study, teacher-reported UDNs were associated with developmental vulnerability in kindergarten children. Teacher reported unmet dental needs in kindergarten children may be a proxy for poor developmental health at school entry, and thus a marker for supporting both children’s oral health and early developmental needs.
Highlights
Dental problems are the most prevalent chronic disease worldwide, with up to half of all kindergarten children having tooth decay
Children with special health needs (SHNs) are defined as having either a disability, exceptionality, or a functional impairment, such as a visual or hearing impairment, and they typically require additional assistance in the classroom [16]. Research indicates that they have poorer oral hygiene and a greater incidence of caries, as well as other oral diseases compared to their non-SHNs peers [17, 18], with reports of 20% of children with a SHN having unaddressed dental needs (UDNs) [19]
Children with teacherreported UDNs were similar in age but more likely to be male, have a special needs designation, have English or French as a second language (E/FSL), and have lower neighbourhood-level socioeconomic status (SES) than children without teacher-reported UDNs
Summary
Dental problems are the most prevalent chronic disease worldwide, with up to half of all kindergarten children having tooth decay. Children with SHNs are defined as having either a disability, exceptionality, or a functional impairment, such as a visual or hearing impairment, and they typically require additional assistance in the classroom [16]. Research indicates that they have poorer oral hygiene and a greater incidence of caries (both treated and untreated), as well as other oral diseases compared to their non-SHNs peers [17, 18], with reports of 20% of children with a SHN having UDNs [19]. It has been suggested that a lack of training for dental professionals on how to treat children with SHNs [20] is one of the reasons for their poorer oral health, as some of them, such as children with Autism Spectrum Disorder (ASD), appear to face multiple barriers in accessing dental care [21]
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