Dental Caries and Preventive Dental Visits Among Children in the U.S.: The Impact of Race/Ethnicity and Immigration

Abstract

Introduction: National data on dental caries and dental service use among immigrant children in US is limited. It is not known whether race/ethnicity would interact with immigration status to increase these disparities. Using a national representative sample, we assessed the interaction effects of immigrant generation status and race/ethnicity on dental caries and dental visits among children in the US. Methods: Data were from the 2020 and 2021 National Survey of Children's Health (NSCH). All data were self-reported by parents/guardians. The two outcomes were (1) dental caries (yes/no) in the past 12 months, and (2) preventive dental visits (yes/no) in the past 12 months. Racial/ethnic groups included non-Hispanic White, Black, Hispanics, and Asian Americans. The analytical sample included 66,167children ages 2-17 years, including 1,243 first generation, 11,017 second generation immigrant children, and 53,907 non-immigrant children. We ran separate multiple logistic regression models for the two outcome variables. All analyses accounted for the survey design of NSCH. Results: First generation immigrant children were more likely to have dental caries than non-immigrant children (AOR=1.44). The interaction of race/ethnicity and immigrant generation status was significant (P =0.04) in the preventive dental visits model, indicating increased challenges in getting dental visits among minority immigrant children in comparison with non-Hispanic White immigrant children, especially among first generation immigrant children of Asian Americans (AOR=0.41) and non-Hispanic Black (AOR=0.37) immigrant children. Conclusions: We found that first generation immigrant children were less likely to see a dentist and more likely to have dental caries than non-immigrants. Moreover, first generation immigrant children from minority racial/ethnic groups were the least likely to seek dental services. To further reduce disparities in oral health and dental use among children in the U.S., culturally sensitive health promotion is warranted to improve oral health literacy and reduce barriers to dental care for immigrants, especially immigrant children of the minority groups.