Oral Health Care For Children Research Articles

New Age Parenting and Its Impact on Child’s Oral Health: Cross-sectional Questionnaire Study

Abstract Background: With increased globalization, East culture is meeting West culture and parenting style has been completely changed. Children depend significantly on their parents for provision, instruction, and supervision of crucial preventive oral hygiene habits. The education level and awareness of parents regarding preventive oral health measures play a pivotal role in this aspect. Therefore, it becomes imperative to evaluate and educate parents about proper oral hygiene care for their children, ultimately contributing to the overall well-being of the child. Aim: The aim of this study was to assess an impact of new age parenting on oral health of their children. Methodology: A cross-sectional questionnaire study was conducted among 204 parents of children aged 5–10 years, consisting of 27-item questionnaires containing four domains of demographic data, knowledge, attitude, and practice, which was distributed among the participants. A descriptive analysis was done using IBM SPSS software (version 22.0 Chicago, IL, USA). Results: It was surprising to note that 32.84% of parents were unaware about the specialist dentist is available for children. About 65.69% of parents had low level of knowledge regarding oral health of their children. The correlation among knowledge, attitude, and practice was determined to be highly statistically significant (P = 0.0001). Conclusion: Our study concluded that knowledge, attitude, and practice of oral health care of children are low among new age parents and there is a need to educate these parents regarding the same.

Oral Health Care for Children and Youth With Developmental Disabilities: Clinical Report.

Oral health is an essential component of overall health for all individuals. The oral health of children and youth with developmental disabilities (CYDD) involves unique characteristics and needs of which pediatricians and pediatric clinicians can be aware. Risk for oral disease in CYDD is multifactorial and includes underlying medical conditions, medications, and ability to participate in preventive oral health care and treatment, and lack of access to providers is common for this population despite being eligible for Medicaid. Pediatric clinicians are uniquely positioned to support the oral health needs of CYDD and their families through the medical home. This clinical report aims to inform pediatric clinicians about the unique oral health needs of CYDD. It provides guidance on assessing caries risk and periodontal status using structured screening instruments; understanding dental trauma, the role of diet and caries risk, trauma prevention, and malocclusion; and providing anticipatory guidance on oral hygiene that includes tooth brushing, use of fluoridated toothpaste, assessing community water fluoridation, advocating for a dental home by 1 year of age, and transition to adult dental care as part of adolescent health care. It also highlights special considerations for dental treatment rendered under sedation or general anesthesia that CYDD may need. Pediatric clinicians can help reduce risk of CYDD developing dental disease by understanding the unique needs of their patients and their barriers to accessing oral health care in their community, communicating with the child's dental home, and advocating for safe and accessible dental procedures.

Challenges faced by dentists during provision of oral health care in children and adolescents with special health-care needs: A scoping review.

Oral health care for children with special health-care needs (CSHCN) is often overlooked despite a substantial global population with disabilities or special needs. This scoping review delves into the challenges dentists face in delivering oral health care to CSHCN. The scoping review was conducted as per the guidelines of PRISMA-ScR with a search strategy based on the population, intervention, comparison, and outcome (PICO) framework of the research question. The databases searched were PUBMED, Google Scholar, and EBSCOhost. Articles published within 20 years and in the English language were included in the study. The review included 20 studies and highlighted several significant barriers encountered by dentists when providing oral health care for CSHCN. They included inadequate training among dentists in managing special needs patients, the time-intensive nature of oral procedures for this population, and the unpredictable behaviors exhibited by CSHCN during dental visits. The findings underscore the crucial need to address the challenges dentists face in delivering oral health care to CSHCN.

A cross sectional mixed method study to assess knowledge, practices and barriers of caregivers regarding oral health care in children (2-6 years) in selected rural areas of Meghalaya

A cross sectional mixed method study to assess knowledge, practices and barriers of caregivers regarding oral health care in children (2-6 years) in selected rural areas of Meghalaya

영유아를 둔 부모의 자녀 구강건강에 대한 중요도 인식과 실행수준

Purpose: This study was conducted to suggest implications for oral health education for young children by examining the recognition of the importance of young children's oral health and the level of implementation among parents of recognition. Method: A survey was conducted on 320 parents of young children in Region C from July 10 to July 28, 2023. A total of 293 questionnaires were used in the final analysis. The collected data were conducted to frequency analysis, IPA analysis using IBM SPSS Statistics 25.0 Results: First, the question with the highest recognition of the importance of oral health care for children among parents of young children was ‘If a child says their teeth hurt, they receive dental treatment quickly. The item with the highest level of implementation was ‘When purchasing a toothbrush, purchase a children’s toothbrush that matches the size of child’s teeth.’ Second, the question with the highest recognition of the importance of oral health education for children among parents of young children was ‘Instructing children to brush their teeth, tongue, and gums when brushing their teeth.’ The question with the highest level of implementation was ‘Educate child to eat foods that are beneficial to dental health.’ Conclusions: There is a need to improve parents' level of practice regarding oral health of young children, including proper brushing of teeth, oral check-ups, and use of oral products. Nutrition education, oral health and safety parent education, and early childhood teacher retraining are requested.

Factors associated with the use of oral health care services among Canadian children and youth.

This study investigates the association between dental insurance, income, and dental care access for Canadian children and youth aged 1 to 17 years. It contributes to a baseline understanding of oral health care use before the implementation of the Canadian Dental Care Plan (CDCP). This study used data from the 2019 Canadian Health Survey on Children and Youth (n=47,347). Descriptive statistics and logistic regression models were employed to assess the association of dental insurance, adjusted family net income, and other sociodemographic factors on oral health care visits and cost-related avoidance of oral health care. A large percentage of children under the age of 5 had never visited a dentist (79.8% of 1-year-olds to 16.4% of 4-year-olds). Overall, 89.6% of Canadian children and youth aged 5 to 17 had visited a dental professional within the past 12 months: 93.1% of those who were insured and 78.5% of those who were uninsured. Insured children and youth had a 4.5% cost-related avoidance of dental care, contrasting with 23.3% for uninsured children and youth. After adjustment for sociodemographic variables, children and youth with dental insurance were nearly three times more likely (odds ratio [OR]: 2.94; 95% confidence interval [CI]: 2.60 to 3.33) to have visited a dental professional in the past 12 months than uninsured children and youth. Having dental insurance (OR: 0.19; 95% CI: 0.16 to 0.21) was protective against barriers to seeing a dental professional because of cost. There was a strong income gradient for both dental service outcomes. The study emphasizes the significant association of dental insurance and access to oral health care for children and youth. It highlights a significant gap between insured and uninsured children and youth and points out the influence of sociodemographic and income factors on this disparity.

Applying Social Practice Theory to Explore Australian Preschool Children's Oral Health.

Despite substantial research and provision of dental care, significant morbidity remains for children's oral health. Guided by social practice theory (SPT), this research moves away from the often-ineffective focus on changing individual behavior to rethinking the centrality of the social world in promoting or undermining oral health outcomes. We define social practice as a routinized relational activity linking and integrating certain elements (competence, materials, and meanings) into the performance of a practice that is reproduced across time and space. To investigate oral health in preschool children in Perth, Western Australia, using social practice theory. With no definitive methodology for investigating SPT, we chose focused ethnography as a problem-focused, context-specific approach using mainly interviews to investigate participants' experience caring for their children's oral health. The focus of analysis was the practice of oral health care, not individual behavior, where themes identified from participants' transcripts were organized into categories of elements and performance. Eleven parents, all of whom were married or partnered, were interviewed in 2021. Findings identified social practices relevant to oral health within parenting and family relations linked to routine daily activities, including shopping, consumption of food and beverages, and toothbrushing. Oral health literacy was reflected in integrating competence, materials, and meanings into performing oral health care, notably preferences for children to drink water over sugary beverages and information often being sourced from social media and mothers' groups rather than health providers. Focusing on social practices as the unit of analysis offers a more layered understanding of elements in young children's oral health care that can indicate where the problem may lie. Findings provide an opportunity to consider future research and policy directions in children's oral health. Examining social practices related to young children's oral health care identifies parents/carers' knowledge about, for example, toothbrushing, the resources required, and why toothbrushing is important. Analyzing these separate elements can reveal both enablers and barriers to oral health care. This provides researchers, clinicians and policymakers an opportunity to focus on not changing individual behavior but understanding how social context impacts parents/carers' capacity to make optimum decisions around young children's oral health.

Gamification and Oral Health in Children and Adolescents: Scoping Review.

Oral health is a determinant of overall well-being and quality of life. Individual behaviors, such as oral hygiene and dietary habits, play a central role in oral health. Motivation is a crucial factor in promoting behavior change, and gamification offers a means to boost health-related knowledge and encourage positive health behaviors. This study aims to evaluate the impact of gamification and its mechanisms on oral health care of children and adolescents. A systematic search covered multiple databases: PubMed/MEDLINE, PsycINFO, the Cochrane Library, ScienceDirect, and LILACS. Gray literature, conference proceedings, and WHOQOL internet resources were considered. Studies from January 2013 to December 2022 were included, except for PubMed/MEDLINE, which was searched until January 2023. A total of 15 studies were selected following PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines. The eligibility criteria were peer-reviewed, full-text, and empirical research related to gamification in oral health care, reports of impact, and oral health care outcomes. The exclusion criteria encompassed duplicate articles; unavailable full texts; nonoriginal articles; and non-digital game-related, non-oral health-related, and protocol studies. Selected studies were scrutinized for gamification mechanisms and outcomes. Two main questions were raised: "Does gamification in oral health care impact oral health?" and "Does oral health care gamification enhance health promotion and literacy?" The PICO (Patient, Intervention, Comparison, Outcome) framework guided the scoping review. Initially, 617 records were obtained from 5 databases and gray literature sources. After applying exclusion criteria, 15 records were selected. Sample size in the selected studies ranged from 34 to 190 children and adolescents. A substantial portion (11/15, 73%) of the studies discussed oral self-care apps supported by evidence-based oral health. The most clearly defined data in the apps were "brushing time" (11/11, 100%) and "daily amount brushing" (10/11, 91%). Most studies (11/15, 73%) mentioned oral health care behavior change techniques and included "prompt intention formation" (11/26, 42%), "providing instructions" (11/26, 42%), "providing information on the behavior-health link" (10/26, 38%), "providing information on consequences" (9/26, 35%), "modeling or demonstrating behavior" (9/26, 35%), "providing feedback on performance" (8/26, 31%), and "providing contingent rewards" (8/26, 31%). Furthermore, 80% (12/15) of the studies identified game design elements incorporating gamification features in oral hygiene applications. The most prevalent gamification features were "ideological incentives" (10/12, 83%) and "goals" (9/16, 56%), which were found in user-specific and challenge categories, respectively. Gamification in oral health care shows potential as an innovative approach to promote positive health behaviors. Most studies reported evidence-based oral health and incorporated oral health care behavior change techniques.

Two-Year Trajectories of Dental Anxiety in Parents and Their Association with Parents' and Children's Oral Healthcare Procedures in FinnBrain Birth Cohort Study.

We aimed to identify parents' dental anxiety trajectories and the association of the trajectories with the number of parents' and their children's oral healthcare procedures in the FinnBrain Birth Cohort Study. Dental anxiety was measured with the Modified Dental Anxiety Scale at gestational weeks (gw) 14 and 34, as well as 3 and 24 months (mo) after childbirth. Oral healthcare procedures from gw14 to 24 mo were obtained from the national patient data register and categorized as preventive and treatment. Trajectories were identified with latent growth mixture modelling for 2068 fathers and 3201 mothers. Associations between trajectories and procedures adjusted for education were analyzed using unordered multinomial logit models. Fathers' trajectories were stable low (80.1%), stable high (3.4%), stable moderate (11.0%), moderate increasing (3.9%) and high decreasing (1.6%). Mothers' trajectories were stable low (80.7%), stable high (11.2%), moderate increasing (5.3%) and high decreasing (2.8%). Mothers with decreasing dental anxiety had a higher number of preventive and treatment procedures. Fathers with decreasing dental anxiety had a higher number of preventive and treatment procedures, while fathers with increasing dental anxiety had fewer procedures. Children of mothers with stable low dental anxiety had higher number of preventive procedures. There seems to be a two-way association between dental anxiety trajectories and oral healthcare procedures.

Oral health care in children with disabilities: A narrative review

Children with disabilities face discrepancies in receiving oral health services due to several barriers. This article aims to provide an overview on the oral health status of children with disabilities, impact on Quality of Life of children with disabilities and their family members, approaches in oral health education and/or services, roles of medical/oral health care providers, carers/parents, and special schools/centres, and future aspiration concerning these children. Articles were searched using online databases (Google Scholar, MEDLINE/PubMed) using various terms. Additional articles were searched manually from the reference list of the previously searched articles. Children with disabilities showed a higher prevalence of caries and periodontal disease and had irregular dental visits owing to the limitations encountered by the carers/parents. The psychological and physical health of carers/parents, and the well-being of children with disabilities are interrelated, suggesting the need for a comprehensive support system to address the specific needs of these groups. Oral hygiene care services for these children could be improved using oral health education tools, strengthening dental outreach programs, and/or adopting behaviour modification techniques. Oral health in children with disabilities is a global concern, therefore a holistic approach addressing this problem from the individual to international level, including interprofessional collaboration is imperative.

Perception of oral health professionals towards oral health care in children with attention deficit hyperactivity disorder: a cross-sectional questionnaire study

Background: Attention deficit hyperactivity disorder is one of the most common psychiatric disorders that affects both children and adults and is characterized by inattention, hyperactivity, and impulsivity. Around 9% of worlds’ child population and 20% of India’s is affected by ADHD. A child with ADHD can often have neglected or poor oral hygiene. Attending to the dental treatment of such children can be a challenging task for dentists. The aim of the study was to assess the knowledge, attitude, and practices of oral health care towards children with ADHD among oral health professionals. Methods: The study was carried out among 151 oral health professionals using a validated questionnaire. The results were tabulated in an excel sheet and analysed using SPSS software version 22.0. Results: It was found that among the participants, 71.52% had knowledge scores below the mean knowledge score, while 74.83% had attitude scores below the mean and likewise, 53.64% had practice scores below the mean practice scores. A positive correlation was found between knowledge, attitude, and practice by Karl Pearson’s correlation coefficient with a highly statistically significant p value of 0.0001 (p<0.05). This signified low knowledge correlated with less positive attitude leading to poor practices. Conclusions: Majority of the participating professionals perceive that their training did not prepare them well to treat ADHD affected children. However, practice levels were better among those with more years of experience.

AWARENESS AND HEALTH SEEKING BEHAVIOUR OF PARENTS REGARDING THEIR CHILDREN’S ORAL HEALTH AND PROFESSIONAL DENTAL CARE

Parents' awareness and health-seeking behaviour concerning their children's oral health and professional dental care are vital components shaping pediatric dental wellness. The study's primary objective is to find parents' awareness and health-seeking behaviour regarding their children’s oral health and professional dental care. This cross-sectional study was conducted in Karachi. Data was collected from 320 parents who participated in this study. To capture a comprehensive understanding, participant recruitment involves a diverse selection of parents, ensuring representation across various demographics, including age, socioeconomic status, educational background, and geographical location. Data were collected from 320 participants. Participants belong to different age groups. Respondents with a high school education or less constituted 35%, while those with a bachelor's degree represented 30% of the participants. The survey outlined varying degrees of parental awareness regarding specific oral health practices. While a high percentage of parents were aware of the importance of fluoride use for children (85%) and the ideal age for dental check-ups (60%), adherence to the American Academy of Pediatric Dentistry (AAPD) brushing recommendations and awareness of proper flossing techniques were notably lower, at 25% and 40%, respectively. It is concluded that early dental checkups play a crucial role in preventing conditions like dental caries. Founding good oral habits and hygiene during the formative years significantly contributes to lifelong oral health in children.

A STEPwise Approach for Oral Hygiene Behavior of Schoolchildren in Romania.

This research analyzes the dental hygiene habits of schoolchildren from parents' perspectives, using the STEPS approach recommended by the World Health Organization. The key points of oral health care in children include the role of the family in encouraging and maintaining proper oral hygiene practices. This study aimed to assess the oral hygiene practices of schoolchildren with on-site dentists in Romania. Additionally, it sought to establish correlations between these behaviors and the educational levels of the adults with whom they live with. The participants were selected from the zero grade to the eighth grade, totaling 3843students. Statistical analysis involved the application of Fisher's Exact Test and Z-tests with Bonferroni correction. Multinominal and binominal logistic regression models were employed to predict the impact of parents' education on children's oral health status and behavior. The oral health status of children evaluated by parents as poor was more frequent in children whose parents had a primary or gymnasium education (p < 0.001). Female adults with a university education evaluated the gum health of their children as very good to a much greater extent (41.7%, p < 0.001). Regarding the use of auxiliary means, the majority of parents with a university education mentioned that their children use dental floss (26.4% females/27.4% males) (p < 0.001), compared to those with primary education, where the percentage was only (1.2% males/3.5% females) (p < 0.001). The results of this study highlight that the education level of the adults with whom the children live with influences the perception of the teeth and gums health status, the frequency of oral hygiene, the use of fluoride toothpaste, and auxiliary brushing aids.

Correlation between oral health and modified OIDP index in pediatric patients undergoing treatment in Clove Dental Clinics: A cross sectional pilot study

ABSTRACT Aim: This research article aims to assess the correlation between oral health and the modified Child Oral Impact on Daily Performance (C-OIDP) index in pediatric patients undergoing treatment at Clove Dental Clinics. The study focuses on evaluating the psychometric properties of the modified C-OIDP index using a Google Forms questionnaire in a multicentric pediatric population across 10 states in India. Materials and Methods: A descriptive cross-sectional study was conducted in two phases among pediatric patients (age range: 2–18 years) undergoing treatment at Clove Dental Clinics in Pan-India. Phase 1: (1) The English version of the C-OIDP index was converted into a pretreatment and posttreatment assessment Google Forms questionnaire. (2) The psychometric and linguistic properties of the modified C-OIDP index were assessed by a panel of experts, incorporating their feedback, and resolving any discrepancies. (3) The modified Google Forms questionnaire was tested on 20 random walk-in pediatric patients visiting two Clove Dental Clinics. (4) Discussions were held with the patients, accompanying guardians, and pedodontists to evaluate their understanding and optimize the questionnaire’s face and content validity. Phase 2: (1) The main study included the reassessment of the modified C-OIDP index using the Google Forms questionnaire on a larger sample of 200 pediatric patients undergoing treatment at Clove Dental Clinics. (2) The questionnaire was administered in both pretreatment and posttreatment scenarios, with a 1-week recall period between assessments. (3) All study participants and their accompanying guardians provided written informed consent. (4) Changes to content wordings during the cultural adaptation process were summarized. Results: (1) A total of 206 voluntary responses were collected from pediatric patients across 341 Clove Dental Clinics in 10 states of India. (2) The factor analysis study revealed good internal consistency reliability and validity of the modified C-OIDP index. (3) The pretreatment and posttreatment modified OIDP scores showed a significant decrease, indicating improved oral health-related quality of life (OHRQoL) posttreatment. Conclusions: The modified C-OIDP index demonstrated good psychometric properties and validity when used in a Google Forms questionnaire among pediatric patients undergoing treatment at Clove Dental Clinics in India. The study highlights the importance of assessing OHRQoL in pediatric populations and provides valuable insights for planning and prioritizing oral health care for children.

THE ESSENTIAL COMPONENTS OF PEDIATRIC DENTISTRY: NURTURING HEALTHY SMILES FROM AN EARLY AGE

Pediatric dentistry encompasses crucial components aimed at promoting optimal oral health in children. This article highlights the essential elements of pediatric dentistry, including preventive care, behavior management, growth and development monitoring,comprehensive dental treatments, and specialized materials and methods. By emphasizing preventive measures, creating supportive environments, and addressing the unique needs of pediatric patients, pediatric dentists play a pivotal role in nurturing healthy smiles from an early age. The integration of these components underscores the commitment to providing compassionate, tailored, and effective oral health care for children, ultimately contributing to the long-term oral health and well-being of pediatric patients.

Effectiveness of Structured Visual Pedagogy in Improving Knowledge of Nursing Graduates Regarding Oral Healthcare of Children with Special Healthcare Needs: AQuasi-experimental Study

Introduction: Nurses are the primary contact for caregivers of Children with Special Healthcare Needs (CSHCN). Parent counselling and health screening programs are undertaken in which nurses play an important role. Along with this, it is also essential to have knowledge of oral health and the importance of maintaining oral hygiene, especially for CSHCN. Aim: To evaluate the knowledge of nursing graduates regarding oral healthcare for CSHCN at baseline, one week and one month after a Structured Visual Pedagogy (SVP) intervention, and to compare their knowledge scores before and after the intervention. Materials and Methods: This pretest-posttest quasiexperimental study was conducted at Dr. D.Y. Patil College of Nursing, Pune, Maharashtra, India, between February 2023 and June 2023, among 60 nursing graduates. An SVP was curated and delivered to the study population. It was an audio-video discussion-based intervention covering the various domains of oral healthcare for CSHCN, including their oral manifestations, barriers to oral hygiene maintenance, and their management through counselling and timely referrals. Participants completed a pre-validated questionnaire at three intervals: before the intervention, one week after and one month after the intervention, and their knowledge was analysed. The data were analysed using International Business Machines (IBM) Statistical Package for Social Science (SPSS) software version 21.0, USA. Results: The mean age of study group was 21±0.85 years. Among the participants, 52 (86.6%) were females and 8 (13.4%) were males. Between the baseline and the first week of the SVP, as well as, between the baseline and the first month, nursing graduates’ understanding of the oral health requirements of CSHCN increased. The mean knowledge score at the preintervention stage was 6.83±2.35; at one week post-intervention, the mean knowledge score was 14.40±1.50; and one month post-intervention, the mean knowledge score was 13.65±1.40. It was observed that there was a statistically significant increase in the mean knowledge score one week, as well as, one month post-intervention compared to the baseline (p-value&lt;0.05). Conclusion: The SVP was highly effective among the nursing graduates, clearly highlighted its use as a training tool for nurses.

Educators' perception of oral health in children's schools in Brazil

This study aimed to explore educators' perceptions regarding oral health promotion and the application of Atraumatic Restorative Treatment in the school environment. It is an exploratory descriptive observational study with a qualitative approach. The sample consisted of 18 educators from an Early Childhood Education Center. For data collection, a form was used with open and closed questions about oral health care for children: recreational and educational activities, supervised brushing and Atraumatic Restorative Treatment. Data were analyzed by descriptive analysis and by the Discourse of the Collective Subject. About 60% of educators considered caries a disease, 50% having observed toothache in children in the school environment. The educators considered the educational/preventive activities and the use of Atraumatic Restorative Treatment beneficial to the children. They reported relevance in oral health prevention and promotion actions carried out in the school environment, observing the generation of autonomy and empowerment in children. They also cited a favorable opinion on the use of Atraumatic Restorative Treatment.

HAART medication and oral health status in children and adolescent HIV infected: A case control study.

The advent of Highly Active Anti-Retroviral Therapy (HAART) does influence the overall oral health care of children. The children undergoing HAART have shown an increase in caries activity owing to sugars in medicines to make them more palatable. The aim of the study was to assess and compare the Oral Health of Children Living with HIV/AIDS (CLHAs) and Adolescents Living with HIV/AIDS (ALHAs) undergoing HAART and those who are HAART-naïve. This study was carried out at different Non-Governmental Organizations (NGO's) across Kerala, India. The study group consisted of 150 HIV-infected children aged 6-18 years. They were divided into two groups. Group 1 comprised of children prior to onset of HAART and Group 2 included children who had been on HAART for more than 3 years (HAART naïve). The assessment of dental caries status and dental plaque status was done. The observations were tabulated and statistically analyzed. On Statistical Analysis, significant difference was noted between the groups with the Group 1(2.26±0.58;p value=.000*) showing higher scores of dental plaque and a significant difference was also observed with respect to dental caries scores with DMFT and dmft scores higher in Group 2(dmft 2.08±2.85; p value=.001* and DMFT 4.10±1.71;p value=.003*). It was concluded that oral hygiene conditions were poor in children with HIV, with dental plaque scores more in HAART-naïve which may be due to their lesser visits and reinforcements regarding oral hygiene from a dentist and dental caries score more in HAART group, this may be attributed to the hidden sugars present in HAART medications to make it more palatable. Early recognition and management of oral conditions are important to improve the quality of life for these children.

Assessment of knowledge, attitude, and behavior related to children's oral health in pediatricians and students in the pediatric field in Iran: a cross-sectional study.

Pediatricians have an important role to play in motivating and instructing parents on oral health in children. The aim of this study was to assess knowledge of, attitude to, and behavior regarding oral health care in children among pediatricians and students in the pediatric field in Iran. This cross-sectional study included all students in the pediatric field (those who had started a residency or fellowship) and practicing pediatricians in provincial centers and universities (61 setting centers) throughout Iran in the course of 2021. Participants completed an online questionnaire assessing details of the parameters of knowledge of, attitude to, and behavior toward oral health for each individual. A convenience sampling technique was used to gather the study sample. All data were coded for each of the parameters. The data were analyzed by one-way ANOVA (Analysis of Variance)/Tukey and Pearson's correlation tests and path analysis. Out of 582 participants who visited the website, a total of 217 completed the entire questionnaire (participation rate of 37.2%). On the attitude parameter, 84.8% of participants scored above 75% of the possible attainable score, while only 37.9% and 48.1% of them had adequate knowledge and behavior for the possible score, respectively. Specialists had a higher mean score on behavior and knowledge than residents (P=0.001). There was a significant correlation between the scores on attitude and behavior (r=0.42, P<0.001), attitude and knowledge (r=0.19, P=0.005), and behavior and knowledge (r=0.25, P<0.001). Nearly all of the participants, 216 (99.5%), felt the need for the principles of dentistry to be included in the curriculum. Pediatricians showed a favorable attitude to oral health, but their knowledge of and behavior in the field was inadequate. Improvement of pediatricians' interest and performance in oral health in children should be encouraged through the inclusion of these parameters in the curriculum for students of the pediatric field. Implementing training programs for practical pediatricians or incorporating independent theoretical and clinical courses offered by pediatric dentists in dental school departments into the field curriculum of the students in the pediatric field is recommended.

Access to restorative oral health care for children living in Illinois with Medicaid vs private dental insurance: An audit study

BackgroundPublic dental insurance programs for children aim to provide access to care, but barriers remain that preclude care delivery. Understanding these barriers is an important health policy concern. MethodsA telephone audit sought to ascertain availability of oral health care for children in dental offices eligible to bill Medicaid. Female callers posing as mothers called eligible offices requesting appointments. In this cross-over design, offices were randomized to public or private insurance for initial calls and then to the other condition after a washout period. ResultsUsing mixed models, privately insured patients had 5.9 times (95% CI, 4.55 to 7.69) greater odds of obtaining an appointment than Medicaid patients. Compared with patients in Cook County, suburban patients had slightly better odds, whereas nonurban patients in larger and smaller rural counties had lower odds of success. ConclusionsMedicaid compares poorly with private insurance for providing access to pediatric oral health care. Regardless of insurance conditions, access is poor in less urban environments compared with metropolitan communities. Practical ImplicationsEven Medicaid-enrolled dental practices limit the care they extend to insured children. Providing Medicaid by itself cannot overcome large oral health care access disparities, which are greatest in rural communities.