Enabling factors and oral health care use among children aged 0 through 5 years: Insight from the 2022-2023 National Survey of Children's Health.

BACKGROUND: Oral health care is vital to early childhood health, yet many young children in the United States do not receive timely oral health care services. Enabling resources may influence access, but their specific impact remains unclear.

METHODS: In this cross-sectional study, the authors used 2022-2023 National Survey of Children's Health data to examine enabling factors associated with oral health care use among children aged 0 through 5 years. Guided by Andersen's Behavioral Model of Health Services Use, the outcome was whether the child had a dental visit (yes, no). Enabling factors included neighborhood safety or support, food or cash assistance, food security, financial stability (ie, ability to pay medical bills), and insurance status. Predisposing (ie, demographic characteristics, caregiver's education, and poverty) and need factors (ie, sugary drink consumption) were controlled for. Weighted descriptive statistics and logistic regression models were conducted using IBM SPSS software, Version 29 (IBM Corp). A P value less than or equal to .05 was the threshold for statistical significance.

RESULTS: Among 34,622 children (weighted n = 17,036,874), 35.8% had not received any oral health care. Children with food or cash assistance (odds ratio [OR], 1.26; 95% CI, 1.07 to 1.48) and insurance coverage (private: OR, 2.36; 95% CI, 1.65 to 3.38; public: OR, 2.64; 95% CI, 1.80 to 3.88) were more likely to have had a dental visit. Difficulty paying medical bills was negatively associated with care use (OR, 0.83; 95% CI, 0.69 to 0.99). Neighborhood and food security were not significant predictors.

CONCLUSIONS: Insurance coverage, public assistance, and financial stability are key enabling resources that influence young children's oral health care use.

PRACTICAL IMPLICATIONS: Policies that expand insurance access and address financial hardship may improve oral health equity by means of increasing oral health care use among vulnerable young children.