Predictors of Dental Service Utilization among Preschool Children in Hong Kong

Abstract

bjectives: There is no city-wide preschool dental service provided by the Government of Hong Kong. Oral health disparities and lack of access to dental care are the major problems for preschool children. This study examined the association between dental service utilization of preschool children and family socioeconomic factors, caregiver’s oral health characteristics, and children’s caries status. Methods: Using baseline data from a clinical trial with pre-school children aged 3-4, a multiple logistic regression model assessed factors contributing to dental services utilization. Using the backward regression, the independent variables included (a) family socioeconomic factors (family monthly income, parental education, district of residence, and new immigrants); (b) caregiver's oral health characteristics (self-reported caries status, belief of preventing dental caries, and self-efficacy about tooth brushing and sugar restriction on children); and (c) children's caries status. Results: Children's mean age was 46.5±4.0 (range 33-57) months. Among the 736 participating preschool children, the overall caries prevalence (cavitated and non-cavitated lesions) was 78.5%. Over 85% of children had no dental visit experience. More than 75% of caregivers reported experience of tooth decay; around 20% of them had not visited a dentist. The backward regression analysis showed that parents with education beyond high school graduation had a significantly higher chance of bringing their children to a dental visit (OR= 2.40, 95% CI = 1.20, 4.82, P < 0.01). Children born in Hong Kong were associated with 2.55 times as likely of having visited a dentist (OR=2.55, 95% CI = 1.25, 5.21, P < 0.01) compared to new immigrants. Caregiver's oral health characteristics and children's caries status were not associated with children's dental service utilization (P >0.05). Conclusions: Dental care utilization among 3-4 years old children was low in Hong Kong. Preschool children with parental education beyond high school graduation and born in Hong Kong had significantly higher dental service utilization.