Pediatric Care Coordination and Oral Health Outcomes in the United States: A Cross-Sectional Analysis of 2022-23 National Survey of Children's Health.

Abstract

The association between pediatric care coordination (PCC) and the prevalence of oral health problems (OHP) among children and youths in the United States was investigated. Using data from the 2022 to 23 National Survey of Children's Health for participants ≤17 years, multivariable Poisson regression models were employed to estimate the association between effective PCC and OHP (the presence of ≥1 parent-reported case of dental caries, gum bleeding, or dental pain). The study estimated the population attributable risk (PAR) to quantify the proportion of potentially avoidable OHP with effective PCC. All models were weighted to account for the complex survey design and adjusted for sociodemographic, health insurance, and geographic covariates. The analytical sample comprised 56,287 participants, representing an estimated target population of 34 million children ≤17 years of age who needed PCC. After controlling for covariates, the difference in the prevalence of OHP between children who received effective PCC (13.1%) and those who did not (17.5%) was statistically significant (adjusted prevalence ratio: 1.33, 95% CI:1.22, 1.44). The PAR was 9.9%, indicating OHP was 9.9% more prevalent among children who lacked effective PCC. Not receiving needed effective PCC was associated with a greater burden of OHP among U.S. children and adolescents. This finding highlights the importance of intentional organization of health services among relevant stakeholders to support optimal oral health.