Maternal and Child Health Journal

, Volume 20, Issue 3, pp 495–506 | Cite as

Single and Cumulative Relations of Social Risk Factors with Children’s Dental Health and Care-Utilization Within Regions of the United States

  • Alyssa J. YangEmail author
  • Andrea N. Gromoske
  • Melissa A. Olson
  • Jeffrey G. Chaffin


Objectives The purpose is to examine the relation of social risk factors, and the cumulative burden of social risk factors, on parent-reported dental health and dental care-seeking behavior. Methods National Survey of Children’s Health data (2011–2012) were analyzed for US children by Title V Block Grant regions. Multivariate logistic regressions were estimated for ten social risk factors, as well as a cumulative risk index, to find any associations with poor condition of teeth, presence of dental caries, and no dental care visits. Results Almost all of the risk factors were significantly associated with poor condition of teeth and presence of dental caries for the US. Models associating no dental care visits suggested that low family income (OR 1.58), poor maternal mental health (OR 1.54), high school education or less (OR 1.34), and multi-racial/other race (OR 1.18) were significant factors for the US. Regional variation existed for those risk factors and their association with the outcomes, but income, education, and poor maternal mental health consistently played a significant role in adverse outcomes. The cumulative risk index was strongly related to poor oral health outcomes, with a weaker relationship to dental care utilization. Conclusions for Practice US children experiencing certain social risk factors, such as low family income, high school education or less, and poor maternal mental health, are likely to be at greater risk for poor dental health and low levels of dental-care seeking behavior. Children experiencing multiple social risks are at greater risk for poor oral outcomes than children who experience fewer social risks. An approach that involves the social determinants of health is needed to address these issues.


Oral health Dental caries Dental health services Social risk factors 



This study was supported in part by an appointment to the Applied Epidemiology Fellowship Program administered by the Council of State and Territorial Epidemiologists (CSTE) and funded by the Centers for Disease Control and Prevention (CDC) Cooperative Agreement Number 1U380T000143-01.


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Copyright information

© Springer Science+Business Media New York 2015

Authors and Affiliations

  • Alyssa J. Yang
    • 1
    • 2
    Email author
  • Andrea N. Gromoske
    • 2
  • Melissa A. Olson
    • 2
  • Jeffrey G. Chaffin
    • 3
  1. 1.Urban Indian Health Institute, a Division of the Seattle Indian Health BoardSeattleUSA
  2. 2.Wisconsin Department of Health ServicesMadisonUSA
  3. 3.Delta Dental of IowaJohnstonUSA

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