Psychosocial Risk Exposure Limits Routine Pediatric Oral Health Care

Dorota T Kopycka-Kedzierawski; Changyong Feng; Ronald J Billings; Gene E Watson; Patricia G Ragusa; Kimberly Flint; Cynthia L Wong; Steven R Gill; Samantha Manning; Thomas G O'Connor

doi:10.1016/j.focus.2024.100191

Psychosocial Risk Exposure Limits Routine Pediatric Oral Health Care

AJPM Focus. 2024 Jan 20;3(2):100191. doi: 10.1016/j.focus.2024.100191. eCollection 2024 Apr.

Authors

Dorota T Kopycka-Kedzierawski¹, Changyong Feng^{2

3}, Ronald J Billings¹, Gene E Watson^{1

4

5}, Patricia G Ragusa¹, Kimberly Flint¹, Cynthia L Wong^{6

7}, Steven R Gill^{6

7

8}, Samantha Manning², Thomas G O'Connor^{9

10

11

12}

Affiliations

¹ Department of Dentistry, Eastman Institute for Oral Health, University of Rochester, Rochester, New York.
² Department of Biostatistics and Computational Biology, University of Rochester, Rochester, New York.
³ Department of Anesthesiology and Perioperative Medicine, University of Rochester, Rochester, New York.
⁴ Department of Pharmacology & Physiology, University of Rochester, Rochester, New York.
⁵ Department of Environmental Medicine, University of Rochester, Rochester, New York.
⁶ Department of Pediatric Dentistry, Eastman Institute for Oral Health, University of Rochester, Rochester, New York.
⁷ Department of Pediatrics, Eastman Institute for Oral Health, University of Rochester, Rochester, New York.
⁸ Department of Microbiology and Immunology, University of Rochester, Rochester, New York.
⁹ Department of Psychiatry, University of Rochester, Rochester, New York.
¹⁰ Department of Psychology, University of Rochester, Rochester, New York.
¹¹ Department of Neuroscience, University of Rochester, Rochester, New York.
¹² Department of Obstetrics and Gynecology, University of Rochester, Rochester, New York.

Abstract

Introduction: This study aimed to identify social, psychological, and contextual factors that influenced attendance at routine oral health visits in a cohort of 189 preschool children who were followed over a 2-year period.

Methods: Generalized estimating equation was used to examine the association between clinic attendance and the predictors. ORs and 95% CIs were reported in the multiple logistic regression models. The study was conducted in Rochester, New York, between February 2016 and February 2021.

Results: Prior to the COVID-19 pandemic declaration, the rate of canceled and no-show appointments was greater for routine clinic visits (20% and 24%, respectively) than for research visits (14% and 9%, respectively) for the same participants; these rates increased during the pandemic. After adjusting for sociodemographic factors, the likelihood of a canceled or no-show appointment was associated with parental depression (OR=1.06, CI=1.03, 1.09), regardless of the type or occurrence of the visit.

Conclusions: Findings from this study demonstrate that attendance to oral health care in young children is reliably reduced with parental depression and that this may provide one mechanism for early emerging health inequalities of oral health.

Keywords: COVID-19; Oral health care; parental depression; psychosocial factors; routine oral health visit; social factors.