Tooth decay – or cavities – is one of the most common preventable chronic health conditions in childhood. Tooth decay can have major health and school-related consequences for kids. For instance, children who experience tooth decay are more likely to experience severe dental pain, miss school, and perform poorly in school.
In this report, we examine child dental health as well as parent dental health in Chicago. Researchers at Ann & Robert H. Lurie Children’s Hospital teamed up with the Chicago Department of Public Health (CDPH) on the 2018-19 Healthy Chicago Survey, Jr. to ask parents from all 77 community areas in Chicago whether their child had a preventive dental visit in the last year, and whether parents themselves had a preventive dental visit.
To explore pediatric dental health in Chicago, we asked parents the following question about one of their children, who was selected at random: “During the past 12 months, did your child see a dentist or other oral health care provider for preventive dental care, such as check-ups and dental cleanings, dental sealants, or fluoride treatments?” Eighty-seven percent of children who were one year old or older had received preventive dental care within the last year (Figure 1). We limited this analysis to children one year old and older based on the American Academy of Pediatric Dentists recommendation that children have their first dental visit when the first tooth appears or no later than his or her first birthday.
The rates of pediatric preventive dental care for Chicago children from our survey were higher than rates for children in Illinois (76%) and nationally (80%) based on data from the National Survey of Children’s Health 2017-2018 (the most recently available data).
Illinois is one of only fourteen states in the nation, plus the District of Columbia, that has mandated school-entrance dental exams. The Illinois mandate requires that all children entering Kindergarten, Grade 2, Grade 6 and Grade 9 have an oral health examination by a licensed dentist. This requirement applies to children in public, private, and parochial schools, and parents must present a Proof of School Dental Examination Form before the end of the school year. In the 2013-14 school year (the most recent year for which data is available), 71% of Illinois students were in compliance with the state mandated school-entrance dental exams.
Among Chicago youth who had a preventive dental visit within the last year, the majority went to a dentist office for their care (85%), and 15% went to a non-dentist office (e.g., health center, school).
Chicago Public Schools has information online about dental examinations and their oral health program with the Chicago Department of Public Health.
There were no differences in preventive dental care among Chicago youth by household income, child’s school type (public vs. non-public), child gender, child’s race and ethnicity, health insurance coverage, or the child’s health status. However, there was a difference by child age such that older children (6-18 years old) were more likely to have had a preventive dental visit in the last year (94%) than younger children (0-5 years old; 72%), which is consistent with state and local data.3
One potential reason that older Chicago children are more likely to access preventative dental care is that the Illinois mandate for preventive dental care applies to school-age children, not children who have not yet entered kindergarten.
We also asked parents about their own preventive dental care with the following question: “How long has it been since you had your teeth cleaned by a dentist or dental hygienist?” Among parents in our survey, only 66% had their teeth cleaned by a dentist or dental hygienist in the last year (Figure 2). This is similar to national data from 2017, which showed that 64% of adults 18-64 had a preventive dental health visit in the last year. Furthermore, in Chicago, 10% of parents said that they had not had a teeth cleaning in five years or more.
In contrast with the findings for child dental preventive care, parental dental care was associated with factors such as household income, education level, ethnicity, health insurance and health status. For instance, parents with low household income (below the federal poverty line) were the least likely to have had a dental checkup (53%), followed by low to middle income parents (100-399% FPL; 64%), and those with higher income (400%+ FPL, 80%) (Figure 2). Parent dental visits were also associated with the likelihood that their child had a preventive dental visit. Specifically, parents who had been to the dentist for preventive care themselves were more likely to have children who received dental care in the last year as well (90% vs. 80%).
Oral health is connected to positive outcomes for both youth and adults. Establishing healthy dental hygiene practices such as daily brushing and flossing, and having regular preventive dental care can help set children up for better oral health in childhood and into adulthood.