366 - Age at Dental Home Establishment and Caries Onset Time

Age at Dental Home Establishment and Caries Onset Time,  Wong C, Enany E, Wang H (University of Rochester, Rochester, NY)

Purpose: The purpose was to explore the relationship between the age of dental home establishment and caries experience in children on state-funded insurance. We hypothesized that the later the age of dental home establishment, the patient would experience dental caries earlier, and the patient’s caries extent would likely require advanced behavior management such as nitrous oxide inhalation, oral conscious sedation, or general anesthesia.

Methods: The retrospective pilot study (chart review) included 500, 1 to 5 year old children having their first dental visit at EIOH Pediatric Dentistry Clinic during a 2-year period. All study subjects were followed for a period of 4 years. Kaplan Meier survival curves were plotted with the survival time to new caries as the outcome. Spearman correlations were used to determine the relationship between age at first dental visit and primary caries, number of fluoride varnish applications, and number of recall visits.

Results: The average age at dental home establishment was 37 months and average time to new caries detection was 21 months. Children who established their dental home at <1 year of age remained caries-free during 4 year follow-up period and exhibited better survival time to first caries detection. As age at first dental visit increased, the number of children needing advanced behavior guidance techniques increased. A potential protective relationship between number of fluoride varnish applications and age at first dental visit, indicating a protective effect, was seen.

Conclusion: The results support the AAPD recommendation of dental home establishment by age 1.