Associations of socioeconomic status and lifestyle factors with dental neglect of elementary school children: the MEXT Super Shokuiku School Project

ABSTRACT: BACKGROUND: Despite the fact that there are parents who do not take children with untreated dental caries to a dental clinic, few studies have been conducted to identify the responsible underlying social and family factors. The aim of this study was to investigate whether socioeconomic status and lifestyle factors are associated with dental neglect in elementary school children. METHODS: This study was conducted in 2016 with 1655 children from the Super Shokuiku School Project in Toyama. Using Breslow’s seven health behaviors, the survey assessed: the grade, sex, and lifestyle of the children; parental internet and game use and lifestyle; socioeconomic status. The odds ratios (OR) and 95% confidence intervals (CIs) for having untreated dental caries were calculated using logistic regression analysis. RESULTS: Among the children participating, 152 (3.2%) had untreated dental caries. Among them, 53 (34.9%) had not been taken to a dental clinic despite the school dentist’s advice. Dental neglect was significantly associated with children in higher grades (OR, 2.08; 95% CI, 1.14–3.78), father’s Internet and game use ≥ 2 h/day (OR, 1.99; 95% CI, 1.02–3.88), not being affluent (OR, 2.78; 95% CI, 1.14–6.81), and non-engagement in afterschool activities (OR, 1.99; 95% CI, 1.10–3.62). CONCLUSIONS: Socioeconomic status was the strongest factor associated with dental neglect despite the fact that the children’s medical expenses are paid in full by the National Health Insurance in Toyama, Japan. Future studies should investigate what factors prevent parents of non-affluent families from taking their children to dental clinics and how they can be socially supported to access adequate medical care.