LAUSR

BACKGROUND Dental caries is a significant public health problem for low-income children with special health care needs (CSHCN). AIM We evaluated associations between oral health behaviors (e.g., diet, fluoride, dental care) and caries for CSHCN enrolled in Medicaid, a health insurance program for low-income populations that provides comprehensive dental coverage for children. DESIGN We recruited 116 CSHCN ages 7 to 20 years from Medicaid enrollment files in Washington state, USA. Caregivers completed a 166-item questionnaire and children received a dental screening. The outcome was dental caries, defined as total pre-cavitated, decayed, missing, or filled tooth (PDMF) surfaces. We ran log-linear regression models and generated prevalence rate ratios (PRR). RESULTS The mean age of study participants was 12.4±3.1 years, 41.4% were female, and 38.8% were white. The mean PDMF surfaces was 6.4±9.4 (range: 0 to 49). Only sugar-sweetened beverage intake was significantly associated with dental caries. CSHCN who consumed >4 sugar-sweetened beverages per week were significantly more likely to have tooth decay than those who consumed no sugar-sweetened beverages (PRR: 2.58; 95% CI: 1.37, 4.85; P<0.01). CONCLUSION Sugar-sweetened beverages are an important target for future behavioral interventions aimed at preventing dental caries in low-income CSHCN.