Characteristics and influencing factors of the first dental visit among children in Bangkok, Thailand: a cross-sectional study

Kasemkhun et al. BMC Oral Health (2024) 24:11 https://doi.org/10.1186/s12903-023-03811-4 BMC Oral Health Open Access RESEARCH Characteristics and influencing factors of the first dental visit among children in Bangkok, Thailand: a cross-sectional study Pornpailin Kasemkhun1*, Varangkanar Jirarattanasopha1 and Wannee Lertsooksawat2 Abstract Background The first dental visit (FDV) is fundamental to good oral health. This study aimed to investigate the characteristics of FDV, including the influencing factors, in children attending the government dental hospital in Bangkok. Methods This study included 289 pairs of new patients (aged 0–12 years) and their parents. The questionnaires, consisting of three parts: socio-demographic, reasons for the child’s FDV and for not having FDV earlier, and the children’s oral health knowledge and attitude, were completed by parents. The Chi-square and Kruskal-Wallis tests were used to compare variables among age groups. The level of statistical significance was set at p < 0.05. A multiple linear regression analysis was performed to identify the factors that influence the age at FDV. The variables included in the analysis were the child’s characteristics, the family’s socio-demographic background, the presence of symptoms, and the parents’ knowledge and attitude towards their child’s oral health. Results The mean ages of children at FDV were 5.57 ± 2.88 (age range of 0.58–11.92) years. There were 2.42% who had FDV ≤ 12 months of age, and 76.5% of all children already had dental caries. A low attitude score among parents was significantly found in the older age group of children (p = 0.001). The influencing factors with the age at FDV were the parental age (p < 0.001), the presence of symptoms or chief complaints (p = 0.016), and the presence of dental caries (p < 0.001). Conclusions Children in Bangkok had seriously delayed FDV compared to the recommended guidelines. The parental age strongly influenced the proper age at FDV, together with the presence of symptoms or chief complaints, and the presence of dental caries. Thus, an effective campaign to raise awareness about FDV is still needed, especially in advanced maternal age. Keywords Dental caries, First dental visit, Oral health *Correspondence: Pornpailin Kasemkhun 1 Department of Pediatric Dentistry, Faculty of Dentistry, Mahidol University, Bangkok, Thailand 2 Department of Pharmacology, Faculty of Dentistry, Mahidol University, Bangkok, Thailand © The Author(s) 2023. Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article’s Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article’s Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated in a credit line to the data. Kasemkhun et al. BMC Oral Health (2024) 24:11 Background According to the recommendation of the American Academy of Pediatric Dentistry (AAPD) [1], American Dental Association (ADA) [2] and European Academy of Pediatric Dentistry (EAPD) [3], the first dental visit (FDV) is recommended at the time of the first tooth eruption and not later than 12 months of age. The objective is to provide parents with the anticipatory guidance and preventive counseling on dental health for children that can also establish the good attitudes in parents that will be passed on to their children and consequently improve the long-term quality of their lives. Moreover, it was found that the sooner a child is seen by a dentist, the smaller the number of treatment needs and the lower the cost of dental procedures [4]. Previous studies showed the different ages of a child’s first dental visit in different countries between the ages of 7 months and 14 years of age. Unfortunately, more than 50% show up with symptoms, and the most common reasons were pain and dental caries [5–10]. Although some of those came for only prophylactic reasons, the decayed teeth and poor oral hygiene were still detected. This demonstrates the misunderstanding of parents about their children’s oral health because the disease already existed in their child’s mouth. Thus, the anticipatory guidance in FDV should not be overlooked. Numerous factors can possibly affect the time of the FDV, such as the socio-demographic characteristics, knowledge, and attitude of parents toward the oral health of themselves and their children. In developing countries, apart from socioeconomic status, it was found that the education level and attitude towards dental health of parents also played an important role in the child’s FDV due to their inverse relationship. In Thailand, the prevalence of dental caries was 52.9%, and the mean decayed teeth have already reached 2.8 per person in 3-year-old children, which could imply that the dental caries occurred instantly after the primary dentition had erupted completely [11]. Thus, characteristics of children’s FDV and the influencing factors affecting the proper period of the FDV are still needed for developing and providing an appropriate strategy to increase parents awareness of the FDV as it has never been specifically established before in Thailand. Therefore, this cross-sectional study is aimed at investigating the characteristics of FDV, including influencing factors, in children attending the government dental hospital in Bangkok, Thailand. Methods Ethical considerations and sample size This cross-sectional study was conducted among children who were aged up to 12 years old and came for the FDV at the pediatric dental clinic of Mahidol University Page 2 of 7 between October 2022 and March 2023, following the protocol that was approved by The Ethics Committee of Mahidol University, Thailand (MU-DT/PY-IRB 2022/ DT115). The sample size was determined by the total population size of the new patients, or 1,042 children who attended the pediatric dental clinic at the same time in the previous year, using Yamane’s formula [12] with 0.05 as the margin of error. The calculated sample size was 289. The inclusion criteria for this study were children aged up to 12 years old who came for their first dental visit and had never had a previous dental visit at any other dental clinic before. The exclus (...truncated)