Many young children off to a poor start with dental health

October 24, 2011 Volume 13 Issue 6
  • Dental visits are recommended to begin by age 1, but most children 1-2 years old have not seen a dentist.
  • Less than half of parents say health care providers talked with them about taking their child to a dentist.
  • 1 in 10 parents say a health care provider noted a problem with their child’s teeth at age 1-2.

Dental problems such as early childhood caries (cavities in the baby teeth) are the leading cause of chronic disease for young children.  Therefore, child health experts recommend that children begin oral health care by age 1, or when their first teeth emerge. However, families may not know about recommendations for early oral health care. In addition, finding a dentist who will see young children – especially those covered by Medicaid – is a longstanding problem in many communities.  To address this issue, pediatricians and other health care professionals are now seen as key partners in oral health.  

In April 2011, the National Poll on Children’s Health asked parents about oral health care for children age 1-5. 

Dental Visits

As shown in Figure 1, the proportion of young children who have been to the dentist increases with age.  However, more than half of children under age 3 have not seen a dentist.

Among parents of children age 1-2, only 37% thought the first dental visit should occur at age 1 or earlier; 49% said age 2-3, and 14% said age 4 or older. 

Oral Health Care during Well-Child Visits

Parents of children age 1 to 2 reported on oral health care performed by a health care provider during their children’s most recent well-child visit.

  • 68% said their children’s teeth were examined
  • 46% discussed taking their children to the dentist
  • 47% talked about how to clean their children’s teeth
  • 10% were told there was a problem with their children’s teeth
  • 16% said fluoride varnish was applied to their children’s teeth


Based on strong evidence of dental problems in up to one third of preschool-aged children, the American Academy of Pediatrics and other child health organizations have boosted their recommendations for oral health care, including dental visits beginning at age 1. However, many parents do not appreciate the importance of establishing dental care early in life.  Findings from this Poll indicate that the majority of children 1-2 years old have not seen a dentist, and many of their parents do not believe a dental visit is necessary at such a young age.  Thus, the majority of children rely on pediatricians and other medical providers as their chief source of early oral health care.

Almost all children obtain well-child care. These visits are an ideal time for providers to examine the teeth, assess the risk of caries and other dental problems, and guide parents about the actions needed to maintain healthy teeth, including dental visits.  Unfortunately, these critical activities do not appear to happen routinely for very young children:  1 in 3 children younger than 3 years old did not have their teeth examined, and only half of parents recall a discussion about cleaning the teeth or taking the child to the dentist.  It is not surprising that 10% of parents of 1-to-2-year-olds report being told their child already had problems with their teeth. 

Children will benefit if parents, health care providers, and dentists all recognize the need for oral health care early in life and work together to ensure that children receive the appropriate dental care at home, in the primary care setting, and at the dentist’s office.  

Data Source

This report presents findings from a nationally representative household survey conducted exclusively by Knowledge Networks, Inc. (KN), for C.S. Mott Children’s Hospital via a method used in many published studies. The survey was administered in May 2011 to a randomly selected, stratified group of parents age 18 and older (n= 571) with a child age 1 to 5 from the KN standing panel that closely resembles the U.S. population.  The sample was subsequently weighted to reflect population figures from the Census Bureau.  The survey completion rate was 54% among parent panel members contacted to participate.  The margin of error is ± 5 to 11 percentage points.

Director: Matthew M. Davis, MD, MAPP
Associate Director: Sarah J. Clark, MPH
Manager & Editor: Dianne C. Singer, MPH
Data Analyst: Amy T. Butchart, MPH
Web Editor: Anna Daly Kauffman, BA

This Report includes research findings from the C.S. Mott Children's Hospital National Poll on Children's Health, which do not represent the opinions of the investigators or the opinions of the University of Michigan. The University of Michigan reserves all rights over this material.


We are interested in learning about how parents take care of their children’s teeth. For the following questions, please think about your [x-year old] child. Sometimes, health care providers (doctors or nurse practitioners) examine children’s teeth as part of well-child visits (check-ups).

Q1. At your [x-year old] child's most recent well-child visit, did the health care provider:
Select one response in each row.

  Yes No Don't know
Examine your child’s teeth      
Apply fluoride varnish to child’s teeth      
Talk with you about how to clean child’s teeth      
Talk with you about how to keep teeth healthy      
Talk with you about taking child to the dentist      
Say that there is a problem with your child’s teeth      

Q2. In YOUR opinion, at what age should children have their first visit to a dentist?

[drop down box age 0-8]

Q3. Has your [x-year old] child been to a dentist?

  • Yes
  • Tried but did not have visit
  • No, never tried

[If Q3 = Yes, then Q4]

Q4. How old was your [x-year old] child at his/her first dentist visit?

[drop down box age 0-5 yrs]

Participants were also asked demographic questions on gender, race/ethnicity, annual household income, education and insurance status.

All information is the sole property of the University of Michigan C.S. Mott Children's Hospital National Poll on Children's Health.  It can only be used if there is an acknowledgment that "The information came from, is copyright by and is owned by and belongs to the Regents of the University of Michigan and their C.S. Mott Children's Hospital National Poll on Children's Health. It cannot be republished or used in any format without prior written permission from the University."

C.S. Mott Children’s Hospital National Poll on Children’s Health
Director: Matthew M. Davis, MD, MAPP
Associate Director: Sarah J. Clark, MPH
Manager & Editor: Dianne C. Singer, MPH
Data Analyst: Amy T. Butchart, MPH
Web Editor: Anna Daly Kauffman, BA

Click on an image to download the full-size version

Young ChildrenPoor Start with Dental Health