Oral Health and Academic Achievement of Children in Low-Income Families

Abstract

Low-income children have higher rates of unmet oral health needs. Prior research suggests that poor oral health is associated with lower academic performance but uses cross-sectional and mostly parent-reported measures. This study examined the association between oral health during the first 5 y of life and subsequent academic achievement for low-income children. Birth certificates of children born in Iowa in 1999–2009 were linked to Medicaid enrollment and dental claims data in 1999–2014 and reading and math standardized school test scores for grades 2 through 11. The following oral health measures were examined: having minor dental treatments (mostly surface fillings), major dental treatments (mostly crowns and pulpotomy) or extractions, and comprehensive dental exams during the first 5 y of life. Regression models were estimated adjusting for sociodemographic factors, early infant health, and school district effects. The sample included 28,859 children and 127,464 child-grade observations. In total, 21%, 12%, and 62% of children had at least 1 minor dental treatment, 1 major treatment or extraction, and 1 comprehensive dental exam in the first 5 y of life, respectively. Children who received a minor dental treatment had higher reading and math scores by 1 percentile (95% CI, 0.09–1.9) and 0.9 percentiles (95% CI, 0.02–1.8), respectively. Children who had a major dental treatment or extraction had lower reading and math scores by 2.4 (95% CI, −3.5 to −1.4) and 1.8 (95% CI, −2.8 to −0.8) percentiles. Children who had a comprehensive oral exam had higher reading and math scores by 0.7 (95% CI, 0.06–1.4) and 1.2 (95% CI, 0.6–1.9) percentiles. The findings suggest that children’s oral health before school age is associated with academic achievement later during school years.