Abstract: Objectives Early diagnosis and treatment are particularly important for children who have dental caries. It has been reported that some children are not taken to a dental clinic even though they are diagnosed with dental caries at school dental check-ups. The purpose of this study is to investigate factors related to the passive attitude of caregivers regarding dental care visits when elementary and junior high school children are diagnosed with dental caries.Methods A cross-sectional study was conducted utilizing data from the 2016 Adachi Child Health Impact of Living Difficulty (A-CHILD) study. A questionnaire was administered to 1,994 parents of 4th and 6th grade students in elementary school, and 8th grade students in junior high school. Out of the 1,994 parents, 1,652 (83%) responded. Caregivers were asked whether they take their child to the dental clinic immediately if their child is diagnosed with dental caries. Those who answered "cannot take immediately" were defined as caregivers with a passive attitude towards dental care visits. Their reasoning was further probed by the questionnaire. The validity of the answer (i.e., taking their child to the dental clinic) was assessed with the child's untreated dental caries obtained from the results from the school dental health checkup. The number of children excluded in the analysis due to a lack of information on dental caries and/or the attitude of the parents was 1,613. A logistic regression analysis was performed to investigate the association between passive attitude on dental care visit and demographic factors (e.g., child's sex, grade, number of siblings, and household members), lifestyle (e.g., time home for caregiver, grandparent co-residence, skipping breakfast, snacking habits, sugar-sweetened beverage intake, frequency of teeth brushing, and parent-child relationship), and socioeconomic status (e.g., annual household income, educational attainment of caregiver, employment status of caregiver).Results In total, 269 (16.7%) caregivers reported a passive attitude for the dental care visit of their child. The most frequent reason was "I don't have time to take my child to the dental clinic" (172 people, 55.8%). The passive attitude by the caregivers was associated with untreated decay for the child (P<0.001). The passive attitude of the caregiver on the dental care visit was associated with lower maternal educational attainment, skipping breakfast for the child, and lower frequency of brushing teeth. In elementary school children, the passive attitude of the caregiver on the dental care visit was also significantly associated with maternal employment, later time of getting home by the mother and a lack of interaction with children by the caregiver.Conclusion The passive attitude of the caregiver as pertaining to the dental care visit of the child was associated with maternal socioeconomic background. Health promotion activities considering maternal socioeconomic background is needed.
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