Understanding and reducing delayed dental care for early childhood caries: a structural equation model approach

Abstract Objective This study aimed to examine the factors that affect treatment delay in early childhood caries (ECC), guided by a modern medical model. This study attempted to analyze the pathways influenced by these factors and provide a theoretical foundation for designing targeted intervention...

Full description

Saved in:
Bibliographic Details
Main Authors: Mengmeng Wang, Yu Zhang, Xiaofei Li, Xin Liu
Format: Article
Language:English
Published: BMC 2025-02-01
Series:BMC Public Health
Subjects:
Online Access:https://doi.org/10.1186/s12889-025-21701-y
Tags: Add Tag
No Tags, Be the first to tag this record!
_version_ 1823861495811801088
author Mengmeng Wang
Yu Zhang
Xiaofei Li
Xin Liu
author_facet Mengmeng Wang
Yu Zhang
Xiaofei Li
Xin Liu
author_sort Mengmeng Wang
collection DOAJ
description Abstract Objective This study aimed to examine the factors that affect treatment delay in early childhood caries (ECC), guided by a modern medical model. This study attempted to analyze the pathways influenced by these factors and provide a theoretical foundation for designing targeted intervention programs. Methods Data were collected from young children who visited the department of stomatology at a tertiary hospital from January to December 2023. Data were collected via a general information survey questionnaire, the Scale of Oral Health Outcomes for 5-year-old Children (SOHO-5), the Children’s Fear Survey Schedule-Dental Subscale-Chinese (CFSS-DS-C), the Parental Caregiver Perceptions Questionnaire-8 (P-CPQ-8), the Family Impact Scale (FIS-8), and the Perceived Barriers to Health Care-Seeking Decision-Chinese (PBHSD-C). The data in this study were analyzed using a variety of statistical tests, including the Kruskal-Wallis and Mann-Whitney tests, correlation analysis, multiple stepwise regression analysis, and structural equation modeling (SEM). Results The treatment delay score of early childhood caries was 36.77 ± 10.11, indicating that the state of early childhood caries was currently at a moderate level of delay. The SOHO-5 score was 6.41 ± 1.78, the CFSS-DS-C score was 23.60 ± 6.91, the P-CPQ-8 score was 18.43 ± 4.33, and the FIS-8 score was 18.66 ± 4.28. Multi-factor analysis revealed key factors affecting treatment delay, including permanent residence, medical insurance type, oral health habits, reasons for visit, first symptoms, the time of first discovery of oral problems, brushing teeth before bedtime every day, a genetic history of dental caries and the staging of dental caries. A positive correlation existed between oral health, children’s dental fear and treatment delay, whereas social support was negatively correlated with treatment delay. The SEM, which is based on the modern medical model, revealed that children’s dental fear plays a mediating role in the relationships among social support, oral health, and treatment delay. Conclusion The present study developed a novel model to study the ECC treatment delay, elucidated the causal links between the identified variables, and proposed potential intervention strategies to enhance oral health awareness, knowledge, and skills among young children and their parents. These strategies can help improve children’s dental visiting behavior and reduce treatment delay.
format Article
id doaj-art-b6dae2e7106a41e1bb2c89551cab3532
institution Kabale University
issn 1471-2458
language English
publishDate 2025-02-01
publisher BMC
record_format Article
series BMC Public Health
spelling doaj-art-b6dae2e7106a41e1bb2c89551cab35322025-02-09T12:58:27ZengBMCBMC Public Health1471-24582025-02-0125111310.1186/s12889-025-21701-yUnderstanding and reducing delayed dental care for early childhood caries: a structural equation model approachMengmeng Wang0Yu Zhang1Xiaofei Li2Xin Liu3The 960th Hospital of the Joint Logistic Support Force of the Chinese People’s Liberation ArmyThe 960th Hospital of the Joint Logistic Support Force of the Chinese People’s Liberation ArmyThe 960th Hospital of the Joint Logistic Support Force of the Chinese People’s Liberation ArmyThe 960th Hospital of the Joint Logistic Support Force of the Chinese People’s Liberation ArmyAbstract Objective This study aimed to examine the factors that affect treatment delay in early childhood caries (ECC), guided by a modern medical model. This study attempted to analyze the pathways influenced by these factors and provide a theoretical foundation for designing targeted intervention programs. Methods Data were collected from young children who visited the department of stomatology at a tertiary hospital from January to December 2023. Data were collected via a general information survey questionnaire, the Scale of Oral Health Outcomes for 5-year-old Children (SOHO-5), the Children’s Fear Survey Schedule-Dental Subscale-Chinese (CFSS-DS-C), the Parental Caregiver Perceptions Questionnaire-8 (P-CPQ-8), the Family Impact Scale (FIS-8), and the Perceived Barriers to Health Care-Seeking Decision-Chinese (PBHSD-C). The data in this study were analyzed using a variety of statistical tests, including the Kruskal-Wallis and Mann-Whitney tests, correlation analysis, multiple stepwise regression analysis, and structural equation modeling (SEM). Results The treatment delay score of early childhood caries was 36.77 ± 10.11, indicating that the state of early childhood caries was currently at a moderate level of delay. The SOHO-5 score was 6.41 ± 1.78, the CFSS-DS-C score was 23.60 ± 6.91, the P-CPQ-8 score was 18.43 ± 4.33, and the FIS-8 score was 18.66 ± 4.28. Multi-factor analysis revealed key factors affecting treatment delay, including permanent residence, medical insurance type, oral health habits, reasons for visit, first symptoms, the time of first discovery of oral problems, brushing teeth before bedtime every day, a genetic history of dental caries and the staging of dental caries. A positive correlation existed between oral health, children’s dental fear and treatment delay, whereas social support was negatively correlated with treatment delay. The SEM, which is based on the modern medical model, revealed that children’s dental fear plays a mediating role in the relationships among social support, oral health, and treatment delay. Conclusion The present study developed a novel model to study the ECC treatment delay, elucidated the causal links between the identified variables, and proposed potential intervention strategies to enhance oral health awareness, knowledge, and skills among young children and their parents. These strategies can help improve children’s dental visiting behavior and reduce treatment delay.https://doi.org/10.1186/s12889-025-21701-yEarly childhood cariesTreatment delayOral healthChildren’s dental fearSocial support
spellingShingle Mengmeng Wang
Yu Zhang
Xiaofei Li
Xin Liu
Understanding and reducing delayed dental care for early childhood caries: a structural equation model approach
BMC Public Health
Early childhood caries
Treatment delay
Oral health
Children’s dental fear
Social support
title Understanding and reducing delayed dental care for early childhood caries: a structural equation model approach
title_full Understanding and reducing delayed dental care for early childhood caries: a structural equation model approach
title_fullStr Understanding and reducing delayed dental care for early childhood caries: a structural equation model approach
title_full_unstemmed Understanding and reducing delayed dental care for early childhood caries: a structural equation model approach
title_short Understanding and reducing delayed dental care for early childhood caries: a structural equation model approach
title_sort understanding and reducing delayed dental care for early childhood caries a structural equation model approach
topic Early childhood caries
Treatment delay
Oral health
Children’s dental fear
Social support
url https://doi.org/10.1186/s12889-025-21701-y
work_keys_str_mv AT mengmengwang understandingandreducingdelayeddentalcareforearlychildhoodcariesastructuralequationmodelapproach
AT yuzhang understandingandreducingdelayeddentalcareforearlychildhoodcariesastructuralequationmodelapproach
AT xiaofeili understandingandreducingdelayeddentalcareforearlychildhoodcariesastructuralequationmodelapproach
AT xinliu understandingandreducingdelayeddentalcareforearlychildhoodcariesastructuralequationmodelapproach