Timing of and reason for the first dental visit in pediatric patients diagnosed with Global Developmental Delay
Vassiliki Vallerie Markopoulos1, 2, Rehka Raveendrakumari1, 2, Edwin K.M. Chan1, 2, Beatriz Ferraz Dos Santos1, 2
1Division of Dentistry, Montreal Children’s Hospital, 2Faculty of Dental Medicine and Oral Health Sciences, McGill University,
Background: Global Development Delay (GDD) is defined as the inability to attain developmental milestones in two or more domains. Children with GDD are more likely to have unmet dental needs because of difficulty to implement oral hygiene practices at home, medication use, impaired salivary function, oral aversions, and use of G-tubes. Despite the current recommendation that the first dental visit occurs in the first 12 months of a child’s life, less than 1% of Canadian children visit the dentist by age 2. Although children with GDD are followed by other healthcare professionals, there are currently no studies on whether children with GDD are more or less likely to have their first dental visit at the proposed time in comparison to healthy children. This study aims to determine the age and reason for the first dental visit among children with GDD in comparison with healthy children.
Methods: A retrospective study was conducted at the Montreal Children’s Hospital. Charts of all children diagnosed with GDD and healthy children (controls) who underwent a new patient dental examination between January 1st, 2018 and January 1st, 2023 were reviewed. Data included children’s demographic characteristics, age at first dental visit, referral pathway, family and child’s chief complaint, children’s caries experience, oral hygiene status, and recommended modality of care and treatment needed.
Results: We included 315 children (GDD: 81 and Control: 234). Most patients in both groups were male. The majority of children with GDD underwent their first dental visit were referred by a healthcare
provider whereas, most of the children in the control group were self-referred (56% and 87%, respectively; p<0.001). Children diagnosed with GDD were found to have their first dental visit significantly later than the control group (59 ±40 months and 36 ±21 months, respectively; p<0.0001); however, both groups had their first dental visit significantly later than the recommended 12 months of
age. Importantly, most children in both groups had active caries lesions and required dental treatment (dmft=2.77 for GDD and dmft=3.06 for controls).
Conclusion: Despite being followed by several healthcare providers since a very young age, children with GDD established a dental home much later than the recommended age of 12 months. Strengthened partnerships between the healthcare providers and the dental community is warranted to improve access to oral health services for children with GDD.