This study aimed to investigate the factors influencing treatment delay in early childhood caries (ECC) and to explore the pathways through which these factors impact the delay. Guided by a modern medical model, the research seeks to provide a theoretical foundation for developing targeted intervention programs.
Data were collected from young children visiting the stomatology department of a tertiary hospital between January and December 2023. Various tools were used to gather information, including a general information survey, 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). Statistical tests, including Kruskal-Wallis, Mann-Whitney tests, correlation analysis, multiple stepwise regression, and structural equation modeling (SEM), were used to analyze the data.
The study found that the average treatment delay score for early childhood caries was 36.77 ± 10.11, reflecting a moderate delay in seeking treatment. The SOHO-5 score averaged 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. The multi-factor analysis revealed several key factors contributing to treatment delay, including the child’s permanent residence, type of medical insurance, oral health habits, reasons for visiting the dentist, timing of the first symptom, the moment when oral problems were first noticed, whether the child brushed their teeth before bedtime daily, genetic history of dental caries, and the stage of dental caries. A positive correlation was observed between oral health status, children’s dental fear, and treatment delay, while social support was found to be negatively correlated with treatment delay.
The SEM, based on a modern medical model, highlighted that children’s dental fear plays a mediating role between social support, oral health, and treatment delay.
This study introduces a novel model for understanding ECC treatment delay and identifies causal relationships between various factors influencing the delay. It proposes intervention strategies aimed at increasing awareness and improving knowledge and skills related to oral health among young children and their parents. These strategies are expected to enhance dental care-seeking behavior and reduce treatment delays in young children.
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