Parental incarceration and children's oral health in the United States: Findings from the 2016-2018 National Survey of Children's Health

Objective: This study aimed to examine the association between parental incarceration and children's oral health in the United States and assess the degree to which household socioeconomic factors, children's healthcare insurance and oral healthcare utilization/preventive care explain this association. Methods: Using data from the 2016-2018 National Survey of Children's Health (NSCH; N = 99 962), a series of logistic regression models were used to investigate the association between parental incarceration and a variety of children's oral health conditions. The Karlson-Holm-Breen method was used to assess the degree to which household socioeconomic factors, children's healthcare insurance and oral healthcare utilization/preventive care visits reduced the association between parental incarceration and children's oral health. Results: Results from logistic regression analyses demonstrated that net of control variables, children of incarcerated parents have significantly worse oral health including poor or fair teeth condition (OR = 2.71, 95% CI = 2.23-3.29), toothaches (OR = 1.72, 95% CI = 1.36-2.18), gum bleeding (2.12, 95% CI = 1.52-2.94), cavities/tooth decay (OR = 1.50, 95% CI = 1.26-1.77) and are more likely to have unmet dental care needs (OR = 1.78, 95% CI = 1.28-2.46). Attenuation analyses demonstrated this relationship is partially explained by household material hardship and children's health insurance. Conclusions: Parental incarceration is associated with worse oral health and unmet dental care needs. Household material hardship and children's health insurance partially attenuate this association. Efforts to expand oral health literacy to incarceration-exposed parents, and policies that buffer against material hardship and inadequacies in children's health insurance may be useful for improving oral health of children whose parents have been incarcerated.