Sociodemographic determinants of dental care utilization among children receiving public assistance in Japan: A one-year observational study

Background Access to dental care for all children is a matter of human rights. While public assistance (PA) programs can potentially improve access to dental care through income support for daily living and healthcare services among children in low-income households, other social vulnerabilities influence access. We aimed to investigate the sociodemographic determinants of dental care access for children on PA in Japan. Methods This study included all children receiving PA benefits in six municipalities. We extracted sociodemographic data as of April 2016 on age, sex, single-parenthood, parents’ working status, nationality, presence of siblings, disability certificates, and timing of households’ PA receipt, and observed them for one year. Medical assistance claim data was used to identify children’s dental care use as the outcome. Cumulative incidence ratios (CIR) for each variable were calculated using multivariable modified Poisson regression analysis. Results Of the 1,990 children on PA, the mean age was 8.32 (standard deviation; 4.12), 998 (50.2%) were girls, 1256 (63.1%) lived in single-parent households, and 532 (26.7%) were born into households already receiving PA, and 1085 (54.5%) children accessed dental care. Children living in single-parent households had a higher dental care use (CIR: 1.12, 95% CI: 1.03–1.23) than those in non-single-parent households. Children born in PA households had a lower dental care use (CIR: 0.88, 95% CI: 0.79–0.98) than those who began receiving PA after birth. Conclusions Despite Japan’s comprehensive welfare PA system, dental care access barriers persist, particularly among children from non-single-parent households and those born into PA.