Geographic Distance to Dental Home and Dental General Anesthesia Utilization Among Children with Cleft Lip and/or...

ObjectivesTo describe oral health status, sociodemographics, and history of dental general anesthesia (DGA) utilization, and to evaluate whether geographic distance to dental home was associated with DGA utilization among patients with cleft lip and/or palate (CL/P).DesignCross-sectional study using caregiver questionnaires, dental examinations, and electronic health records.SettingInstitutional tertiary craniofacial center.Patients, Participants452 patients from birth to 19 years of age seen between August 2023 and October 2025.ExposuresEuclidean distance, driving distance, and driving time from residence to dental home.Main Outcome Measure(s)The association between geographic distance from patient residence to dental home and history of DGA utilization was investigated using a multivariable logistic regression model.ResultsThe study population included patients with cleft lip alone (14.4%), cleft palate alone (36.7%), and cleft lip and palate (48.9%). 19.3% had an associated condition, most commonly Pierre Robin sequence. Most patients were male (56.2%), White (46.2%), and Medicaid-insured (61.3%). The prevalence of dental caries, restorations, gingivitis, and dental trauma were 26.1%, 45.8%, 41.7%, and 10.8%, respectively. Most patients (84.0%) had an established dental home, and 21.7% had a history of DGA. DGA prevalence increased linearly across driving distance quartiles from 15.2% to 30.4%. Each quartile increase in driving distance was associated with higher odds of DGA use (adjusted odds ratio = 1.36; 95% confidence interval: 1.07-1.72).ConclusionsGreater distance to dental home was associated with history of DGA utilization among patients with CL/P, suggesting geographic access may be associated with patterns of dental care delivery and warranting further investigation.