Modifying Rural Adolescent Dental Avoidance: Recruitment Difficulties

Objectives: Adolescents living in rural areas have higher rates of dental disease than their urban counterparts. Adolescents are at an important stage of development during which they are increasingly responsible for their own health. This research attempted to assess an intervention to increase dental attendance in rural avoidant adolescents. Methods: A total of 2762 adolescents (60% of the enrolled students) from 20 junior high and high schools in a rural county in Washington State were examined with a light and mirror by calibrated dentists and dental hygienists using WHO criteria. After the screening, parents received letters describing the extent of their childrens' dental needs (no needs, some needs, and serious needs). Parents of children with serious dental needs were urged to seek dental care for their children and were offered the chance to enroll their child in a study comparing two programs designed to help the adolescent decide to seek out dental care. A second group of emancipated adolescents and young adults (aged < 26) receiving services at the local Health Department was also screened, and eligible individuals were also offered the chance to enroll. Results: Only 23 (6%) of 357 eligible middle and high school adolescents enrolled, compared with 23% of the eligible Health Department clients. A second follow-up letter was sent to the 85 parents of un-enrolled adolescents with the most severe caries, offering direct assistance in obtaining dental care for their children; only 3 families responded. Conclusions: Results of this study suggest that families of avoidant adolescents may not put a high priority on obtaining dental care for their adolescents. The results also suggest that slightly older rural individuals are more interested in overcoming barriers to seeking out dental care. Other, more personal recruitment strategies are suggested for recruiting avoidant adolescents. Supported by NIH/NIDCR grants U54 DE14254 and DE016952.