Age at First Dental Visit of Preschool Children Utilizing Public Sector Dental Services in Southeast Queensland, Australia: A Retrospective Cohort Study

OBJECTIVES: This retrospective cohort study describes public dental service use among children aged 0-4 years attending public sector oral health services in Metro North and Metro South Hospital and Health Services, Southeast Queensland. This study analyzes age and reason for first dental visits, and whether access pathways, including Lift the Lip (LtL), influence access for key sociodemographic groups. METHODS: We analyzed electronic oral health records for 41,614 children with a first dental visit between January 2014 and December 2022. Age at first visit and reason for attendance were summarized descriptively. Early attendance (≤ 12 and ≤ 24 months) was compared across LtL and non-LtL pathways and risk groups using chi-square tests with risk differences and risk ratios. RESULTS: The mean age at first visit was 37.7 months (SD 17.0). Overall, 11% of children attended by 12 months and 27% by 24 months, and 83% first presented for general care. LtL-referred children were more likely to attend by 12 (27.7% vs. 4.7%) and 24 months (66.7% vs. 12.4%) than non-LtL children. Early attendance remained lower for Indigenous children, those living with greater disadvantage, and Child Dental Benefits Schedule-eligible children, and higher for children from culturally and linguistically diverse backgrounds. Attendance by 12 months increased after 2016, from 5.2% to 12.0%. CONCLUSION: Few children accessed public dental care by the recommended age of first visit. While LtL substantially improved early attendance, equity gaps persisted, highlighting the need to strengthen early-referral pathways and parent/carer awareness of the recommended timing for a first dental visit.