# Implementation of statutory oral health examinations among Finnish preschool children: a register-based pilot study

## TL;DR

This study examines how well Finland's legal oral health care for preschool children is being implemented, finding significant gaps in service delivery and professional cooperation.

## Contribution

The study provides new insights into the implementation challenges of statutory oral health care for preschool children in Finland.

## Key findings

- 8.7% – 21.4% of children dropped out of statutory oral health care services across different age groups.
- Dentists performed only 3.1% of oral health examinations for preschool-aged children.
- There was scarce cooperation between oral health professionals and no referrals to Child Protection Services.

## Abstract

The purpose of statutory oral health care services based on the Health Care Act (implemented 01 May 2011) and Decree (implemented 06 April 2011) is to provide equal services nationwide for all children. The aim of this register-based study was to explore the implementation and content (multiprofessional co-operation, absenteeism and the need for family’s special support) of statutory oral health examinations and screenings among a group of Finnish preschool children.

The study group consisted of the medical records of Finnish children in the City of Oulu from three different age groups (born in 2014–2018, n = 2,023–2,456). In this pilot study, data on dental examinations/screenings and missed appointments and their reasons of 206 randomly selected preschool-aged were collected from patient records in oral and public child health clinics during March 2022 to July 2022. Referrals within oral health care, along with the occupations of those referred to, were registered. Chi-squared or Fisher’s Exact Test was used to evaluate differences between three age groups.

Across different age groups, 8.7% – 21.4% of children dropped out of statutory oral health care services. Dentists performed only a small proportion of oral health examinations for preschool-aged children (3.1%). Co-operation between oral health professionals was scarce. They rarely solved the reasons for missed appointments of dental care visits (5.1%). No referrals to Child Protection Services were made from oral health care.

In this group of preschool children, implementation of Health Care Act and Decree was only partially completed. Absenteeism from statutory oral health care, addressing the need for Child Protection Services, and lack of multiprofessional co-operation seem to be causes for concern. Further research and attention to this topic is necessary.