BACKGROUND: Preterm birth is associated with long-term developmental vulnerability, including altered dental development and oral health. Although preterm children tend to visit dental clinics earlier and receive preventive care more frequently than full-term peers, it remains unclear whether such preventive-oriented utilization reduces the need for invasive dental treatment. This study aimed to evaluate dental care utilization patterns and clinical outcomes according to gestational age in preterm children. METHODS: This retrospective observational study analyzed electronic medical records of children who attended a tertiary pediatric dental clinic between January 2020 and December 2024. Participants were classified into four groups based on gestational age: extremely preterm (< 28 weeks), very preterm (28-31 weeks), late preterm (32-36 weeks), and full-term (≥ 37 weeks). Demographic characteristics, age at first dental visit, reasons for visits, preventive and therapeutic dental procedures, sedation and general anesthesia, and early extraction of primary molars were assessed. Group differences were evaluated using chi-square tests and one-way analysis of variance. Multivariable logistic regression analyses were performed to estimate adjusted odds ratios for dental outcomes according to gestational age, controlling for sex, age at first dental visit, and residential area. RESULTS: A total of 7,352 children were included in the analysis. Preterm children, particularly those born extremely preterm, visited dental clinics at a younger age and received preventive interventions, such as fluoride application, more frequently than full-term children (p < 0.001). Despite higher preventive care utilization, extremely preterm children showed higher frequencies of invasive treatments, including tooth extraction and inpatient general anesthesia. Tooth developmental anomalies were significantly more prevalent in all preterm groups, with the highest risk observed in extremely preterm children (adjusted odds ratio 3.43, 95% confidence interval 2.23-5.26). Early extraction was selectively concentrated in the second primary molars among extremely preterm children. CONCLUSIONS: Preterm children, especially those born extremely preterm, demonstrate a distinct dental care trajectory characterized by early preventive utilization but an increased likelihood of invasive treatment once intervention becomes necessary. These findings highlight the importance of risk-stratified surveillance and tailored preventive strategies, with particular attention to developmentally vulnerable teeth, to optimize long-term oral health outcomes in preterm populations.
Lee et al. (Wed,) studied this question.