Factors contributing to failed pediatric dental appointments: A scoping review

Stephanie Hsu1image, Katheryn Goldman2image, Manali Murarka3image

Highlights

Children depend on caregivers for dental care access, increasing vulnerability to missed appointments. Identifying barriers is essential to support families and improve pediatric dental attendance.

This scoping review included nine studies and found that children from families using public insurance experience the highest rates of missed pediatric dental appointments.

Findings support targeted outreach for publicly insured families, including reminders, flexible scheduling, transportation support, and policy actions to reduce access inequities.

Abstract

Children are uniquely dependent on caregivers to access health care services, including dental appointments. Reviewing existing literature to identify barriers to care may help highlight at-risk populations and inform strategies to improve appointment attendance and overall access to pediatric dental care. The aim of this scoping review was to identify key factors contributing to missed or failed pediatric dental appointments. A comprehensive literature search was conducted across PubMed, CINAHL, MEDLINE, and Scopus using controlled vocabulary and free-text terms related to pediatric dental care and appointment attendance. Eligible studies were peer-reviewed, published in English after 2000, conducted in the United States, and focused exclusively on missed pediatric dental appointments as the primary outcome. Nine studies were included in the review, each examining barriers to accessing pediatric dental care. Recurrent factors associated with missed appointments were identified across studies. Five studies reported higher nonattendance among populations utilizing Medicaid, four identified longer wait times between scheduling and appointments, three reported racial disparities, and two cited a prior history of no-show appointments as a significant predictor. Missed pediatric dental appointments are consistently associated with lower socioeconomic status and related social determinants of health. Families utilizing public health insurance, including Medicaid for dental care or transportation, experience higher rates of appointment failure. Additional risk factors include children with special health care needs, unconfirmed appointments or caregiver forgetfulness, and logistical challenges such as transportation barriers and limited job flexibility.

Keywords: Appointment and Schedules; Health Services Accessibility; Medicaid; Pediatric Dentistry; Social Determinants of Health

Author Affiliations

  1. Nemours Children’s Health, Wilmington, USA 
  2. Department of Oral Maxillofacial Surgery and Pediatrics, ThomasJefferson University, USA (Correspondence:katheryn.goldman@nemours.org)
  3. Department of Oral Maxillofacial Surgery and Pediatrics, Thomas Jefferson University, USA
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Article Info

Contemp Pediatr Dent 2026:7(1):1-9

Received: 08 August 2025

Accepted: 07 January 2026

Online First: 18 April 2026

DOI: 10.51463/cpd.2025.45

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					Stephanie Hsu, Katheryn Goldman, Manali Murarka. Factors contributing to failed pediatric dental appointments: A scoping review. Contemp Pediatr Dent 2026:7(1):1-9

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