Effects of Physician-Based Preventive Oral Health Services on Dental Caries

Overview

Journal Pediatrics

Specialty Pediatrics

Date 2015 Jul 1

PMID 26122805

Citations 30

Authors

Ashley M Kranz

John S Preisser

R Gary Rozier

Affiliations

Soon will be listed here.

Abstract

Background: Most Medicaid programs reimburse nondental providers for preventive dental services. We estimate the impact of comprehensive preventive oral health services (POHS) on dental caries among kindergarten students, hypothesizing improved oral health among students with medical visits with POHS.

Methods: We conducted a retrospective study in 29,173 kindergarten students by linking Medicaid claims (1999-2006) with public health surveillance data (2005-2006). Zero-inflated regression models estimated the association between number of visits with POHS and (1) decayed, missing, and filled primary teeth (dmft) and (2) untreated decayed teeth while adjusting for confounding.

Results: Kindergarten students with ≥4 POHS visits averaged an adjusted 1.82 dmft (95% confidence interval: 1.55 to 2.09), which was significantly less than students with 0 visits (2.21 dmft; 95% confidence interval: 2.16 to 2.25). The mean number of untreated decayed teeth was not reduced for students with ≥4 POHS visits compared with those with 0 visits.

Conclusions: POHS provided by nondental providers in medical settings were associated with a reduction in caries experience in young children but were not associated with improvement in subsequent use of treatment services in dental settings. Efforts to promote oral health in medical settings should continue. Strategies to promote physician-dentist collaborations are needed to improve continuity of care for children receiving dental services in medical settings.

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References

Pierce K, Rozier R, Vann Jr W . Accuracy of pediatric primary care providers' screening and referral for early childhood caries. Pediatrics. 2002; 109(5):E82-2. DOI: 10.1542/peds.109.5.e82. View

Rozier R, Sutton B, Bawden J, Haupt K, Slade G, King R . Prevention of early childhood caries in North Carolina medical practices: implications for research and practice. J Dent Educ. 2003; 67(8):876-85. View

dela Cruz G, Rozier R, Slade G . Dental screening and referral of young children by pediatric primary care providers. Pediatrics. 2004; 114(5):e642-52. DOI: 10.1542/peds.2004-1269. View

Austin P . A critical appraisal of propensity-score matching in the medical literature between 1996 and 2003. Stat Med. 2007; 27(12):2037-49. DOI: 10.1002/sim.3150. View

Quinonez R, Pahel B, Rozier R, Stearns S . Follow-up preventive dental visits for Medicaid-enrolled children in the medical office. J Public Health Dent. 2008; 68(3):131-8. DOI: 10.1111/j.1752-7325.2007.00055.x. View

King R, Rozier R . School-based dental disease prevention and oral health education: programs of the North Carolina oral health section. N C Med J. 2009; 69(6):490-4. View

Okunseri C, Szabo A, Jackson S, Pajewski N, Garcia R . Increased children's access to fluoride varnish treatment by involving medical care providers: effect of a Medicaid policy change. Health Serv Res. 2009; 44(4):1144-56. PMC: 2739021. DOI: 10.1111/j.1475-6773.2009.00975.x. View

Kressin N, Nunn M, Singh H, Orner M, Pbert L, Hayes C . Pediatric clinicians can help reduce rates of early childhood caries: effects of a practice based intervention. Med Care. 2009; 47(11):1121-8. PMC: 2920219. DOI: 10.1097/MLR.0b013e3181b58867. View

Herndon J, Tomar S, Lossius M, Catalanotto F . Preventive oral health care in early childhood: knowledge, confidence, and practices of pediatricians and family physicians in Florida. J Pediatr. 2010; 157(6):1018-1024.e1-2. DOI: 10.1016/j.jpeds.2010.05.045. View

10.

Beil H, Rozier R . Primary health care providers' advice for a dental checkup and dental use in children. Pediatrics. 2010; 126(2):e435-41. DOI: 10.1542/peds.2009-2311. View

11.

Carvalho D, Salazar M, Oliveira B, Coutinho E . Fluoride varnishes and decrease in caries incidence in preschool children: a systematic review. Rev Bras Epidemiol. 2010; 13(1):139-49. DOI: 10.1590/s1415-790x2010000100013. View

12.

Rozier R, Stearns S, Pahel B, Quinonez R, Park J . How a North Carolina program boosted preventive oral health services for low-income children. Health Aff (Millwood). 2010; 29(12):2278-85. PMC: 5702492. DOI: 10.1377/hlthaff.2009.0768. View

13.

Pahel B, Rozier R, Stearns S, Quinonez R . Effectiveness of preventive dental treatments by physicians for young Medicaid enrollees. Pediatrics. 2011; 127(3):e682-9. PMC: 3065140. DOI: 10.1542/peds.2010-1457. View

14.

Jevtovic-Todorovic V . Anesthesia and the developing brain: are we getting closer to understanding the truth?. Curr Opin Anaesthesiol. 2011; 24(4):395-9. DOI: 10.1097/ACO.0b013e3283487247. View

15.

Albert J, Wang W, Nelson S . Estimating overall exposure effects for zero-inflated regression models with application to dental caries. Stat Methods Med Res. 2011; 23(3):257-78. PMC: 3809340. DOI: 10.1177/0962280211407800. View

16.

Long C, Quinonez R, Beil H, Close K, Myers L, Vann Jr W . Pediatricians' assessments of caries risk and need for a dental evaluation in preschool aged children. BMC Pediatr. 2012; 12:49. PMC: 3394214. DOI: 10.1186/1471-2431-12-49. View

17.

Beil H, Preisser J, Rozier R . Accuracy of record linkage software in merging dental administrative data sets. J Public Health Dent. 2012; 73(2):89-93. PMC: 4629501. DOI: 10.1111/j.1752-7325.2012.00343.x. View

18.

Preisser J, Stamm J, Long D, Kincade M . Review and recommendations for zero-inflated count regression modeling of dental caries indices in epidemiological studies. Caries Res. 2012; 46(4):413-23. PMC: 3424072. DOI: 10.1159/000338992. View

19.

Stearns S, Rozier R, Kranz A, Pahel B, Quinonez R . Cost-effectiveness of preventive oral health care in medical offices for young Medicaid enrollees. Arch Pediatr Adolesc Med. 2012; 166(10):945-51. PMC: 4610377. DOI: 10.1001/archpediatrics.2012.797. View

20.

Dye B, Li X, Thorton-Evans G . Oral health disparities as determined by selected healthy people 2020 oral health objectives for the United States, 2009-2010. NCHS Data Brief. 2012; (104):1-8. View