Ashley M Kranz1, John S Preisser2, R Gary Rozier3. 1. Department of Pediatric Dentistry, School of Dentistry, and akranz@unc.edu. 2. Departments of Biostatistics and. 3. Health Policy and Management, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina.
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.
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.
Authors: Rocio B Quinonez; Ashley M Kranz; Charlotte W Lewis; Lauren Barone; Suzanne Boulter; Karen G O'Connor; Martha Ann Keels Journal: Acad Pediatr Date: 2014-10-30 Impact factor: 3.107
Authors: S Amanda Dumas; Katelynn E Weaver; Seo Young Park; Deborah E Polk; Robert J Weyant; Debra L Bogen Journal: Clin Pediatr (Phila) Date: 2013-04-09 Impact factor: 1.168
Authors: Caroline K Geiger; Ashley M Kranz; Andrew W Dick; Erin Duffy; Mark Sorbero; Bradley D Stein Journal: J Rural Health Date: 2018-12-07 Impact factor: 4.333
Authors: Patricia A Braun; Katina Widmer-Racich; Carter Sevick; Erin J Starzyk; Katya Mauritson; Simon J Hambidge Journal: Am J Public Health Date: 2017-05 Impact factor: 9.308
Authors: Ashley M Kranz; Rachel Ross; Mark Sorbero; Aaron Kofner; Bradley D Stein; Andrew W Dick Journal: J Am Dent Assoc Date: 2020-02-17 Impact factor: 3.634
Authors: David Selvaraj; Shelley Curtan; Tashyana Copeland; Erin McNamee; Jelena Debelnogich; Taylor Kula; Hasina Momotaz; Suchitra Nelson Journal: J Public Health Dent Date: 2020-11-02 Impact factor: 1.821