Outcomes of Early Preventive Dental Care

Abstract

Research Article| August 01 2017 Outcomes of Early Preventive Dental Care AAP Grand Rounds (2017) 38 (2): 21. https://doi.org/10.1542/gr.38-2-21 Views Icon Views Article contents Figures & tables Video Audio Supplementary Data Peer Review Share Icon Share Facebook Twitter LinkedIn MailTo Tools Icon Tools Get Permissions Cite Icon Cite Search Site Citation Outcomes of Early Preventive Dental Care. AAP Grand Rounds August 2017; 38 (2): 21. https://doi.org/10.1542/gr.38-2-21 Download citation file: Ris (Zotero) Reference Manager EasyBib Bookends Mendeley Papers EndNote RefWorks BibTex toolbar search toolbar search search input Search input auto suggest filter your search All PublicationsAll JournalsAAP Grand RoundsPediatricsHospital PediatricsPediatrics In ReviewNeoReviewsAAP NewsAll AAP Sites Search Advanced Search Topics: dental procedures, dental caries Source: Blackburn J, Morrisey MA, Sen B. Outcomes associated with early preventive dental care among Medicaid-enrolled children in Alabama. JAMA Pediatr. 2017; 171(4): 335– 341; doi: https://doi.org/10.1001/jamapediatrics.2016.4514Google Scholar Investigators from the University of Alabama at Birmingham and Texas A&M University conducted a retrospective study to assess the effectiveness of preventive dental care during the first 2 years after birth in reducing subsequent caries-related treatment. For the study, they reviewed administrative data of children born between 2007 and 2012 and continually enrolled in Medicaid in Alabama for at least the first 3 years after birth. By using Current Dental Terminology codes, the investigators identified preventive dental care in the first 2 years after birth in study children, including examinations and fluoride varnish administration. Early dental care was dichotomized as being provided by dentists or primary care providers (PCPs). Data on any dentist visits and/or caries-related treatment visits and expenditures beginning during a study child’s third year after birth were identified; dental care expenditures were estimated as the amount paid by Medicaid. Children who receive early preventive dental care were matched to those receiving no early care by using high-dimensional propensity score matching to reduce confounding. Up to 50 demographic, diagnostic, dental procedure, and treatment variables were used in the matching. Regression models were used to compare caries-related treatment and all dental visit rates and expenditures. Separate analyses were conducted in children who received early preventive care from dentists (and their matched control subjects) and those whose early care was provided by PCPs and their matched control subjects. Among 19,658 eligible children, 5,095 (25.9%) received early preventive dental care, including 3,878 from dentists and 1,217 from PCPs. Children who received early preventive care from dentists were significantly more likely to have a subsequent caries-related treatment visit than those in the matched control cohort who received no early preventive dental care (20.6% and 11.3%, respectively; P < .001) and higher mean annual expenditures for caries treatment ($91 and $50, respectively; P < .001). These children with early preventive care provided by dentists also had significantly higher rates of any annual dentist visits and significantly higher dental care expenditures than those without early preventive care. There were no significant differences in visit rates or expenditures between children who received early preventive dental care from a PCP and their matched control cohort. The investigators conclude that children who receive early preventive care from dentists were more likely to have subsequent dental care, including caries-related treatments, and greater dental expenditures than those without early preventive care. Overall, they observed no benefit of early preventive dental care, regardless of provider type. Dr Dubik has disclosed no financial relationship relevant to this commentary. This commentary does not contain a discussion of an unapproved/investigative use of a commercial product/device. Oral health is important to overall health, including growth and performance in school.1 It seems reasonable that preventive dental services, delivered in a timely and efficient manner,... You do not currently have access to this content.