Background The authors conducted an observational cohort study to determine the levels of and examine the associations of oral health literacy (OHL) and oral health knowledge in low-income patients who were pregnant for the first time. Methods An analytic sample of 119 low-income patients who were pregnant for the first time completed a structured 30-minute, in-person interview conducted by two trained interviewers in seven counties in North Carolina. The authors measured OHL by means of a dental word recognition test and assessed oral health knowledge by administering a six-item knowledge survey. Results The authors found that OHL scores were distributed normally (mean [standard deviation], 16.4 [5.0]). The percentage of correct responses for each oral health knowledge item ranged from 45 to 98 percent. The results of bivariate analyses showed that there was a positive correlation between OHL and oral health knowledge (P < .01). Higher OHL levels were associated with correct responses to two of the knowledge items (P < .01). Conclusions OHL was low in the study sample. There was a significant association between OHL and oral health knowledge. Clinical Implications Low OHL levels and, thereby, low levels of oral health knowledge, might affect health outcomes for both the mother and child. Tailoring messages to appropriate OHL levels might improve knowledge.
Background The authors evaluated adherence of state Medicaid Early and Periodic Screening, Diagnosis and Treatment (EPSDT) guidelines to recommended best oral health practices for infants and toddlers. Methods The authors obtained state EPSDT guidelines via the Internet or from the Medicaid-CHIP State Dental Association in Washington. The authors identified best oral health practices through the American Academy of Pediatric Dentistry (AAPD), Chicago. They evaluated each EPSDT dental periodicity schedule with regard to the timing and content of seven key oral health domains for infants and toddlers. Results Thirty-two states and the District of Columbia (D.C.) had EPSDT dental periodicity schedules. With the exception of the dentist referral domain, 29 states (88 percent) adhered to the content and timing of best oral health practices, as established by the AAPD guideline. For the dentist referral domain, 31 of the 32 states and D.C. (94 percent) required referral of children to a dentist, but only 11 states (33 percent adhered to best oral health practices by requiring referral by age 1 year. Conclusions With the exception of the timing of the first dentist referral, there was high adherence to best oral health practices for infants and toddlers among states with separate EPSDT dental periodicity schedules. Practical Implications States with low adherence to best oral health practices, especially regarding the dental visit by age 1 year can strengthen the oral health content of their EPSDT schedules by complying with the AAPD recommendations.
Objectives We examined the effect of hospital payor-mix on the proportion of pediatric ED visits that were dental-related. Methods We used the NC Emergency Room Discharge Database from 2007 to 2009 to estimate the relationship between the percent of pediatric ED patients that were covered by Medicaid and the percent of pediatric ED visits that were dental-related. Hospital-level fixed effects controlled for unobserved hospital-level characteristics. Discharge claims from 110 ED facilities in NC were analyzed over the 3-year study period. Claims were limited to individuals under 18 years-old with dental disease-related ICD-9-CM diagnostic codes, 520.00-530.00. Results Using 327 hospital-years of data, 62% of ED visits for pediatric dental reasons were covered by Medicaid, a proportion over two times greater than for pediatric reasons overall, 26%. Hospitals with a greater proportion of Medicaid payors had a greater proportion of pediatric dental ED visits (P<0.01). Conclusions Hospitals serving a large population of children on Medicaid should be prepared to provide emergency dental services. Public health administrators should prioritize oral health resources at hospital communities with a high proportion of Medicaid payors.
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