Dental Homes for Children With Autism

Donald, L.; Momany, Elizabeth T.; Mancl, Lloyd; Lindgren, Scott D.; Zinner, Samuel H.; Steinman, Kyle J.

doi:10.1016/j.amepre.2015.08.022

Cited by 13 publications

(7 citation statements)

References 40 publications

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“…SHCN has been classified as a moderate risk for dental caries in children at 0–5 years ( 37 ). Chi and colleagues found that children with autism were less likely to utilize preventive dental care than those without autism ( 38 ). All those findings indicated that children with complex medical conditions tend to have more dental conditions.…”

Section: Discussionmentioning

confidence: 99%

A Machine Learning Approach to Uncovering Hidden Utilization Patterns of Early Childhood Dental Care Among Medicaid-Insured Children

Peng

Zeng

Townsend

et al. 2021

Front. Public Health

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Background: Early childhood dental care (ECDC) is a significant public health opportunity since dental caries is largely preventable and a prime target for reducing healthcare expenditures. This study aims to discover underlying patterns in ECDC utilization among Ohio Medicaid-insured children, which have significant implications for public health prevention, innovative service delivery models, and targeted cost-saving interventions.Methods: Using 9 years of longitudinal Medicaid data of 24,223 publicly insured child members of an accountable care organization (ACO), Partners for Kids in Ohio, we applied unsupervised machine learning to cluster patients based on their cumulative dental cost curves in early childhood (24–60 months). Clinical validity, analytical validity, and reproducibility were assessed.Results: The clustering revealed five novel subpopulations: (1) early-onset of decay by age (0.5% of the population, as early as 28 months), (2) middle-onset of decay (3.0%, as early as 35 months), (3) late-onset of decay (5.8%, as early as 44 months), (4) regular preventive care (67.7%), and (5) zero utilization (23.0%). Patients with early-onset of decay incurred the highest dental cost [median annual cost (MAC) = $9,499, InterQuartile Range (IQR): $7,052–$11,216], while patients with regular preventive care incurred the lowest dental cost (MAC = $191, IQR: $99–$336). We also found a plausible correlation of early-onset of decay with complex medical conditions diagnosed at 0–24 months. Almost one-third of patients with early-onset of decay had complex medical conditions diagnosed at 0–24 months. Patients with early-onset of decay also incurred the highest medical cost (MAC = $7,513, IQR: $4,527–$12,546) at 0–24 months.Conclusion: Among Ohio Medicaid-insured children, five subpopulations with distinctive clinical, cost, and utilization patterns were discovered and validated through a data-driven approach. This novel discovery promotes innovative prevention strategies that differentiate Medicaid subpopulations, and allows for the development of cost-effective interventions that target high-risk patients. Furthermore, an integrated medical-dental care delivery model promises to reduce costs further while improving patient outcomes.

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Section: Discussionmentioning

confidence: 99%

A Machine Learning Approach to Uncovering Hidden Utilization Patterns of Early Childhood Dental Care Among Medicaid-Insured Children

Peng

Zeng

Townsend

et al. 2021

Front. Public Health

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“…Increased reimbursement also increased utilization of preventive services in dental offices, but it created gaps and exacerbated disparities for certain groups requiring comprehensive care (5)(6)(7)(8). For example, children with autism or intellectual and developmental disability had lower preventive care utilization than their peers (8,9).…”

Section: Introductionmentioning

confidence: 99%

The Impact of COVID-19 on Preventive Oral Health Care During Wave One

Meyer

Danesh

2021

Front. Dent. Med

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Introduction: Early childhood caries burdens children, their families, and the health care system. Utilizing fluoride varnish at medical well-child visits with non-dental primary care providers can be an interprofessional strategy to combat early childhood caries. The COVID-19 pandemic dramatically altered preventive health care delivery and the effects on preventive oral health care delivery have not been previously described.Methods: This analysis used descriptive statistics and non-parametric Wilcoxon Mann-Whitney tests to compare preventive oral health utilization among 1 to 5-year old children in two state Medicaid agencies before and during the pandemic. Fluoride utilization rates at dental visits and medical well-child visits were calculated as number of users per 1,000 enrolled children. Additionally, the proportion of well-child visits that included fluoride application was calculated for each state.Results: During the pandemic, the quarterly fluoride utilization rate significantly decreased at dental visits (pre-pandemic = 153.5 per 1,000 enrolled children; pandemic = 36.1 per 1,000 enrolled children, p < 0.001) and signficantly decreased at medical well-child visits (pre-pandemic = 72.2 per 1,000 enrolled children; pandemic = 32.3 per 1,000 enrolled children, p = 0.03) during the pandemic.Conclusions: The findings highlight the importance of interprofessional collaboration among non-dental primary care providers and dental providers to provide access to preventive oral health services, particularly when access to dentists is limited. Future directions might include rigorous evaluations of co-located medical and dental services or the use of interprofessional telehealth technologies.

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Section: Resultsmentioning

confidence: 99%

“…The percentage of children who required assistance from an adult to perform tooth brushing and did not do so independently ranged from 64.2% (Hage et al, 2020) to 68.0% (Orellana et al, 2019). Medicaid-enrolled children aged 3-17 years with ASD were significantly less likely to utilize preventive care than children without ASD (Chi et al, 2016). Murshid (2015) found that half of the healthcare providers did not provide guidance regarding the importance of oral hygiene and how to perform it on their children.…”

Section: Oral Health Practices Among People With Asd Caregiversmentioning

confidence: 99%

Oral health-care practices and dental assistance management strategies for people with autism spectrum disorder: An integrative literature review

Pimentel Júnior,

de Barros,

de Jesus Filho

et al. 2023

Autism

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Autism spectrum disorder requires a careful approach from professionals and a favorable clinical environment for dental care and assistance. This article aims To perform a literature review about oral health among people with autism spectrum disorder and dental management strategies for this group. An integrative literature review was carried out in three databases, associating the descriptors: (autism or autism spectrum disorder) with (oral health or oral diseases) and (dental care or dental services). After identification and screening steps, 32 articles were included in the study. The most prevalent subjects were oral health conditions, parents’ understanding and practical attitudes about oral health, treatment and management strategies, and the use of technology. The principal barriers to dental care were the scarcity of specialized professionals, unpreparedness in the referral system, poor accessibility of the clinics, and lack of specific care protocols. The world literature on the subject is scarce, and there is still a need for investment and scientific production due to the incidence of autism in the world population and the maintenance of difficulties and barriers in offering quality health care to this group. Lay abstract Autism spectrum disorder requires a more careful approach from oral health professionals and a favorable clinical environment related to dental care and assistance. This article has the objective to perform a literature review about the oral health-care knowledge and practices in people with autism spectrum disorder, as well as the characteristics of dental care for this group. It was carried out in three articles databases, associating descriptors such as autism or autism spectrum disorder; oral health or oral diseases; dental care or dental services. We identified 32 articles. The most prevalent subjects were oral health conditions, treatment strategies, parents’ understanding and practical attitudes about oral health, management, and use of technology to improve oral health care. The principal barriers to people with autism spectrum disorder to access dental care were the scarcity of specialized professionals, unpreparedness in the referral system, poor accessibility of the clinics, and lack of specific care protocols. The world literature on the subject is scarce, and there is still a need for investment and scientific production due to the incidence of autism in the world population and the maintenance of difficulties and barriers in offering quality health care to this group.

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Dental Homes for Children With Autism

Cited by 13 publications

References 40 publications

A Machine Learning Approach to Uncovering Hidden Utilization Patterns of Early Childhood Dental Care Among Medicaid-Insured Children

A Machine Learning Approach to Uncovering Hidden Utilization Patterns of Early Childhood Dental Care Among Medicaid-Insured Children

The Impact of COVID-19 on Preventive Oral Health Care During Wave One

Oral health-care practices and dental assistance management strategies for people with autism spectrum disorder: An integrative literature review

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