Effectiveness of Preventive Dental Treatments by Physicians for Young Medicaid Enrollees

Abstract

North Carolina's IMB program was effective in reducing caries-related treatments for children with ≥ 4 IMB visits. Multiple applications of fluoride at the time of primary tooth emergence seem to be most beneficial. Referrals to dentists for treatment of existing disease detected by physicians during IMB implementation limited the cumulative reductions in caries-related treatments, but also contributed to improved oral health.

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

“…Previous studies of NC's POHS program have provided circumstantial evidence of improved oral health status on the basis of administrative claims, including a reduction in dental caries-related treatments and Medicaid payments up to 6 years of age. 18,19 This study provides the first empirical evidence that comprehensive POHS provided by physicians in nondental primary care settings as part of a statewide Medicaid benefit reimbursement policy are associated with a reduction in dental caries in children.…”

“…12,13 The literature suggests that physicians will adopt these services and provide quality care that is effective in increasing access to preventive services, reducing treatment needs, averting hospitalizations, and lowering Medicaid costs. [14][15][16][17][18][19][20] Studies reporting improved oral health have either provided circumstantial evidence on the basis of administrative claims 18,19 or have not examined comprehensive services, which include fluoride varnish applications. 15 This study extends previous work by evaluating the impact of comprehensive POHS, which includes screening and risk assessment, fluoride varnish applications, and parental oral health counseling, provided in medical offices by nondental providers, on the dental caries experience of children enrolled in North Carolina's (NC's) Medicaid program.…”

A review of strategies to increase access to oral health services

“…There is a direct relationship between the oral health status of patients and their socioeconomic and education status (Maupomé, 2013;Oral Health, 2014;Pahel, Rozier, Stearnes, & Quiñonez, 2011;White, 2012). These affected individuals and families have poorer oral health and decreased access to dental care than those with more affluent and educated backgrounds.…”

“…Further, when children receive preventive dental care, it is often not in a timely manner; many parents take their children to the dentist only in times of emergency. Children with dental caries suffer consequences such as tooth pain and difficulty eating or sleeping, which increases the risk of damage to their permanent teeth (Pahel, Rozier, Stearnes, & Quiñonez, 2011). Although dental caries are infectious, they can be prevented with routine visits to the dentist.…”

“…For children up to 6 years of age, treatment caused a 17% reduction in dental caries relative to children with no visits. Thus, the program was effective in reducing dental caries and contributed to improved oral health (Pahel, Rozier, Stearnes, & Quiñonez, 2011).…”