Preventive Dental Care and Long‐Term Dental Outcomes among <scp>ALL</scp> Kids Enrollees

Sen, Bisakha; Blackburn, Justin; Kilgore, Meredith L.; Morrisey, Michael A.; Becker, David J.; Caldwell, Cathy; Menachemi, Nir

doi:10.1111/1475-6773.12469

Cited by 15 publications

(23 citation statements)

References 20 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Despite early reports suggesting that dental caries–related expenditures are less among children who use POHS (Pahel et al 2011; Beil et al 2012; Sen et al 2013; Achembong et al 2014; Sen et al 2016), our results are consistent with more recent data (Blackburn et al 2017). Our results show that non-GA dental expenditures are similar over an 8-y follow-up regardless of whether children used POHS.…”

Section: Discussionsupporting

confidence: 86%

“…An opportunity exists to explore the impact of POHS on dental GA utilization and expenditures. While some authors have examined caries-related treatment differences between children who received POHS and those who did not (Beil et al 2012; Sen et al 2013; Sen et al 2016), no evaluation compares the use of GA for dental treatment between these groups. The purpose of this article is to begin to assess whether POHS may influence dental GA utilization among Medicaid-enrolled children in North Carolina.…”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

The Effect of Physician Oral Health Services on Dental Use and Expenditures under General Anesthesia

Meyer

Wang

Steiner

et al. 2019

JDR Clinical & Translational Research

View full text Add to dashboard Cite

Background: Despite early evidence touting the effectiveness of physician-provided oral health services (POHS), recent evidence suggests these services might have little impact on caries-related outcomes in children. General anesthesia (GA) is often used to treat early childhood caries and may be considered the most extreme utilization outcome. We sought to assess the impact of POHS utilization on dental GA utilization and expenditures. Methods: We used the Medicaid claims of a birth cohort of children born in 2008 in North Carolina ( N = 32,558) to determine the impact of POHS on dental utilization and expenditures under GA for individual children. Children were followed until their eighth birthday. We analyzed the association of the number of prior POHS visits with visit-specific outcomes of dental treatment under GA using population-averaged models fit with generalized estimating equations with exchangeable working correlation structure. Results: Children with 2 or more previous POHS visits had reduced odds of GA (odds ratio [OR] = 0.93; confidence interval [CI], 0.87–0.99; P = 0.029) and expenditures ($114; CI,−$152.61 to −$75.19; P < 0.001) compared to those without physician-provided oral health visits, adjusting for age, sex, race/ethnicity, and geographic residence. Dental expenditures did not differ between POHS and non-POHS subjects at non-GA visits. Conclusions: POHS decreased the odds of having dental GA treatment and dental expenditures at GA visits. The role of physicians in oral health care can reduce the impact on the most severe outcome—treatment under general anesthesia. Knowledge Transfer Statement: The results of this study have important financial implications for state Medicaid programs and disease management programs trying to mitigate the costs of treating early childhood caries under general anesthesia. Children who receive physician oral health care are less likely to use and more likely to save money on general anesthesia to complete dental treatment.

show abstract

Section: Discussionsupporting

confidence: 86%

Section: Introductionmentioning

confidence: 99%

The Effect of Physician Oral Health Services on Dental Use and Expenditures under General Anesthesia

Meyer

Wang

Steiner

et al. 2019

JDR Clinical & Translational Research

View full text Add to dashboard Cite

show abstract

“…18,19,58,59,60 Sen et al reported that among Medicaid-enrolled children under age 3, preventive dental visits without sealant placement were associated with increased NTDC ED use. 32…”

Section: Other Enabling Factorsmentioning

confidence: 99%

“…There is considerable heterogeneity within the literature in the methods used for analyzing ED use for NTDCs. Some studies have examined primary data, 14,27,28,29,30 discharge records, 31 claims data, 13,17,32 or self-reported surveys. 33,34 Regarding study setting, studies have analyzed data from local, state, or nation-wide electronic databases, raising questions about generalizability of the findings.…”

Section: Introductionmentioning

confidence: 99%

Emergency department visits for nontraumatic dental conditions: a systematic literature review

Akinlotan

Ferdinand

2020

J Public Health Dent

View full text Add to dashboard Cite

Objective: To summarize the literature on factors associated with emergency department (ED) use for nontraumatic dental conditions (NTDCs). Methods: Following a database search, empirical studies were included if they examined factors associated with ED visits for NTDCs. The factors identified in these studies were further categorized using the Andersen Behavioral Model. Where appropriate, odds ratios (ORs) predicting the likelihood of NTDC ED visits were extracted to obtain summary estimates using random effects models. Results: Sixty-three articles were included. Nontraumatic dental ED visits made up about 2.2 percent of all ED visits. Having public health insurance coverage such as Medicaid [OR = 2.17, 95 percent confidence interval (CI) = 1.79-2.64], and being uninsured (OR = 2.80, 95 percent CI = 2.39-3.39) were predictive of ED visits for NTDCs. Adults were more likely to use the ED for NTDCs compared to children and older adults. Rural adults had increased odds of ED use for NTDCs compared to urban adults (OR = 1.31, 95 percent CI = 1.12-1.52). Among younger children, regular dental care without sealant placement was associated with increased ED use for NTDCs. In the United States, both expansion and restriction of Medicaid dental coverage for adults were associated with increased ED visits for NTDCs. Conclusions: Policy makers and health care providers should address modifiable factors such as accessible dental care for the uninsured, and comprehensive dental coverage for those with public dental benefits. Targeted interventions should focus on young adults, children with special needs, and subpopulations with low socioeconomic status and chronic health conditions.

show abstract

“…Additionally, although reimbursement may affect getting children to the dental office, it may not influence services received there and may differentially benefit the oldest children rather than the youngest (13). In response to a 2004 US Supreme Court decision that required Texas's Medicaid program to comply with guidelines on increasing access to dental care providers (14), Texas increased the amount of fees reimbursed for dental preventive care by 52.5% on September 1, 2007. Although increasing access to preventive dental care is important, preventive care alone does not reduce the likelihood of needing tertiary oral health services (caries-related surgery, sedation, and ED visits) (15). Previous research established that Medicaid reimbursements for preventive dental care substantially increased selfreported preventive dental visits in several states (11).…”

Section: Introductionmentioning

confidence: 99%

Does Preventive Care Reduce Severe Pediatric Dental Caries?

et al. 2020

View full text Add to dashboard Cite

What is already known on this topic? Increasing dental provider reimbursements for preventive care visits is an effective policy intervention to increase preventive dental visit use among Medicaid-enrolled children. What is added by this report? Increased preventive care dental visits did not translate into significant changes in pediatric dental surgeries after a reimbursement-focused policy intervention. What are the implications for public health practice? Interventions to reduce pediatric dental surgery should reflect the social determinants of oral health, including access to regular dental care and household oral health behaviors.

show abstract

Preventive Dental Care and Long‐Term Dental Outcomes among ALL Kids Enrollees

Abstract: Whether PDVs without sealants actually reduce restorative/emergency pediatric dental services is questionable. Further research into benefits of PDV is needed.

Cited by 15 publications

References 20 publications

The Effect of Physician Oral Health Services on Dental Use and Expenditures under General Anesthesia

The Effect of Physician Oral Health Services on Dental Use and Expenditures under General Anesthesia

Emergency department visits for nontraumatic dental conditions: a systematic literature review

Does Preventive Care Reduce Severe Pediatric Dental Caries?

Contact Info

Product

Resources

About