Preventive dental utilization for Medicaid-enrolled children in Iowa identified with intellectual and/or developmental disability

Abstract

Objectives To compare preventive dental utilization for children with intellectual and/or developmental disability (IDD) and those without IDD and to identify factors associated with dental utilization. Methods We analyzed Iowa Medicaid dental claims submitted during calendar year (CY) 2005 for a cohort of children ages 3–17 who were eligible for Medicaid for at least 11 months in CY 2005 (n=107,605). A protocol for identifying IDD children was developed by a group of dentists and physicians with clinical experience in treating children with disabilities. Utilization rates were compared for the two groups. Crude and covariate-adjusted odds ratios were estimated using conditional logistic regression modeling. Results A significantly higher proportion of non-IDD children received preventive care than those identified as IDD (48.6% versus 46.1%; p<0.001). However, the final model revealed no statistically significant difference between the two groups. Factors such as older age, not residing in a dental Health Professional Shortage Area, interaction with the medical system, and family characteristics increased one’s likelihood of receiving preventive dental care. Conclusion Although IDD children face additional barriers to receiving dental care and may be at greater risk for dental disease, they utilize preventive dental services at the same rate as non-IDD children. Clinical and policy efforts should focus on ensuring that all Medicaid-enrolled children receive need-appropriate levels of preventive dental care.

Dental utilization for Medicaid‐enrolled children with cystic fibrosis

“…The main dependent variable in our study was whether a child utilized any dental care in 2012, defined as the presence of any dental claim (84). In addition, we created four variables to represent different types of dental care using previously published criteria (84).…”

“…In addition, we created four variables to represent different types of dental care using previously published criteria (84). Diagnostic care (e.g.…”

Economic Modeling of Sealing Primary Molars Using a “Value of Information” Approach

“…However, consistent with caries prevalence rates, only half as many low-income children receive sealants as their higher income peers (Dye et al, 2007). Previous studies have identified the enablers and barriers to preventive dental care services for publicly insured children (Chi and Milgrom, 2009;Chi et al, 2010;Rozier et al, 2010;Askelson et al, 2014). Only 1-in-3 state Medicaid programs reimburses dentists for primary molar sealants (Chi and Singh, 2013), which is a potential barrier to the receipt of sealants for low-income children.…”

Perceptions of autistic children’s parents about dental care: Preliminary study. Concepción, 2012.

“…The main barriers are the child's behavior and the economic cost and the percentages and barriers are almost identical to those found in this study. However, in the United States it has been reported that, in spite of some barriers, access to preventive treatment for children with intellectual or development deficits is close to 50%, similar to that of children without these disorders 12 . On the other hand, the results of this study indicate that a third of such population attends only for check-up, very few only for emergency and they are mostly attended by pediatric dentists.…”

“…Second, there are no validated or at least widely used instruments to assess parents' perception about dental care. Therefore, an unprecedented survey, condensing the main issues reported in literature, was compiled [1][2][3][4][5][6][7][8][9][10][11][12][13][14][15][16][17][18] .…”