Preventive Services by Medical and Dental Providers and Treatment Outcomes

Abstract

Objective: Nearly all state Medicaid programs reimburse nondental primary care providers (PCPs) for providing preventive oral health services to young children; yet, little is known about how treatment outcomes compare with children visiting dentists. This study compared the association between the provider of preventive services (PCP, dentist, or both) with Medicaid-enrolled children before their third birthday and subsequent dental caries-related treatment (CRT) and CRT payment. Methods: We conducted a retrospective study of young children enrolled in North Carolina Medicaid during 2000 to 2006. The annual number of CRT and CRT payments per child between the ages of 3 and 5 yr were estimated with a zero-inflated negative binomial regression and a hurdle model, respectively. Models were adjusted for relevant child- and county-level characteristics and used propensity score weighting to address observed confounding. Results: We examined 41,453 children with > 1 preventive oral health visit from a PCP, dentist, or both before their third birthday. Unadjusted annual mean CRT and payments were lowest among children who had only PCP visits (CRT = 0.87, payment = $172) and higher among children with only dentist visits (CRT = 1.48, payment = $234) and both PCP and dentist visits (CRT = 1.52, payment = $273). Adjusted results indicated that children who had dentist visits (with or without PCP visits) had significantly more CRT and higher CRT payments per year during the ages of 3 and 4 yr than children who had only PCP visits. However, these differences attenuated each year after age 3 yr. Conclusions: Because of children’s increased opportunity to receive multiple visits in medical offices during well-child visits, preventive oral health services provided by PCPs may lead to a greater reduction in CRT than dentist visits alone. This study supports guidelines and reimbursement policies that allow preventive dental visits based on individual needs.

From theoretical concepts to policies and applied programmes: the landscape of integration of oral health in primary care

“…Positive outcomes included enhanced interprofessional collaboration, satisfaction of non-dental primary care providers with the oral health care training, increased performance of non-dental care providers, and patient satisfaction with care delivery [ 50 – 52 , 54 , 56 , 58 – 61 , 64 , 66 – 69 ]. Objective outcomes included an increase in the number of trained non-dental health care providers, the number of dental visits, screening and preventive acts, referrals, as well as a decrease in the percentage of patients’ dental treatment non-attendance and finally improved access to dental care [ 12 , 49 – 52 , 54 , 55 , 60 , 69 , 70 , 72 , 73 ]. Haughney et al (1998) reported on the follow-up of a co-located model of integrated care and demonstrated that after three years, the total number of medical/dental visits as well as dental visits by the 0–5 year age group and by the elderly increased by 90%, 32% and 24%, respectively [ 49 ].…”

Estimating the Cost Savings of Preventive Dental Services Delivered to Medicaid‐Enrolled Children in Six Southeastern States

“…; Kranz et al. ). Because dental caries often takes many months to progress to a point at which restorative care is required, studies that used a shorter length may not capture as much downstream treatment costs.…”

A chimeolysin with extended-spectrum streptococcal host range found by an induced lysis-based rapid screening method

“…4 ). S. mutans , which usually grows as a biofilm, is a significant periodontal pathogen responsible for dental caries, a condition that lacks effective therapeutic options 49 . Significantly, many lysins active against planktonic streptococci and staphylococci have also been reported to be highly active against their biofilms, such as the ClyR CD donor, PlyC 50 , and the ClyR CBD donor, PlySs2 51 .…”