The effectiveness and estimated costs of the Access to Baby and Child Dentistry program in Washington state

Kobayashi, Michelle; Chi, Donald; Coldwell, Susan E.; Domoto, P; Milgrom, Peter

doi:10.14219/jada.archive.2005.0341

Cited by 23 publications

(20 citation statements)

References 7 publications

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“…The ABCD Program is associated with lower tooth decay rates and improved preventive dental care utilization rates for children under age 6 years. 21-22 Under such circumstances, concerns have been raised about the potential for widening disparities associated with public health programs that are not tailored to high-risk subgroups like CSHCN. 23 The idea is that such programs “skim off the top” by benefitting individuals who are best positioned to take advantage of the program, leaving behind less advantaged program participants.…”

Section: Discussionmentioning

confidence: 99%

“…The ABCD Program is one of the longest-standing dental Medicaid programs and has been in operating for nearly 25 years. 22, 37 Other states with child dental Medicaid programs should devote resources for similar analyses to evaluate program outcomes and identify areas for program improvement.…”

Section: Discussionmentioning

confidence: 99%

“…21 In addition, an early evaluation of one ABCD county compared to a non-ABCD county found that tooth decay rates were significantly lower in the ABCD county. 22 Despite the program’s initial successes, published data indicate that only 21% of all Medicaid-enrolled children under age 3 years in Washington utilized preventive care. 14 This raises specific concerns about vulnerable child subgroups within ABCD, like CSHCN, because of the potential for programs like ABCD to widen oral health inequalities.…”

mentioning

confidence: 99%

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Preventive dental care use for children with special health care needs in Washington's Access to Baby and Child Dentistry program

Craig¹,

Scott²,

Slayton³

et al. 2019

The Journal of the American Dental Association

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Background. Low-income, preschool-aged children with special health care needs (CSHCN) are at increased risk for poor oral health. The study goal was to assess preventive dental care use for Medicaid-enrolled CSHCN within Washington state’s Access to Baby and Child Dentistry (ABCD) Program. Methods. We analyzed 2012 Medicaid eligibility and claims files for children under age 6 years in the ABCD Program (N=206,488). Medical diagnosis and eligibility data were used to identify each child’s special needs status (no/yes). The outcome was preventive dental care use (no/yes). Modified Poisson regression models were used to estimate crude and covariate-adjusted prevalence rate ratios (PRR). Results. Of the 206,488 children in the study, 2.1% were CSHCN and 114,570 utilized preventive dental care (55.5%). CSHCN utilized preventive care at similar rates compared to children without SHCN (54.7% and 55.5%, respectively; P=0.32). After adjusting for confounders, CSHCN were significantly less likely to utilize preventive dental care than children without SHCN (PRR: 0.91; 95% CI: 0.88, 0.94; P<0.001). Older preschoolers were significantly more likely to use preventive dental care than younger preschoolers. A significantly higher proportion of preventive medical care utilizers also utilized preventive dental care. Conclusions. Medicaid-enrolled CSHCN in Washington’s ABCD Program were less likely to utilize preventive dental care than Medicaid-enrolled children without SHCN. Practical Implications. Future intervention research should evaluate strategies to improve access to preventive dental care for CSHCN. Additional strategies may be needed to improve oral health behaviors for preschool-aged CSHCN in Medicaid.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

mentioning

confidence: 99%

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Preventive dental care use for children with special health care needs in Washington's Access to Baby and Child Dentistry program

Craig¹,

Scott²,

Slayton³

et al. 2019

The Journal of the American Dental Association

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“…36 These are core features of programs designed to increase access to dental care (such as the Access to Baby and Child Dentistry (ABCD) Program in Washington State). 36–40 …”

Section: Discussionmentioning

confidence: 99%

Preventive Dental Service Utilization for Medicaid-Enrolled Children in New Hampshire: A Comparison of Care Provided by Pediatric Dentists and General Dentists

Chi¹,

Milgrom²

2009

hpu

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In this study, we compared preventive dental utilization through visits to a pediatric dentist (PD) vs. visits to a general dentist (GD) among Medicaid-enrolled children in New Hampshire (n=12,964). Dental claims were analyzed using conditional logistic regression models. After adjusting for covariates, children seen by a PD were 51% more likely to have received fluoride treatment, 26% more likely to have had at least two dental examinations, and 19% more likely to have received a sealant than children seen by a GD. Overall, our results suggest that children seen by a PD were more likely to have received preventive services than those seen by a GD. Because Medicaid-enrolled children are at increased risk for poor oral health, policies should be enacted to ensure that high-risk children receive appropriate and regular prevention-oriented dental care.

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“…First, Spokane county was the first to implement the Access to Baby and Child Dentistry (ABCD) program in 1995, a special state-wide program to improve dental care utilization rates for Medicaid-eligible children under age 6 years. 29 The long-standing presence of the ABCD program is likely to provide young CSHCN and their families with strong community-based oral health resources. 30 Second, Spokane county is a non-fluoridated community, thought to have widespread deliberate efforts to help parents prevent dental disease in children through other at-home and professional dental care methods.…”

Section: Methodsmentioning

confidence: 99%

Oral health services within community‐based organizations for young children with special health care needs

Cruz

Donald

Huebner

2016

Special Care in Dentistry

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Purpose To identify the types of oral health services offered by community-based organizations to young children with special health care needs (CSHCN) and the barriers and facilitators to the provision of these in a non-fluoridated community. Methods Thirteen key informant interviews with representatives from early intervention agencies, advocacy groups, and oral health programs who provide services to CSHCN in Spokane county, Washington. We used a content analysis to thematically identify oral health services as proactive or incidental and the barriers and facilitators to their provision. Results We identified four types of oral health services: screenings, parent education, preventive dental care, and dental referrals. Barriers to providing all four services included limited agency resources, restrictive administrative and system-level policies, and low demand from parents. A barrier to providing education and preventive dental care was community disagreement regarding fluoride. A barrier to providing dental referrals was the perceived lack of dentists who could treat CSHCN. Facilitators included community partnerships among the organizations and utilization of the statewide oral health program. Conclusions Oral health services for young CSHCN are limited and often delivered in response to oral health problems. Coordinated efforts between community-based organizations, health providers, and advocates are necessary to ensure the provision of comprehensive care, including preventive and restorative services, to all young CSHCN.

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The effectiveness and estimated costs of the Access to Baby and Child Dentistry program in Washington state

Cited by 23 publications

References 7 publications

Preventive dental care use for children with special health care needs in Washington's Access to Baby and Child Dentistry program

Preventive dental care use for children with special health care needs in Washington's Access to Baby and Child Dentistry program

Preventive Dental Service Utilization for Medicaid-Enrolled Children in New Hampshire: A Comparison of Care Provided by Pediatric Dentists and General Dentists

Oral health services within community‐based organizations for young children with special health care needs

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