263446 Effect of a medical office-based preventive dental program on the odds of visiting a dentist at 3 years of age

Monday, October 29, 2012

Ashley Kranz, BA , Health Policy & Management, UNC Chapel Hill, Carrboro, NC
Gary Rozier, DDS , Department of Health Policy and Management, Gillings School of Global Public Heatlh, Chapel Hill, NC
John S. Preisser , Department of Biostatistics, University of North Carolina at Chapel Hill, Chapel Hill, NC
Morris Weinberger, PhD , Department of Health Policy and Management, University of North Carolina at Chapel Hill, Chapel Hill, NC
Medicaid reimbursement of pediatric primary care providers (PCPs) for preventive dental care has increased access to dental care for infants and toddlers. It is unknown if children visiting PCPs for preventive dental care are able to obtain care from dentists as they age out of these programs. Using North Carolina (NC) Medicaid claims from 2000-2006, this study evaluated the effect of receiving preventive dental care from PCPs on the odds of having a dentist visit during the fourth year of life. We estimated the odds of having a dentist visit for any reason between 36-48 months of age using a logistic regression model that controlled for child- and county-level characteristics. The effect of receipt of preventive dental care before age 3 from PCPs compared to dentists and no care was examined using Wald tests. Among the 311,968 children in the study, 18.4% had a dentist visit between 36-48 months of age. Children receiving preventive dental care from only a PCP before 36 months of age were less likely to have a dentist visit for any reason between 36-48 months of age compared to children who received preventive dental care from a dentist before 36 months (odds ratio[OR]=0.297, 95% confidence interval[CI]=0.271, 0.326) and compared to children who did not receive any preventive dental care before 36 months (OR=0.977, 95% CI=0.815, 0.943). Few young children enrolled in NC Medicaid visit dentists. Dental referrals for children receiving preventive dental services from PCPs need to be strengthened to ensure continuity of oral health services.

Learning Areas:
Conduct evaluation related to programs, research, and other areas of practice
Planning of health education strategies, interventions, and programs
Provision of health care to the public
Public health or related public policy

Learning Objectives:
1. Identify the number of children in enrolled in North Carolina (NC) Medicaid receiving preventive dental care before three years old from primary care providers, dentists, both, and no care. 2. Identify the number of children in enrolled in NC Medicaid having a dentist visit at three years old. 3. Evaluate the effect of receipt of preventive dental care before three years old from primary care providers compared to no care and compared to the conventional model, dentist visits, on the odds of having a dentist visit at three years old.

Keywords: Child Health, Medicaid

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I have conducted research related to the dental health of children for the past four years under the direction of R. Gary Rozier. I have multiple first-author publications in the Journal of Public Health Dentistry. I received a National Research Service Award pre-doctoral fellowship from AHRQ to examine the effect of delivery models for preventing dental caries in young children. I have experience with the data set being used for this study.
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.

Back to: 3093.0: Oral-Systemic Linkages and Integrated Health Care Delivery Programs