Use of data linkage to identify opportunities for early oral health prevention, therapeutic intervention and care coordination to establish dental homes

Hospital Discharge data show that Medicaid pays for 83% of Vermont hospital outpatient visits for children aged 0-5 years who present with potentially preventable dental conditions. Analysis of Medicaid claims data showed that 2,201 eligible children aged 0-5 years received an endodontic, extraction or restoration procedure in 2009, accounting for 3,205 visits. Of these 3,205 visits, 421 (13%) took place in a hospital outpatient setting. There was a more than ten-fold difference in the average cost of treatment between hospital outpatient facility and dental office settings. The total cost to Medicaid was $2,210,131. Data linkage from Medicaid, through the birth certificate, to data from the Special Supplemental Nutrition Program for Women, Infants and Children (WIC) showed that 76% of the 2,201 children undergoing potentially preventable procedures were born to mothers enrolled in WIC prenatally or shortly after their child's birth. An even higher percentage (81%) of mothers of children requiring hospitalization had been enrolled in WIC. Conclusion: Community outreach programs at WIC clinics provide a unique opportunity for early oral health prevention, therapeutic intervention and care coordination to establish meaningful dental homes.