Dataset Information

Effects of Physician-Based Preventive Oral Health Services on Dental Caries.

ABSTRACT:

Background

Most Medicaid programs reimburse nondental providers for preventive dental services. We estimate the impact of comprehensive preventive oral health services (POHS) on dental caries among kindergarten students, hypothesizing improved oral health among students with medical visits with POHS.

Methods

We conducted a retrospective study in 29,173 kindergarten students by linking Medicaid claims (1999-2006) with public health surveillance data (2005-2006). Zero-inflated regression models estimated the association between number of visits with POHS and (1) decayed, missing, and filled primary teeth (dmft) and (2) untreated decayed teeth while adjusting for confounding.

Results

Kindergarten students with ?4 POHS visits averaged an adjusted 1.82 dmft (95% confidence interval: 1.55 to 2.09), which was significantly less than students with 0 visits (2.21 dmft; 95% confidence interval: 2.16 to 2.25). The mean number of untreated decayed teeth was not reduced for students with ?4 POHS visits compared with those with 0 visits.

Conclusions

POHS provided by nondental providers in medical settings were associated with a reduction in caries experience in young children but were not associated with improvement in subsequent use of treatment services in dental settings. Efforts to promote oral health in medical settings should continue. Strategies to promote physician-dentist collaborations are needed to improve continuity of care for children receiving dental services in medical settings.

SUBMITTER: Kranz AM

PROVIDER: S-EPMC4485004 | biostudies-literature | 2015 Jul

REPOSITORIES: biostudies-literature

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Publications

Effects of Physician-Based Preventive Oral Health Services on Dental Caries.

Kranz Ashley M AM Preisser John S JS Rozier R Gary RG

Pediatrics 20150701 1

<h4>Background</h4>Most Medicaid programs reimburse nondental providers for preventive dental services. We estimate the impact of comprehensive preventive oral health services (POHS) on dental caries among kindergarten students, hypothesizing improved oral health among students with medical visits with POHS.<h4>Methods</h4>We conducted a retrospective study in 29,173 kindergarten students by linking Medicaid claims (1999-2006) with public health surveillance data (2005-2006). Zero-inflated regre ...[more]

PMID: 26122805

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Project description:IntroductionDental caries remains one of the most prevalent but preventable diseases among children worldwide and especially affects children with a lower socioeconomic status or ethnic minority background. It is important that all groups of children are reached by preventive interventions to reduce oral health inequalities. So far, it is unknown whether children from different social and ethnic groups benefit equally from potentially effective oral health interventions.ObjectivesThis scoping review aimed to identify European public health interventions that report their effect on dental caries across different social groups.MethodsFour databases were searched for studies evaluating the effect of oral health interventions on dental caries among children from 0 to 12 y, and studies were included when results were presented by children of different social groups separately.ResultsA total of 14 studies were included, representing 4 different countries: 3 randomized and 11 nonrandomized studies. Most studies were performed at schools. Six studies showed results indicative of a reduction in oral health inequalities, 4 studies showed results that potentially widen oral health inequalities, and 5 studies showed results that were indicative of no impact on oral health inequalities. Interventions that contain early approaches, with a high frequency, approaching multiple levels of influence, and including at least the broader organizational or public policy level, may have the potential to reduce oral health inequalities among children from birth to young adolescence.ConclusionWe recommend researchers to perform high-quality intervention studies and to evaluate the effectiveness of oral health intervention always in different socioeconomic or ethnic groups separately, to better understand their contribution toward oral health (in)equalities.Knowledge transfer statementThis review offers insight in the differential effects that oral health interventions might have across different social groups. Its results can be used to develop interventions that might reduce oral health inequalities among children. Also, we recommend future researchers to always evaluate the effects of any preventive oral health measure in different social groups separately.

Project description:ObjectivesLimited information is known about preventive dental visits (PDVs) before seven years of age among children in China. This study aimed to examine the early PDV rate, identify the impact of PDV on dental caries and untreated dental caries, and explore the factors related to PDV among Chinese sampled children under seven years old.MethodsA cross-sectional survey was conducted in five selected primary health care facilities in Chengdu, China, from May to August 2021. Parent-child dyads during regular systematic medical management were recruited to participate. Children's dental caries were identified through dental examinations and documented as decayed, missing and filled teeth index (dmft) by trained primary care physicians. Dental-related information was collected through a questionnaire. Zero-inflated negative binomial (ZINB) regression was used to test the effect of early PDV on the dmft value, and logistic regression was used to analyse impact factors on the early PDV.ResultsA total of 2028 out of 2377 parent-child dyads were qualified for analysis. Half of the children (50.4%) were male, with a mean age of 4.8 years. Among all the children, 12.1% had their first dental visit for preventive purposes, 34.4% had their first dental visit for symptomatic purposes, and more than half had never visited a dentist. The results showed that a lower dmft value (adjusted OR: 0.69, 95% CI: 0.48-0.84), a higher rate of caries-free (aOR: 6.5, 95% CI: 3.93-10.58), and a lower rate of untreated dental caries (aOR: 0.40, 95% CI: 0.21-0.76) were associated with early PDV utilization. Children who had a higher rate of PDV were positively associated with living in a family with better parental behaviours (aOR: 2.30, 95% CI: 1.71-3.08), better parental oral health perception (aOR: 1.23, 95% CI: 1.06-1.32), fathers who had no untreated caries (aOR: 0.68, 95% CI: 0.47-0.97), families with higher socioeconomic status (aOR: 1.09, 95% CI: 1.04-1.16), and dental health advice received from well-child care physicians (aOR: 1.47, 95% CI: 1.08-2.00).ConclusionsEarly PDV was associated with a lower rate of dental caries prevalence and untreated dental caries among sampled children younger than seven in Western China. Underutilization and social inequities existed in PDV utilization. Public health strategies should be developed to increase preventive dental visits and eliminate social disparities that prevent dental care utilization.

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Project description:ObjectiveTo evaluate effect of dental caries experience and untreated dental decay on Oral Health-Related Quality of Life (OHRQoL) in working adults.MethodsThe clinical records of 160 patients were reviewed. Dental health indicators were derived from individual tooth- and surface-level data allowing for calculating the number of decayed surfaces (D), number of decayed missed filled surfaces (DMFS), and significant caries (SiC) indices. A questionnaire was administered to verify demographic factors and OHRQoL. The questionnaire was administered via face-to-face interview, for patients in the hospital; or via telephone interview, for those who could not complete it during their hospital visit. Models were developed using multivariable linear regression to predict total OHIP-14 scores and examine the simultaneous association of independent and outcome variables. The model was adjusted for age, gender, and nationality..ResultsPhysical limitation and psychological discomfort were the most frequent impacted domains, affecting 17.1% and 7.5% of subjects, respectively. Painful aching was the most frequent item to have any impact, affecting 64.4% of the subjects. The results of multivariable analysis indicated that the SiC score could statistically significantly predict the Oral Health Impact Profile (OHIP) score, P=0.0003. In the linear regression model, for participants with DMFS equal to or higher than the SiC, on average, OHIP scores were almost 10 points higher than for participants with DMFS below the SiC.ConclusionThe more the dental decay the higher the impact on OHRQoL. From a dental public health perspective, using OHRQoL as a need assessment tool, along with dental clinical indicator, can be helpful in planning and targeting public health programs for the most in-need adult populations.Clinical significanceThis study identified that patients with severe dental caries report poorer OHRQoL. Clinicians should be aware of impacts that dental decay may have on OHRQoL, including physical, psychological concerns, and pain.

Dataset Information

Effects of Physician-Based Preventive Oral Health Services on Dental Caries.

Background

Methods

Results

Conclusions

Publications

Effects of Physician-Based Preventive Oral Health Services on Dental Caries.

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