First Dental Episode: Preventive and Corrective Services at CHCs
Presented at the IADR/AADR Annual meeting, San Diego, CA:
Thursday, March 17, 2011: 2:00 p.m. - 3:15 p.m.
Presentation Type: Poster Session
R.A. KUTHY 1, B. PENDHARKAR 1, E.T. MOMANY 2, M.P. JONES 3, N.M. ASKELSON 4, D.L. CHI 5, G.L. WEHBY, 6 and P.C. DAMIANO 1, 1Dept. of Prevent & Comm Dentistry, University of Iowa, Iowa City, IA, 2Public Policy Center, University of Iowa, Iowa City, IA, 3Biostatistics, University of Iowa, Iowa City, IA, 4Community and Behavioral Health, University of Iowa, Iowa City, IA, 5Dental Public Health Sciences, University of Washington, Seattle, WA, 6Health Management and Policy, University of Iowa, Iowa City, IA
Objective: To determine mix of preventive and corrective treatment services, by age, provided to Medicaid-eligible children at their first dental episode. Since community health centers (CHCs) see a disproportionate number of lower-income families, it is important to determine extent of corrective treatment required and preventive services provided at the first and subsequent dental episodes.
Methods: Sampling frame was Iowa's CHCs that provided child dental care prior to 2007 (n=6). Statewide Medicaid claims data were used to address four child inclusion criteria: Medicaid-eligible within two months of birth; continuously Medicaid-eligible; less than 6 years of age at First Preventive Dental Visit (FPDV); and not seen elsewhere for an initial dental examination (CDT=00150). Chart reviews (n=40) were conducted on randomly selected children at each site. Date for each preventive service was recorded as well as number of teeth that required and subsequently received care. Additionally, number of visits and date of last visit was documented for this first episode.
Results: Age was positively associated with dental prophylaxis (p < 0.001); whereas there was no statistically associated relationship with topical fluoride application, dietary counseling, and oral hygiene instruction. 11.3% received all four preventive services and 15.8% received no preventive services at this first episode. Only 6.6% of this population had any caries noted on treatment plan at FPDV; however, two children were referred for operating room for corrective care. Mean number of restorations planned was 0.30 (1.44); mean number of restorations received was 0.21 (0.78). The ratio of minor restorations (1-2 surfaces) to more extensive restorations (3+ surfaces) for this first episode was 2.4:1. Conclusion: On average, children who are seen early for a FPDV had relatively few restorative needs. However, there were few exceptions.
Also available at: http://iadr.confex.com/iadr/2011sandiego/webprogram/Paper143987.html