A longitudinal study of schoolchildren's experience in the North Carolina Dental Medicaid Program, 1984 through 1992

Parental Knowledge and Awareness of the First Permanent Molar

Background and Aim

This study aimed to assess the awareness of parents about the presence of first permanent molar and its effect on the health of this tooth.

Materials and methods

This cross-sectional research has been done on 250 elementary school students which were 6 to 8-year-old boys and their parents in Tehran city. Sampling was done randomly. The questionnaires were filled out by the parents, and then tooth condition was registered in a visit formfor each student separately. Next, the related children’s decayed missing filled teeth (DMFT) was determined and recorded. The mean value was calculated. Data were analyzed using the statistical package for the social sciences (SPSS) via a generalized estimating equation.

Results

There was a significant relationship between parental awareness of being permanent of the first permanent molar and DMFT (p < 0.05).

Conclusion

Socio-economical factors like parental education can have an effect on oral health condition.

How to cite this article: Heydari A, Shahrabi M, Shafizadeh M, Anaraki EA, Aref M, Parental Knowledge and Awareness of the First Permanent Molar. Int J Clin Pediatr Dent, 2018;11(5):382-385.

Effectiveness of a Preventive Educational Programme on the Oral Health of Preschool Children

The aim of the study was to evaluate the impact of a preventive-educational programme in a group of preschool children. The study's population group comprised 58 four-year-old children, with a mean age of 4.17±0.27. Plaque index and gingival index were determined, and a dental examination was performed. The children were randomly assigned to one of two groups: experimental and control. The experimental group received the educational component of the programme which was for children, parents and teachers. The preventive programme was applied to both groups and included topical application of 1.23% acidulated fluoride phosphate, pH 3.5, every 6 months. Outcomes were measured on day 8 and after 6 and 12 months under similar conditions to those at baseline. Results showed a significant decrease in gingival index and plaque index values and no significant increase in decay in the experimental group. The control group showed a significant increase in gingival index, plaque index, and decayed surfaces.

Racial disparity trends in children's dental visits: US National Health Interview Survey, 1964-2010

BACKGROUND AND OBJECTIVE

Research that has repeatedly documented marked racial/ethnic disparities in US children's receipt of dental care at single time points or brief periods has lacked a historical policy perspective, which provides insight into how these disparities have evolved over time. Our objective was to examine the im-pact of national health policies on African American and white children's receipt of dental care from 1964 to 2010.

METHODS

We analyzed data on race and dental care utilization for children aged 2 to 17 years from the 1964, 1976, 1989, 1999, and 2010 National Health Interview Survey. Dependent variables were as follows: child's receipt of a dental visit in the previous 12 months and child's history of never having had a dental visit. Primary independent variable was race (African American/white). We calculated sample prevalences, and χ(2) tests compared African American/white prevalences by year. We age-standardized estimates to the 2000 US Census.

RESULTS

The percentage of African American and white children in the United States without a dental visit in the previous 12 months declined significantly from 52.4% in 1964 to 21.7% in 2010, whereas the percentage of children who had never had a dental visit declined significantly (P < .01) from 33.6% to 10.6%. Pronounced African American/white disparities in children's dental utilization rates, whereas large and statistically significant in 1964, attenuated and became nonsignificant by 2010.

CONCLUSIONS

We demonstrate a dramatic narrowing of African American/white disparities in 2 measures of children's receipt of dental services from 1964 to 2010. Yet, much more needs to be done before persistent racial disparities in children's oral health status are eliminated.

Accuracy of record linkage software in merging dental administrative data sets

OBJECTIVE

To determine the accuracy of record matching using "Link King" software that uses an ordinal score for the certainty that linked records are valid matches.

METHODS

We linked records in North Carolina Medicaid files to public health surveillance files using Link King matching software. We selected a stratified random sample of 230 of 45,295 linked records and 50 of 35,119 non-linked surveillance records, then manually reviewed the records. Sensitivity (Sn) and Specificity (Sp) were calculated based on each cut point of the Link King score, using manual review as the gold standard.

RESULTS

The Sn increased from 0.837 (95% CI: 0.785, 0.892) to 0.935 (0.879, 0.994) and Sp decreased from 0.893 (0.816, 0.976) to 0.865 (0.790, 0.947) as cut points were varied to widen the scope of declared matches. With a goal of both Sn and Sp being large, accuracy was best when linked record pairs from the top three levels of certainty were included in the match.

CONCLUSIONS

This study found that a publicly available software program accurately merged Medicaid and surveillance data. The Link King could be useful to researchers in merging administrative databases.

Early childhood caries and the impact of current u.s. Medicaid program: an overview

Pediatric dental caries is the most common chronic disease among children. Above 40% of the U.S. children aged 2-11 years have dental caries; more than 50% of them come from low-income families. Under dental services of the Medicaid program, children enrolled in Medicaid must receive preventive dental services. However, only 1/5 of them utilize preventive dental services. The purpose of this overview is to measure the impact of Medicaid dental benefits on reducing oral health disparities among Medicaid-eligible children. This paper explains the importance of preventive dental care, children at high risk of dental caries, Medicaid dental benefits, utilization of dental preventive services by Medicaid-eligible children, dental utilization influencing factors, and outcome evaluation of Medicaid in preventing dental caries among children. In conclusion, despite the recent increase of children enrolled in Medicaid, utilizing preventive dental care is still a real challenge that faces Medicaid.

Assessing patterns of restorative and preventive care among children enrolled in Medicaid, by type of dental care provider

BACKGROUND

The authors investigate the relationship of preventive dental treatment to subsequent receipt of comprehensive treatment among Medicaid-enrolled children.

METHODS

The authors analyzed Medicaid dental claims data for 50,485 children residing in Wayne County, Mich. The study sample included children aged 5 through 12 years in 2002 who had been enrolled in Medicaid for at least one month and had had at least one dental visit each year from 2002 through 2005. The authors assessed dental care utilization and treatment patterns cross-sectionally for each year and longitudinally.

RESULTS

Among the Medicaid-enrolled children in 2002, 42 percent had had one or more dental visits during the year. At least 20 percent of the children with a dental visit in 2002 were treated by providers who billed Medicaid exclusively for diagnostic and preventive (DP) services. Children treated by DP care providers were less likely to receive restorative and/or surgical services than were children who were treated by dentists who provided a comprehensive mix of dental services. The logistic model showed that children who visited a DP-care provider were about 2.5 times less likely to receive restorative or surgical treatments than were children who visited comprehensive-care providers. Older children and African-American children were less likely to receive restorative and surgical treatments from both types of providers.

CONCLUSIONS

The study results show that the type of provider is a significant determinant of whether children received comprehensive restorative and surgical services. The results suggest that current policies that support preventive care-only programs may achieve increased access to preventive care for Medicaid-enrolled children in Wayne County, but they do not provide access to adequate comprehensive dental care.

Oral health surveillance: past, present, and future challenges

We reviewed and summarized the efforts in the United States to collect data on oral diseases, conditions, and behaviors implemented at the national and state level. The main characteristics of these efforts were: (1) systematic collection of data from representative samples, mostly at the national level; (2) one-time or sporadic experiences when data are collected at state and local levels; (3) use of visual-tactile protocols implemented at the tooth-surface or tooth-site level for data collection; (4) focus mainly on dental caries and periodontal diseases; and (5) leap-time from data collection to publication of results. Using the definition of surveillance in public health (the ongoing and systematic collection, analysis, and interpretation of outcome-specific data for use in planning, implementing, and evaluating public health practice), we show there is an impending need to develop new techniques to build up surveillance systems for oral diseases, conditions, and behaviors at the national, state, and local levels. In the second part of this review, we presented a number of alternative techniques developed in the last 10 years to collect timely data for oral health. The main characteristics of these efforts include: (1) focusing on data collection at state and local level; (2) integration into existing and ongoing surveillance systems; (3) using visual-only protocols to collect data on oral disease status; (4) focusing on a variety of diseases, conditions, and behaviors; and (5) analyzing the data in a timely matter. Many of these efforts have been integrated into the National Oral Health Surveillance System, which has developed eight indicators in response to national health objectives. Finally, we envision the future of visual-tactile protocols in data collection of representative samples to monitor oral health status at the national level and as a research tool. At the state and local level, however, we envision an integrated system of data collection as a constantly evolving process as new techniques are developed in response to new demands.

Treatment outcomes and costs of dental sealants among children enrolled in Medicaid

OBJECTIVES

This retrospective cohort analysis of children enrolled in the North Carolina Medicaid program compared the likelihood of restorative treatments and associated cumulative Medicaid expenditures for teeth with or without dental sealants.

METHODS

We assessed the dental experience of the cohort of 15 438 children from 1985 to 1992 on the basis of enrollment and claims files. We conducted regression analyses for outcomes (caries-related services involving the occlusal surface [CRSOs] of permanent first molars) and cumulative expenditures, controlling for characteristics of the child, the treating dentist, and the child's county of residence.

RESULTS

Overall, 23% of children received at least 1 sealant and 33% at least 1 CRSO. Sealants were effective in preventing CRSOs, although the degree of effectiveness was highest for children with the greater levels of CRSOs before sealant placement. Estimated cumulative Medicaid expenditures indicated expenditure savings from sealants within 2 years of application for children with 2 or more prior CRSOs.

CONCLUSIONS

Sealant placement was associated with expenditure savings to Medicaid for certain high-risk children, so Medicaid and, more broadly, society will benefit by providing for sealant placement in these children.

Perspectives of dentists, families, and case managers on dental care for individuals with developmental disabilities in Kansas

The status of dental care for individuals with developmental disabilities in Kansas was examined. Dentists, family members, and case managers reported general, but partial, satisfaction with the availability, accessibility, appropriateness, and affordability of such care. Reasons for the results and recommendations for further improvement are discussed.