Access to preventive services after the integration of oral health care into early childhood education and medical care

Background: Despite early evidence touting the effectiveness of physician-provided oral health services (POHS), recent evidence suggests these services might have little impact on caries-related outcomes in children. General anesthesia (GA) is often used to treat early childhood caries and may be considered the most extreme utilization outcome. We sought to assess the impact of POHS utilization on dental GA utilization and expenditures. Methods: We used the Medicaid claims of a birth cohort of children born in 2008 in North Carolina ( N = 32,558) to determine the impact of POHS on dental utilization and expenditures under GA for individual children. Children were followed until their eighth birthday. We analyzed the association of the number of prior POHS visits with visit-specific outcomes of dental treatment under GA using population-averaged models fit with generalized estimating equations with exchangeable working correlation structure. Results: Children with 2 or more previous POHS visits had reduced odds of GA (odds ratio [OR] = 0.93; confidence interval [CI], 0.87–0.99; P = 0.029) and expenditures ($114; CI,−$152.61 to −$75.19; P < 0.001) compared to those without physician-provided oral health visits, adjusting for age, sex, race/ethnicity, and geographic residence. Dental expenditures did not differ between POHS and non-POHS subjects at non-GA visits. Conclusions: POHS decreased the odds of having dental GA treatment and dental expenditures at GA visits. The role of physicians in oral health care can reduce the impact on the most severe outcome—treatment under general anesthesia. Knowledge Transfer Statement: The results of this study have important financial implications for state Medicaid programs and disease management programs trying to mitigate the costs of treating early childhood caries under general anesthesia. Children who receive physician oral health care are less likely to use and more likely to save money on general anesthesia to complete dental treatment.

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Oral Health Knowledge of Pregnant Women on Pregnancy Gingivitis and Children's Oral Health

Journal of Clinical Pediatric Dentistry ◽

10.17796/jcpd.39.2.n66w635638w643n7 ◽

2015 ◽

Vol 39 (2) ◽

pp. 105-108 ◽

Cited By ~ 2

Author(s):

C Zhong ◽

KN Ma ◽

YS Wong ◽

Y So ◽

PC Lee ◽

...

Keyword(s):

Health Care ◽

Early Childhood ◽

Oral Health ◽

Pregnant Women ◽

Early Childhood Caries ◽

Health Knowledge ◽

Oral Health Care ◽

Oral Disease ◽

Children’S Oral Health ◽

Childhood Caries

Objective: Pregnancy gingivitis and early childhood caries remain prevalent in Hong Kong. The aim of this study was to assess pregnant women's knowledge and beliefs related to pregnancy gingivitis and children's oral health. Study design: An outreach survey was carried out in a clinic that provided antenatal examination. A written oral health questionnaire related to pregnancy gingivitis and early childhood caries was administered to pregnant women. Of the 106 pregnant women who enrolled in the study, 100 completed the questionnaires. Results: Among the 100 subjects, only 39% correctly identified that hormonal changes contribute to pregnancy gingivitis. Only 36% identified red and swollen gums as signs of gingivitis. Furthermore, 53% of the surveyed pregnant women were not sure about the amount of toothpaste to administer to a child aged 18 months to 5 years. Almost 50% assumed that a replanted avulsed tooth would probably not survive within a short extra-alveolar period of less than 60 minutes. Conclusion: Prenatal women generally lack knowledge of a common oral disease that occurs during pregnancy and of what constitutes adequate oral health care for children. Oral health care education should be implemented as part of a prenatal care program.

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Prenatal Oral Health Care and Early Childhood Caries Prevention: A Systematic Review and Meta-Analysis

Caries Research ◽

10.1159/000495187 ◽

2019 ◽

Vol 53 (4) ◽

pp. 411-421 ◽

Cited By ~ 15

Author(s):

Jin Xiao ◽

Naemah Alkhers ◽

Dorota T. Kopycka-Kedzierawski ◽

Ronald J. Billings ◽

Tong Tong Wu ◽

...

Keyword(s):

Health Care ◽

Early Childhood ◽

Oral Health ◽

Early Childhood Caries ◽

Meta Analysis ◽

Intervention Group ◽

Oral Health Care ◽

Qualitative Assessment ◽

Gum Chewing ◽

Childhood Caries

Despite the advancement of early childhood caries (ECC) prediction and treatment, ECC remains a significant public health burden in need of more effective preventive strategies. Pregnancy is an ideal period to promote ECC prevention given the profound influence of maternal oral health and behaviors on children’s oral health. However, studies have shown debatable results with respect to the effectiveness of ECC prevention by means of prenatal intervention. Therefore, this study systematically reviewed the scientific evidence relating to the association between prenatal oral health care, ECC incidence, and Streptococcus mutans carriage in children. Five studies (3 randomized control trials, 1 prospective cohort study, and 1 nested case-control study) were included for qualitative assessment. Tested prenatal oral health care included providing fluoride supplements, oral examinations/cleanings, oral health education, dental treatment referrals, and xylitol gum chewing. Four studies that assessed ECC incidence reduction were included in meta-analysis using an unconditional generalized linear mixed effects model with random study effects and age as a covariate. The estimated odds ratio and 95% confidence intervals suggested a protective effect of prenatal oral health care against ECC onset before 4 years of age: 0.12 (0.02, 0.77) at 1 year of age, 0.18 (0.05, 0.63) at 2 years of age, 0.25 (0.09, 0.64) at 3 years of age, and 0.35 (0.12, 1.00) at 4 years of age. Children’s S. mutans carriage was also significantly reduced in the intervention group. Future studies should consider testing strategies that restore an expectant mother’s oral health to a disease-free state during pregnancy.

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Preventive Oral Health Care in Early Childhood: Knowledge, Confidence, and Practices of Pediatricians and Family Physicians in Florida

Yearbook of Pediatrics ◽

10.1016/j.yped.2011.04.054 ◽

2012 ◽

Vol 2012 ◽

pp. 103-105

Author(s):

J.A. Stockman

Keyword(s):

Health Care ◽

Early Childhood ◽

Oral Health ◽

Family Physicians ◽

Oral Health Care

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Patterns of emergency department use for dental and oral health care: implications for dental and medical care coordination

Journal of Public Health Dentistry ◽

10.1111/jphd.12103 ◽

2015 ◽

Vol 76 (1) ◽

pp. 1-8 ◽

Cited By ~ 10

Author(s):

Derek DeLia ◽

Kristen Lloyd ◽

Cecile A. Feldman ◽

Joel C. Cantor

Keyword(s):

Health Care ◽

Emergency Department ◽

Oral Health ◽

Medical Care ◽

Care Coordination ◽

Oral Health Care ◽

Emergency Department Use

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Knowledge, attitude, and practices of oral health care in prevention of early childhood caries among parents of children in Belagavi city: A Questionnaire study

Journal of Family Medicine and Primary Care ◽

10.4103/2249-4863.192332 ◽

2016 ◽

Vol 5 (2) ◽

pp. 286 ◽

Cited By ~ 4

Author(s):

ShivayogiM Hugar ◽

HP Suma Sogi ◽

TriveniMohan Nalawade ◽

Anjali Sinha ◽

Shweta Hugar ◽

...

Keyword(s):

Health Care ◽

Early Childhood ◽

Oral Health ◽

Early Childhood Caries ◽

Oral Health Care ◽

Questionnaire Study ◽

Childhood Caries

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Early childhood caries and oral health care of Hong Kong preschool children

Clinical Cosmetic and Investigational Dentistry ◽

10.2147/ccide.s190993 ◽

2019 ◽

Vol Volume 11 ◽

pp. 27-35 ◽

Cited By ~ 2

Author(s):

Kitty Jieyi Chen ◽

Sherry Shiqian Gao ◽

Duangporn Duangthip ◽

Edward Chin Man Lo ◽

Chun Hung Chu

Keyword(s):

Health Care ◽

Early Childhood ◽

Hong Kong ◽

Preschool Children ◽

Oral Health ◽

Early Childhood Caries ◽

Oral Health Care ◽

Childhood Caries

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Medical, Dental, and Nursing Students’ Knowledge about Early Childhood Oral Health Care

Children ◽

10.3390/children6090097 ◽

2019 ◽

Vol 6 (9) ◽

pp. 97 ◽

Cited By ~ 3

Author(s):

Al-Hatalani ◽

Al-Haj Ali

Keyword(s):

Health Care ◽

Early Childhood ◽

Nursing Education ◽

Oral Health ◽

Nursing Students ◽

Oral Health Care ◽

Dental Students ◽

Further Education ◽

Knowledge Level ◽

Perceived Knowledge

Gaps in knowledge of physicians and nurses about early childhood oral health care were reported and are likely due to the poorly focused education on oral health issues; therefore, the purpose of this study was to assess the knowledge level of Qassim University medical, dental and nursing students about early childhood oral health care and its relation to demographic variables, students’ perceived knowledge, satisfaction with their knowledge and interest in further education about the topic. A total of 571 medical, dental, and nursing students received a questionnaire that included demographic questions, questions to assess knowledge level of the students about early childhood oral health care, and questions to assess their perceived knowledge level, satisfaction with their knowledge and interest in further education about the topic. Results of the study revealed that knowledge of dental students was highest (score 7.72 out of 10) followed by nursing students (4.79), and medical students (4.43). Additionally, students with a higher level of perceived knowledge were more likely to score higher. In view of the inadequate knowledge level of medical and nursing students about early childhood oral health care when compared to dental students, improvements in medical and nursing education programs are necessary at Qassim University.

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