Oral health services, delivered by primary care clinicians and designed to prevent dental caries (cavities) in young children, can improve the oral health of kindergartners enrolled in Medicaid, according to a new study by three researchers affiliated with The University of North Carolina at Chapel Hill’s Gillings School of Global Public Health. However, more effort is required, the study finds, to coordinate services between medical and dental practitioners so that the children’s improved oral health care can be continued over time.
Led by Dr. Ashley Kranz, 2013 UNC Gillings School of Global Public Health alumna and adjunct assistant professor of pediatric dentistry at UNC, the research was published online June 29 in the journal Pediatrics.
[Photo: “Screening and referral [to dentists] are important components of oral health services in medical settings,” the UNC authors write, “but their effectiveness depends upon the successful completion of a number of steps in a complex and often challenging process.” That process includes being able to identify the child’s risk, disease status and need for referral, as well as helping the parent or guardian navigate the dental care system. Photo by clappstar/flickr creative commons]
“Evidence has accumulated, particularly from studies in North Carolina, that offering services in the medical office increases access to recommended preventive dental services for young children and reduces needed treatment for tooth decay and its associated costs,” said Dr. Gary R. Rozier, research professor of health policy and management at the Gillings School and study co-author. “This study provides the first direct evidence that physician-based services will reduce tooth decay and thus improve the oral health status of children entering kindergarten.”
Poor access to oral health care – both geographical and financial – has led to significant health disparities among children of preschool age in NC. At the turn of the twenty-first century, nearly 40 percent of children entering kindergarten in the state had a history of early childhood tooth decay, with rates as high as 67 percent in some counties. In 2000, the NC Medicaid program established the “Into the Mouths of Babes” initiative, and the high rates of dental disease in low-income children were remedied significantly through the training of physicians and nurses to screen for dental caries, counsel parents about oral health and apply fluoride varnish to young children’s teeth.