School screening and parental reminders in increasing dental care for children in need: a retrospective cohort study.
OBJECTIVE
The objective of this study is to assess follow-up dental care received by children given baseline screening and referrals as part of an ongoing clinical trial.


METHODS
A retrospective study with two cohorts of kindergarten children who had baseline and follow-up (9 months later) dental exams was used. The parents/caregivers of children with routine restorative or urgent needs at baseline received a referral letter and telephone reminders to seek care for their child. Children with referrals were evaluated at follow-up exam for the receipt of care. A baseline caregiver questionnaire provided information on the individual and family characteristics of the children.


RESULTS
A total of 303 children had dental exams at both time periods. At baseline, 42 percent (126/303) received referrals and among the referred group19 percent (24/126) received follow-up care. A greater proportion with urgent referrals (10/30, 33 percent) received care than those with routine referrals (14/96, 15 percent). Baseline dmft decayed, missing, filled primary teeth and DMFT decayed, missing, filled permanent teeth was similar between children who did/did not receive follow-up care (P = 0.178 and 0.491, respectively). Children receiving referrals had caregivers with less education, higher Medicaid participation, fewer routine care visits, poorer self-rating of teeth, and a higher proportion of children reporting tooth pain. Children without receipt of follow-up care had caregivers who were more likely to report not visiting a dentist within the last 5 years and a greater number of missed days from work because of tooth problems.


CONCLUSIONS
The rate of dental utilization was low even with school screening, referral and parental reminders among poor, largely minority inner-city kindergarten children.
Department of Community Dentistry, Case Western Reserve University, Cleveland, OH, USA. sxn15@case.edu
Suchitra
S
Nelson
Jason
J
Mandelaris
Gerald
G
Ferretti
Masahiro
M
Heima
Charles
C
Spiekerman
Peter
P
Milgrom
D001741:Black or African American / Q000706:statistics & numerical data; D017028:Caregivers / Q000706:statistics & numerical data; D002648:Child; D002675:Child, Preschool; D015331:Cohort Studies; D004245:DMF Index; D019140:Dental Care for Children / Q000706:statistics & numerical data*; D003731:Dental Caries / Q000175:diagnosis; D005260:Female; D054625:Healthcare Disparities; D006801:Humans; D008297:Male; D008403:Mass Screening; D012017:Referral and Consultation; D017010:Reminder Systems; D012189:Retrospective Studies; D012571:School Dentistry; D011795:Surveys and Questionnaires; D014481:United States; D035862:Vulnerable Populations