title: Office-based preventive dental program and statewide trends in dental caries.
abstract: OBJECTIVE
  To evaluate the impact of a North Carolina Medicaid preventive dentistry program in primary care medical offices (Into the Mouths of Babes Program [IMBP]) on decayed, missing, and filled teeth (dmft) of kindergarten students statewide and in schools with a large proportion of students from low-income families.
  
  
  METHODS
  An ecologic study using panel data of 920,505 kindergarten students with 11,694 school-year observations examined the effect of the IMBP on dmft scores from 1998 to 2009. Ordinary least squares regression with fixed effects determined the association between IMBP visits per child 0 to 4 years of age per county and mean dmft scores per kindergarten student per school, controlling for school-level poverty and ethnicity, county-level Medicaid enrollment, and supply of dentists and physicians.
  
  
  RESULTS
  Mean dmft per kindergarten student per school increased from 1.53 in 1998 to 1.84 in 2004, then decreased to 1.59 in 2009. The mean number of IMBP visits per child 0 to 4 years of age per county increased from 0.01 in 2000 to 0.22 in 2009. A 1-unit increase in IMBP visits per county was associated with a 0.248 (95% confidence interval, -0.40 to -0.10) decrease in dmft per kindergarten student per school. For schools with more students at high risk for dental disease, a 1-unit increase in IMBP visits was associated with a 0.320 (95% confidence interval, -0.55 to -0.09) decrease in dmft.
  
  
  CONCLUSIONS
  IMBP reduced dental caries among targeted vulnerable children, which helped reduce oral health disparities among preschool-aged children in North Carolina.
authors.affiliation: Oral Health Section, Division of Public Health, North Carolina Department of Health and Human Services, Raleigh, North Carolina; and.
authors.forename: Leo N
authors.initials: LN
authors.lastname: Achembong
authors.forename: Ashley M
authors.initials: AM
authors.lastname: Kranz
authors.forename: R Gary
authors.initials: RG
authors.lastname: Rozier
mesh_terms: D002675:Child, Preschool; D003731:Dental Caries / Q000517:prevention & control*; D003752:Dental Health Services; D006078:Government Programs; D006801:Humans; D008484:Medicaid; D009657:North Carolina; D009819:Office Visits; D011314:Preventive Health Services; D014481:United States
keywords: dental caries; early childhood; fluoride varnish; prevention; primary care