Comparing medical and dental providers of oral health services on early dental caries experience.
OBJECTIVE
Most state Medicaid programs reimburse nondental primary care providers (PCPs) for providing preventive oral health services to young children. We examined the association between who (PCP, dentist, or both) provides these services to Medicaid enrollees before age 3 years and oral health at age 5 years.


METHODS
We linked North Carolina Medicaid claims (1999-2006) to oral health surveillance data (2005-2006). Regression models estimated oral health status (number of decayed, missing, and filled primary teeth) and untreated disease (proportion of untreated decayed teeth), with adjustment for relevant characteristics and by using inverse-probability-of-treatment weights to address confounding.


RESULTS
We analyzed data for 5235 children with 2 or more oral health visits from a PCP, dentist, or both. Children with multiple PCP or dentist visits had a similar number of overall mean decayed, missing, and filled primary teeth in kindergarten, whereas children with only PCP visits had a higher proportion of untreated decayed teeth.


CONCLUSIONS
The setting and provider type did not influence the effectiveness of preventive oral health services on children's overall oral health. However, children having only PCP visits may encounter barriers to obtaining dental treatment.
Ashley M. Kranz, R. Gary Rozier, and Sally C. Stearns are with the Department of Health Policy and Management, University of North Carolina (UNC) Gillings School of Global Public Health, Chapel Hill. John S. Preisser is with the Department of Biostatistics, UNC Gillings School of Global Public Health. Morris Weinberger is with the Department of Health Policy and Management, UNC Gillings School of Global Public Health, and the Center for Health Services Research in Primary Care, VA Medical Center, Durham, NC. Jessica Y. Lee is with the Department of Pediatric Dentistry, UNC School of Dentistry and the Department of Health Policy and Management, UNC Gillings School of Global Public Health.
Ashley M
AM
Kranz
R Gary
RG
Rozier
John S
JS
Preisser
Sally C
SC
Stearns
Morris
M
Weinberger
Jessica Y
JY
Lee
D002675:Child, Preschool; D004245:DMF Index; D003731:Dental Caries / Q000453:epidemiology* / Q000517:prevention & control*; D003815:Dentists / Q000458:organization & administration / Q000706:statistics & numerical data*; D005260:Female; D006801:Humans; D007223:Infant; D007345:Insurance Claim Review; D008297:Male; D008484:Medicaid / Q000458:organization & administration / Q000706:statistics & numerical data*; D009657:North Carolina; D011320:Primary Health Care / Q000458:organization & administration / Q000706:statistics & numerical data*; D044469:Racial Groups; D014481:United States