title: Effects of Physician-Based Preventive Oral Health Services on Dental Caries.
abstract: BACKGROUND
  Most Medicaid programs reimburse nondental providers for preventive dental services. We estimate the impact of comprehensive preventive oral health services (POHS) on dental caries among kindergarten students, hypothesizing improved oral health among students with medical visits with POHS.
  
  
  METHODS
  We conducted a retrospective study in 29,173 kindergarten students by linking Medicaid claims (1999-2006) with public health surveillance data (2005-2006). Zero-inflated regression models estimated the association between number of visits with POHS and (1) decayed, missing, and filled primary teeth (dmft) and (2) untreated decayed teeth while adjusting for confounding.
  
  
  RESULTS
  Kindergarten students with ≥4 POHS visits averaged an adjusted 1.82 dmft (95% confidence interval: 1.55 to 2.09), which was significantly less than students with 0 visits (2.21 dmft; 95% confidence interval: 2.16 to 2.25). The mean number of untreated decayed teeth was not reduced for students with ≥4 POHS visits compared with those with 0 visits.
  
  
  CONCLUSIONS
  POHS provided by nondental providers in medical settings were associated with a reduction in caries experience in young children but were not associated with improvement in subsequent use of treatment services in dental settings. Efforts to promote oral health in medical settings should continue. Strategies to promote physician-dentist collaborations are needed to improve continuity of care for children receiving dental services in medical settings.
authors.affiliation: Department of Pediatric Dentistry, School of Dentistry, and akranz@unc.edu.
authors.forename: Ashley M
authors.initials: AM
authors.lastname: Kranz
authors.affiliation: Departments of Biostatistics and.
authors.forename: John S
authors.initials: JS
authors.lastname: Preisser
authors.affiliation: Health Policy and Management, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina.
authors.forename: R Gary
authors.initials: RG
authors.lastname: Rozier
mesh_terms: D002648:Child; D002675:Child, Preschool; D004245:DMF Index; D003731:Dental Caries / Q000517:prevention & control*; D003752:Dental Health Services; D005260:Female; D006801:Humans; D007223:Infant; D008297:Male; D008484:Medicaid; D009909:Oral Health; D010820:Physicians; D011314:Preventive Health Services / Q000379:methods*; D012189:Retrospective Studies; D013334:Students; D014481:United States