Effect of Free Dental Services on Individuals with Sickle Cell Disease.
Poor oral health can have a negative impact on overall health. This is especially concerning for individuals with sickle cell disease (SCD), an inherited blood disorder that affects hemoglobin and can lead to an increased risk of infection and hyperalgesia. Because the majority of individuals with SCD have Medicaid insurance and no dental coverage, we provided free basic dental care to individuals with SCD to determine whether it decreased overall healthcare utilization.



Through a contract with a private dental office, we provided free basic dental care (eg, cleanings, fillings, x-rays) to individuals with SCD. We reviewed medical records for the 12 months before and after their initial dental visit to determine whether there were any changes in acute care visits (defined as a visit to the emergency department, sickle cell infusion center, or visits to both in the same day), hospitalizations, and total days hospitalized. We conducted a negative binomial regression to determine any differences in the pre-post periods.



In our multivariable analysis, there was a statistically significant decrease in hospital admissions. In addition, there was a significant decrease in total days hospitalized if dental work was completed, but an increase in days hospitalized in men.



Providing dental care to individuals with SCD who did not have dental insurance did not greatly alter acute care visits. A larger sample size may be necessary to observe an effect.
From the Departments of Medicine, Pediatrics, and Otolaryngology, and the Berman Institute of Bioethics, Johns Hopkins University, Baltimore, Maryland.
Lauren N
LN
Whiteman
From the Departments of Medicine, Pediatrics, and Otolaryngology, and the Berman Institute of Bioethics, Johns Hopkins University, Baltimore, Maryland.
Carlton
C
Haywood
From the Departments of Medicine, Pediatrics, and Otolaryngology, and the Berman Institute of Bioethics, Johns Hopkins University, Baltimore, Maryland.
Sophie
S
Lanzkron
From the Departments of Medicine, Pediatrics, and Otolaryngology, and the Berman Institute of Bioethics, Johns Hopkins University, Baltimore, Maryland.
John J
JJ
Strouse
From the Departments of Medicine, Pediatrics, and Otolaryngology, and the Berman Institute of Bioethics, Johns Hopkins University, Baltimore, Maryland.
Adrian H
AH
Batchelor
From the Departments of Medicine, Pediatrics, and Otolaryngology, and the Berman Institute of Bioethics, Johns Hopkins University, Baltimore, Maryland.
Anthony
A
Schwartz
From the Departments of Medicine, Pediatrics, and Otolaryngology, and the Berman Institute of Bioethics, Johns Hopkins University, Baltimore, Maryland.
Rosalyn W
RW
Stewart
D000328:Adult; D000755:Anemia, Sickle Cell / Q000150:complications / Q000628:therapy*; D065187:Controlled Before-After Studies; D003695:Delivery of Health Care / Q000706:statistics & numerical data; D003729:Dental Care / Q000191:economics / Q000458:organization & administration; D005260:Female; D006760:Hospitalization / Q000706:statistics & numerical data; D006801:Humans; D007902:Length of Stay; D008297:Male; D008875:Middle Aged; D009057:Stomatognathic Diseases / Q000517:prevention & control / Q000628:therapy; D055815:Young Adult