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Follow-Up Preventive Dental Visits for Medicaid-Enrolled Children in the Medical Office.

Quiñonez RB, Pahel BT, Rozier RG, Stearns SC

Department of Pediatric Dentistry and Pediatrics, Schools of Dentistry and Medicine, University of North Carolina at Chapel Hill, NC, USA.

Objective: To describe the frequency and determinants of follow-up preventive oral health visits at medical offices among children screened for dental disease, receiving fluoride varnish and counseling. Methods: Parents of Medicaid children enrolled in a clinical trial completed a baseline questionnaire before their child's medical visit. The providers completed patient dental encounter forms at each visit, documenting dental services, caries risk, and dental disease. Questionnaires, encounter forms, and Medicaid claims were linked to create a database with information on visits, child and caregiver characteristics, and oral health practices. Descriptive and multivariate analyses assessed associations of variables with likelihood of follow-up visits. Results: A total of 744 children with mean age of 15 months at enrollment had 1,415 oral health visits. Children averaged 0.9 follow-up oral health visits and 1.3 follow-up well-child visits. Fewer children had follow-up oral health visits (55 percent) than well-child visits (70 percent), but children with a baseline preventive dental visit at a younger age had more visits with shorter intervals. Caregivers reporting greater numbers of children and putting the child to bed with the bottle had more subsequent visits. Older age of child, male child, and caregiver education </=12 years were associated with fewer follow-up visits. Conclusions: Children with preventive dental services in medical offices have similar numbers of oral health and well-child visits, with both below recommended numbers. Strategies to increase these services may need to be tied to those aimed at increasing compliance with well-child visits, taking advantage of nonwell-child visits, and implementing Medicaid policies that allow for optimal timing of visits.

Published 8 January 2008 in J Public Health Dent.
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