The Association of Medical Periodicity Adherence and Early Preventive Dental Care With Subsequent Dental Utilization Among Medicaid-Insured Ohio Children.

Abstract

Purpose: To evaluate the association between preventive medical and dental visits before age 30 months with dental utilization after age 30 months. Methods: This retrospective cohort study used Medicaid enrollment and claims data from Partners for Kids, a pediatric accountable care organization in Ohio. Medical periodicity adherence was defined by the HEDIS W30 measure, and early preventive dental care was defined as having a preventive dental visit by age 30 months. Dental utilization outcomes were measured from ages 30 months to eight years. Descriptive statistics, chi-square tests of independence, and stratified, multiple-variable logistic regression were used in the analysis. Results: Among 14,800 included children, 64 percent (N equals 9,322) met medical periodicity adherence and only 15 percent (N equals 2,141) met the early preventive dental care measure. Children who met both medical and dental measures had the highest frequency of caries-related treatment visits (50.3 percent, P<0.001), and had two times the odds of having a caries-related treatment visit (odds ratio equals 1.9, 95 percent confidence interval equals 1.7 to 2.1) than children who met neither measure. Conclusions: Medicaid-enrolled children were much more likely to complete their medical well-child visits than preventive dental visits. Physicians may be the initial source of dental care when access to dental care is limited. Promoting earlier access to dental care or integrating dental care into medical well-child visits may improve pediatric oral health.