Tiwari T, Rai N, Brow A, Tranby E P, Boynes S G
1 Department of Community Dentistry and Population Health, University of Colorado, School of Dental Medicine, Aurora, CO, USA.
2 DentaQuest Partnership for Oral Health Advancement, Boston, MA, USA.
JDR Clin Trans Res. 2019 Jul;4(3):239-245. doi: 10.1177/2380084419841850. Epub 2019 Apr 22.
This study evaluated the impact of well-child visits (WCVs) on promoting preventive visits to the dentist. Effects by age, race, gender, and dental diagnosis were investigated.
Administrative claims data for 1.85 million Medicaid-enrolled children aged 4 or less in 13 states in 2013 were identified from the Truven MarketScan Medicaid Database. A cohort for all children who had a WCV in 2013 was generated and followed for 365 d to identify the date of closest preventive dental visit.
The cohort included 1,308,719 Medicaid-enrolled children with a WCV in 2013. Three percent of children under the age of 1 with a WCV had an oral health assessment within 1 y compared to only 0.4% of all Medicaid-enrolled children in that age group. Similar patterns were seen in all age groups: age 1 (13% vs. 9%), age 2 (32% vs. 23%), age 3 (50% vs. 37%), and age 4 (59% vs. 48%). On average, about 1.4% of children received an oral health assessment during their WCV, and another 0.6% were diagnosed with a dental condition. These children had a higher proportion of visits to the dentist for a preventive visit after a WCV. Children of all races (White, Hispanic, and Black) with a prior WCV had higher preventive dental compared to total enrolled. However, Hispanic children with a WCV reported the highest preventive dental visits within 1 y (White 24%, Black 29%, and Hispanic 46%). Furthermore, Hispanic children visited the dentist earlier than White and Black children; 16.9% of Hispanic children visited the dentist within 90 d of the WCV compared to 8.5% of White and 10% of Black children.
This study demonstrated increased utilization of dental preventive visits for the children who received a well-child visit.
Results of this study indicate a higher number of preventive dental visits for children with prior WCV. Clinical implications of this study would be to continually increase and promote the inclusion of oral health within primary care. This can increase the likelihood of preventative dental visits and, ultimately, better dental health in children.
本研究评估健康儿童体检（WCVs）对促进儿童定期看牙医的影响。研究调查了年龄、种族、性别和牙科诊断的影响。
从Truven MarketScan医疗补助数据库中识别出2013年13个州185万名4岁及以下参加医疗补助计划儿童的管理索赔数据。建立了一个2013年进行过健康儿童体检的所有儿童队列，并随访365天，以确定最近一次预防性牙科就诊的日期。
该队列包括2013年进行过健康儿童体检的1308719名参加医疗补助计划的儿童。1岁以下进行过健康儿童体检的儿童中，3%在1年内进行了口腔健康评估，而该年龄组所有参加医疗补助计划的儿童中这一比例仅为0.4%。所有年龄组均出现类似模式：1岁（13%对9%）、2岁（32%对23%）、3岁（50%对37%）和4岁（59%对48%）。平均而言，约1.4%的儿童在健康儿童体检期间接受了口腔健康评估，另有0.6%被诊断患有牙科疾病。这些儿童在健康儿童体检后进行预防性看牙医的比例更高。所有种族（白人、西班牙裔和黑人）中，之前进行过健康儿童体检的儿童与总参保儿童相比，预防性牙科就诊率更高。然而，进行过健康儿童体检的西班牙裔儿童在1年内的预防性牙科就诊率最高（白人24%，黑人29%，西班牙裔46%）。此外，西班牙裔儿童比白人和黑人儿童更早看牙医；16.9%的西班牙裔儿童在健康儿童体检后9
