| Estimated impact of competing policy recommendations for age of first dental visit. | |
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MedLine Citation:
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PMID: 15805363 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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OBJECTIVE: To compare levels of dental utilization and untreated dental decay among children aged 1 to 3 years that are likely to occur under 2 potential guidance policies: (1) pediatricians refer all toddlers to dentists for screening (consistent with American Academy of Pediatric Dentistry and the American Dental Association recommendations; DENT), and (2) pediatricians receive training in caries risk assessment, screen toddlers, and refer at-risk children to dentists (consistent with American Academy of Pediatrics recommendations; PED). METHODS: Using decision analysis, we estimated the impact of PED and DENT assuming alternately unlimited dental capacity for Medicaid-insured patients and fixed Medicaid dental capacity. Results With unlimited capacity, if DENT were implemented, then dental utilization is estimated to increase from 27% under the status quo to 65% and untreated decay to decrease from a mean of 0.60 surfaces to 0.52 surfaces per child. If PED were implemented, then dental utilization and untreated decay would decrease from status quo levels to an estimated 11% and 0.47 surfaces, respectively, assuming that diagnostic sensitivity and specificity both equaled 1; they would decrease to 13% and 0.53 surfaces, respectively, if sensitivity equaled 0.76 and specificity equaled 0.95. With fixed capacity, under DENT, untreated decay is estimated to increase to 0.63 surfaces because low-risk private-pay patients would crowd out at-risk Medicaid-insured children, whereas under PED, untreated decay would still be less than under the status quo. CONCLUSIONS: Implementing PED will decrease untreated decay under most plausible scenarios, whereas switching to DENT will increase the burden of disease if Medicaid dental capacity is limited. |
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Authors:
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Kari Jones; Scott L Tomar |
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Publication Detail:
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Type: Journal Article |
Journal Detail:
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Title: Pediatrics Volume: 115 ISSN: 1098-4275 ISO Abbreviation: Pediatrics Publication Date: 2005 Apr |
Date Detail:
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Created Date: 2005-04-04 Completed Date: 2005-08-11 Revised Date: 2007-11-15 |
Medline Journal Info:
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Nlm Unique ID: 0376422 Medline TA: Pediatrics Country: United States |
Other Details:
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Languages: eng Pagination: 906-14 Citation Subset: AIM; IM |
Affiliation:
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Division of Public-Private Partnerships, National Center for Health Marketing, Centers for Disease Control and Prevention, 4770 Buford Hwy NE, MS K-39, Atlanta, GA 30341, USA. kjones5@cdc.gov |
Export Citation:
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APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
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Child, Preschool Decision Trees Dental Care for Children / economics, manpower, utilization* Dental Caries / diagnosis, epidemiology, prevention & control* Humans Infant Medicaid* Pediatrics* / manpower Practice Guidelines as Topic* Preventive Dentistry Referral and Consultation* Risk Assessment Sensitivity and Specificity Societies, Dental United States |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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