Document Detail


Estimated impact of competing policy recommendations for age of first dental visit.
MedLine Citation:
PMID:  15805363     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
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.
Authors:
Kari Jones; Scott L Tomar
Related Documents :
19358383 - The use of general anesthesia in pediatric dental care of children at multi-dental cent...
8897743 - Dental caries in children from two libyan cities with different levels of fluoride in t...
20523383 - Complex index of refraction of dental enamel at co(2) laser wavelengths.
Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Pediatrics     Volume:  115     ISSN:  1098-4275     ISO Abbreviation:  Pediatrics     Publication Date:  2005 Apr 
Date Detail:
Created Date:  2005-04-04     Completed Date:  2005-08-11     Revised Date:  2007-11-15    
Medline Journal Info:
Nlm Unique ID:  0376422     Medline TA:  Pediatrics     Country:  United States    
Other Details:
Languages:  eng     Pagination:  906-14     Citation Subset:  AIM; IM    
Affiliation:
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:
APA/MLA Format     Download EndNote     Download BibTex
MeSH Terms
Descriptor/Qualifier:
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


Previous Document:  Importance of catch-up vaccination: experience from a varicella outbreak, Maine, 2002-2003.
Next Document:  Helping parents cope with the trauma of premature birth: an evaluation of a trauma-preventive psycho...