Effectiveness of Preventive Dental Visits in Reducing Nonpreventive Dental Visits and Expenditures

Abstract

BACKGROUND AND OBJECTIVE: Although preventive dental visits are considered important for maintaining pediatric oral health, there is relatively little research showing that they reduce subsequent nonpreventive dental visits or costs. At least 1 study seemed to find that early preventive dental care is associated with more restorative and emergency visits. Previous studies are limited by their inability to account for unmeasurable factors that may lead children to “select” into using both more preventive and nonpreventive dental care. We used econometric techniques that minimize selection bias to assess the effectiveness of preventive dental care in reducing subsequent nonpreventive dental service utilization among children. METHODS: Using data from Alabama’s Children’s Health Insurance Program (CHIP), 1998–2010., a cohort study of children’s dental service utilization was conducted. Outcomes were 1-year lagged nonpreventive dental care and expenditures, and overall dental and medical expenditures. Children who were continuously enrolled for at least 3 years were included. Separate models were estimated for children aged <8 years (n = 14 972) and those aged ≥8 years (n = 21 833). RESULTS: More preventive visits were associated with fewer subsequent nonpreventive dental visits and lower nonpreventive dental expenditures for both groups. However, more preventive visits did not reduce overall dental or medical (inclusive of dental) expenditures. CONCLUSIONS: Preventive dental visits can reduce subsequent nonpreventive visits and expenditures for children continuously enrolled in CHIP. However, they may not reduce overall program costs. Effective empirical research in this area must continue to address unobserved confounders and selection issues.

Parent-reported distress in children under 3 years old during preventive medical and dental care

“…(Savage et al 2004; Sen et al 2013) These findings extend over the life course, reducing overall disease experience into adulthood. (Bhaskar et al 2014) However, receipt of recommended preventive visits is still generally low for US children, and not all children attend PDV at equal rates.…”

Cost-Effectiveness Analysis of Dental Sealants versus Fluoride Varnish in a School-Based Setting

“…One of the major health care challenges in the prevention and treatment of dental caries is access to an oral health care system, which includes both a defined approach to prevention and providers to treat established lesions [Sen et al, 2013]. Dental caries is a preventable disease, and a recognized community-based preventive approach is water fluoridation [Parnell et al, 2009].…”

Assessing the role of appropriate primary health care on the use of dental services by Brazilian low-income preschool children

“…Although there is uncertain evidence in regards to the effectiveness of educative programs in avoiding caries development 30 , studies have shown that early preventive dental care is cost-effective and can reduce the need of further restorative treatment, mainly in highrisk populations 1,29,31,32 .…”