Impact of a Medicaid policy on preventive oral health services for children with intellectual disabilities, developmental disabilities, or both

Kranz, Ashley M.; Ross, Rachel; Sorbero, Mark J.; Kofner, Aaron; Stein, Bradley D.; Dick, Andrew W.

doi:10.1016/j.adaj.2019.12.001

Cited by 7 publications

(17 citation statements)

References 27 publications

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“…While their use is increasing, a number of barriers and facilitators have provided insight to implementation. Lack of training during medical school, limited time with each patient, low reimbursement, poor implementation support, and nonintegrated medical and dental records have prevented more widespread implementation, while having an office champion, implementation teams, good reimbursement policies from state public health programs, and a leader with a clear vision for how oral health will be included in the practice facilitate implementation (10,25,26).…”

Section: Discussionmentioning

confidence: 99%

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The Impact of COVID-19 on Preventive Oral Health Care During Wave One

Meyer

Danesh

2021

Front. Dent. Med

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Introduction: Early childhood caries burdens children, their families, and the health care system. Utilizing fluoride varnish at medical well-child visits with non-dental primary care providers can be an interprofessional strategy to combat early childhood caries. The COVID-19 pandemic dramatically altered preventive health care delivery and the effects on preventive oral health care delivery have not been previously described.Methods: This analysis used descriptive statistics and non-parametric Wilcoxon Mann-Whitney tests to compare preventive oral health utilization among 1 to 5-year old children in two state Medicaid agencies before and during the pandemic. Fluoride utilization rates at dental visits and medical well-child visits were calculated as number of users per 1,000 enrolled children. Additionally, the proportion of well-child visits that included fluoride application was calculated for each state.Results: During the pandemic, the quarterly fluoride utilization rate significantly decreased at dental visits (pre-pandemic = 153.5 per 1,000 enrolled children; pandemic = 36.1 per 1,000 enrolled children, p < 0.001) and signficantly decreased at medical well-child visits (pre-pandemic = 72.2 per 1,000 enrolled children; pandemic = 32.3 per 1,000 enrolled children, p = 0.03) during the pandemic.Conclusions: The findings highlight the importance of interprofessional collaboration among non-dental primary care providers and dental providers to provide access to preventive oral health services, particularly when access to dentists is limited. Future directions might include rigorous evaluations of co-located medical and dental services or the use of interprofessional telehealth technologies.

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Section: Discussionmentioning

confidence: 99%

“…Well-child visits can help improve the utilization of preventive oral health services among young children (10). Compared to children who received preventive oral health services during medical well-child visits, children who received preventive care from a dentist had greater caries related treatment (4).…”

Section: Introductionmentioning

confidence: 99%

The Impact of COVID-19 on Preventive Oral Health Care During Wave One

Meyer

Danesh

2021

Front. Dent. Med

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“…In this regard, one of the main effective policies is health care providers’ collaboration. This policy can significantly improve the access of children with special needs to dental services [ 53 ]. At the same time, policies which aimed at the provision of comprehensive preventive and treatment services for CSHCN can be much more effective than those concentrated only on one separate service [ 49 ].…”

Section: Resultsmentioning

confidence: 99%

“…At the same time, policies which aimed at the provision of comprehensive preventive and treatment services for CSHCN can be much more effective than those concentrated only on one separate service [ 49 ]. It would be clear that policies directed to reducing the barriers of access to services for CSHCN can be much effective [ 53 ].…”

Section: Resultsmentioning

confidence: 99%

“…Another access barrier is the socioeconomic status of families with children with special health needs. This can lead to poor oral health in CSHCN [ 49 , 53 ]. More than economic barriers, other restrictions in resources, administrative limitations and referral system problems along with high costs of the services also can affect the families’ demand for dental services [ 44 , 48 ].…”

Section: Resultsmentioning

confidence: 99%

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Provision of dental services for vulnerable groups: a scoping review on children with special health care needs

Bastani

Mohammadpour

Ghanbarzadegan

et al. 2021

BMC Health Serv Res

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Background The provision of dental services for children with special health care needs (CSHCN) needs to be considered by policymakers. This study is aimed to explore the determinant factors affecting dental and oral services provision for this vulnerable group. Methods A review was conducted applying the 9-steps approach. Five scientific databases of PUBMED, SCOPUS, Web of Science and PROQUEST and EMBASE were searched up to 10.07.2021, applying appropriate keywords. Thematic analysis was used to analyse the extracted data, and a conceptual map was developed according to JBI manual for evidence synthesis. Results From the abstracts of the 136 articles that fulfilled the inclusion criteria, 56 articles were included. Five main themes were identified as determinants affecting the provision of dentistry services for CSHCN, including needs assessment, policy advice, oral health interventions, providers’ perception and access barriers. According to the developed conceptual map, assessing the needs of CSHCN can lead to particular policy advice. Regarding the policies, appropriate oral health interventions can be presented. These interventions, along with providers’ perception about service delivery to CSHCN and the barriers to access them, determine the provision of dentistry services for CSHCN. Conclusions An effective needs assessment of CSHCN and their parents/carers can lead to evidence-informed policymaking and applicable policy advice according to the needs. Then policymakers should develop interventions to improve the community’s health literacy, as well as support the seeking behaviours for appropriate services. Policymakers should also consider how to limit the barriers to accessing oral and dental health by CSHCN to decrease disparities.

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