National Maternal and
Child Oral Health Resource
Center
This and past issues of the Oral Health Alert: Focus on Head Start are available at http://www.mchoralhealth.org/alert/archives.html.
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1. Dental Case Management: Increasing Access to Oral
Health Care for Families and Children with Low Incomes
This article describes how a dental case management program (DCMP) was
used to address the needs of difficult-to-reach populations, increase
the number of Medicaid recipients accessing care, expand dentists'
participation in Medicaid, and reduce the rate of patients' missing
appointments. The authors analyzed program outcomes and comparisons of
utilization data for Medicaid beneficiaries in New York City; Tompkins
County, New York; the rest of New York; and New York state as a whole.
DCMP appears to have contributed to increased dentist participation in
Medicaid and improved use of oral health services by Medicaid
beneficiaries in Tompkins County.
Greenberg BJS, Kumar JV, Stevenson H. 2008. The Journal of the American
Dental Association 139(8):1114-1121. Abstract available at http://jada.ada.org/cgi/content/short/139/8/1114.
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2. Dental Coverage and Care for Low-Income Children: The
Role of Medicaid and SCHIP (updated edition)
This fact sheet discusses the importance of oral health and oral health
care for children and highlights critical health policy challenges.
Topics include disparities in care among children from minority groups
and those from families with low incomes, dental coverage in Medicaid
and in the State Children's Health Insurance Program, and access to
care among children enrolled in these programs. Efforts at the state
and federal levels to improve children's care are also addressed.
Contact: Kaiser Commission on Medicaid and the Uninsured, 1330 G
Street, N.W., Suite 250, Washington, DC 20005. Telephone: (202)
347-5270; fax: (202) 347-5274; e-mail: kcmu@kff.org;
Web site: http://www.kff.org.
Available at no charge from the Web site at http://www.kff.org/medicaid/upload/7681-02.pdf.
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3. Filling an Urgent Need: Improving Children's Access to
Dental Care in Medicaid and SCHIP
This report summarizes findings from a meeting of policy officials and
oral health experts held in October 2007 to discuss children's access
to oral health care in Medicaid and in the State Children's Health
Insurance Program (SCHIP) and to exchange information and perspectives
on strategies that have worked best to improve access. The report
identifies actions that states can take, such as garnering more dentist
participation in Medicaid and SCHIP, increasing the number of Medicaid
and SCHIP patients that dentists see, improving implementation of the
Medicaid Early and Periodic Screening, Diagnosis and Treatment benefit,
coordinating outreach and education, and developing capacity to measure
and monitor the need for services and access to care among children
from families with low incomes. Work force development and the need for
reforms of the paradigm for treating oral disease are also addressed.
Contact: Kaiser Commission on Medicaid and the Uninsured, 1330 G
Street, N.W., Suite 250, Washington, DC 20005. Telephone: (202)
347-5270; fax: (202) 347-5274; e-mail: kcmu@kff.org;
Web site: http://www.kff.org.
Available at no charge from the Web site at http://www.kff.org/medicaid/upload/7792.pdf.
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4. Determinants of Early Childhood Caries in Low-Income
African American Young Children
This article describes the prevalence, incidence, and determinants of
early childhood caries (ECC) in African-American children from families
with low incomes who reside in Detroit, Michigan. The authors found a
high prevalence and incidence of ECC. The ages of the child and
caregiver, the child's gender, and the caregiver's fatalistic belief
and religiosity were significant predictors of ECC and severe early
childhood caries (S-ECC). Consumption of soft drinks was also
associated with development of S-ECC.
Ismail AI, Lim S, Sohn W, Willem JM. 2008. Pediatric Dentistry
30(4):289-296. Abstract available at http://www.aapd.org/searcharticles/article.asp?ARTICLE_ID=2256.
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5. Perceptions of Oral Health Training and Attitudes
Toward Performing Oral Health Screenings Among Graduating Pediatric
Residents
This article describes several aspects of oral health education during
pediatric residency, including the amount of instruction received,
training in performing screenings for disease risk, and ability to
perform screenings. The authors found that most graduating pediatric
residents believe they should be conducting oral health risk
assessments and screenings but feel they lack the skills to do so
because of limited training received during residency. The authors
conclude that, although there are many demands on pediatric residents'
time, oral health training can have considerable impact on
pediatricians' confidence in their ability to participate in
oral-health-promotion activities.
Caspary G, Krol DM, Boulter S, Keels MA, Romano-Clarke G. 2008.
Pediatrics 122(2):e465-e471. Abstract available at http://pediatrics.aappublications.org/cgi/content/abstract/122/2/e465.
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6. Practices and Opinions of Pediatric and General
Dentists in Connecticut Regarding the Age 1 Dental Visit and Dental
Care for Children Younger Than 3 Years Old
This article describes a study to determine the percentage of general
and pediatric dentists in Connecticut who were aware of and follow the
American Academy of Pediatric Dentistry’s (AAPD's) policy for the age 1
dental visit; what types of services dentists provide for infants and
children from birth to age 2, and dentists' reasons for not seeing this
population. The authors found that 98% of pediatric dentists were aware
of the AAPD policy, vs. 41% of general dentists, and 92% of pediatric
dentists agreed with the policy, vs. 45% of general dentists. All
pediatric dentists reported seeing young children, compared to 42% of
general dentists. Most pediatric dentists provided all services
surveyed. Although 75% of general dentists provided prophylaxis, only
57% provided topical fluoride, and only 59% provided restorative care.
Santos CL, Douglass JM. 2008. Pediatric Dentistry 30(4):348-351.
Abstract available at
http://www.aapd.org/searcharticles/article.asp?ARTICLE_ID=2264.
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7. Prevalence of Dental Caries in Early Head Start
Children as Diagnosed Using Teledentistry
This article describes a study on using teledentistry technology to
assess the prevalence of dental caries in children (ages 12 to 60
months) enrolled in inner-city child care centers in Rochester, New
York. The authors found that dental caries was present in almost half
of the study sample. Very few children appeared to have been to a
dentist or to have received treatment for caries. The authors conclude
that teledentistry offers a potentially efficient and cost-effective
means of screening and tracking young children with early childhood
caries (ECC) or who are at high risk for ECC and could be a way to help
families without access to oral heath care establish a dental home.
Kopycka-Kedzierawski DT, Bell CH, Billings RJ. 2008. Pediatric
Dentistry 30(4):329-333. Abstract available at http://www.aapd.org/searcharticles/article.asp?ARTICLE_ID=2262.
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8. Survey of Treatment Provided for Young Children by
West Virginia General Dentists
This article describes a study to obtain information on the age of
populations served by general dentists (GDs) in West Virginia, their
treatment of children enrolled in Medicaid, and what procedures these
dentists perform. The authors found that the great majority of GDs
report providing services to children. However, only 37% will perform
an oral examination on an infant or child age 2 or younger. And more
than half will not place a dental sealant on a primary tooth in a
4-year-old child. Distance and transportation, financial problems, and
refusal to accept new Medicaid patients affected GDs’ ability to refer
a patient to a pediatric dentist.
Shulman ER, Ngan P, Wearden S. 2008. Pediatric Dentistry 30(4):352-357.
Abstract available at http://www.aapd.org/searcharticles/article.asp?ARTICLE_ID=2265.
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