Preventive care provided by dentists for children before the age of 2 years enrolled in Medicaid in Alabama may lead to more long-term care, reports the University of Alabama at Birmingham School of Public Health. A study there has associated early preventive care with more frequent subsequent treatment for tooth decay, more visits, and more spending on dental care.
While professional dental organizations all recommend children see a dentist once their baby teeth begin to come in, limited evidence has been available about the effectiveness of early preventive dental care or whether primary care providers can deliver it. And despite the focus on preventive dental care, dental caries in children under the age of 5 years has been rising, according to the researchers.
The study compared tooth decay-related treatment, visits, and dental expenditures for children receiving preventive dental care from a dentist or primary care provider and those receiving no preventive dental care. It analyzed Medicaid data from 19,658 children in Alabama, 25.8% of whom received preventive care from a dentist before they were 2 years old.
Compared to similar children without early preventive dental care, children who received early preventive care from a dentist had more frequent tooth decay-related treatment (20.6% versus 11.3%), a higher rate of visits, and higher annual dental expenditures ($168 versus $87). Preventive care delivered by primary care providers was not significantly associated with tooth decay-related treatment or expenditures, according to the results.
“This study highlights the need for continued careful evaluation of the evidence basis for clinical recommendations,” said Justin Blackburn, PhD, assistant professor in the Department of Health Care Organization and Policy at the school. “What we find is that we cannot definitively say whether early preventive dental visits reduce tooth decay with the available data.”
The researchers note that the study had limitations. For example, it did not measure other benefits of preventive dental care such as improved quality of life, nor did it include information about oral health behaviors such as teeth brushing. Also, it did not include information regarding water fluoridation.
Regardless of the provider, the researchers observed little evidence of the benefits of this care. The preventive care from dentists even seemed to increase caries-related treatment, which surprised the researchers, who concluded that additional research among other populations and beyond administrative data may be necessary to elucidate the true effects of early preventive dental care.
The study, “Outcomes Associated With Early Preventive Dental Care Among Medicaid-Enrolled Children in Alabama,” was published by JAMA Pediatrics.
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