Effects of early Preventive Dental Visits among Medicaid enrolled Children

Objective: To evaluate the effect of early preventive dental visits among Medicaid enrolled African American children on the frequency and cost of subsequent dental care. Methods: A representative sample of 1,021 low-income African American children in Detroit was recruited and examined for dental caries in 2002-03 (Wave I) and 2004-05 (Wave II). At both waves, the caregivers were interviewed to assess social and behavioral factors. The caregivers also were asked to provide permission to retrieve the Medicaid claims data for the children (954 consented (93.4% approval)). Medicaid dental claims data were obtained between 2000 and 2006 for 855. This analysis focuses on the impact of early preventive dental visits (before the age of 3 or 4 years) on the frequency of subsequent restorative visits and expenditures on dental care. Results: Of the 855 children, only 30 (3.5%) had at least one preventive-only dental visit before 36 months of age. The number increased to 185 (22%) by the age of 4 years. Children's early preventive visits were positively associated with enrollment in WIC in children less than 3 years of age. Enrollment in Head Start and caregivers' preventive visits were significantly associated with preventive visits of children less than 4 years old. Children with early preventive dental visits before 36 months or 48 months of age did not have significantly lower frequency of subsequent restorative treatment in comparison with children with no early preventive visits (p=0.64). The cost of subsequent dental care in children who had early preventive dental visits was $339, which was not significantly different from that ($321) of children with no early preventive visits (p=0.72). Conclusion: Medicaid enrolled African-American children in Detroit do not seek and receive effective early preventive care. Early preventive dental visits did not reduce the need for nor cost of subsequent restorative care. This study is funded by NIDCR/NIH grant number U-54 DE 14261-01.