Physician-provided oral health services reduce caries in kindergarteners

Comprehensive preventive oral health services (POHS) provided by primary care clinicians can help improve the oral health of Medicaid-enrolled children, a retrospective study in more than 29,000 kindergarten students in North Carolina showed.

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Using surveillance data and North Carolina Medicaid files, investigators examined the association between the number of medical visits with POHS, including screening and risk assessment, fluoride varnish applications, and parental oral health counseling, and later oral health outcomes: namely the number of decayed, missing, and filled teeth and untreated decayed teeth. Almost 70% of children had no visits with POHS. Among those who did have such visits, 51% had 1 visit; 29% had 2 visits; 13% had 3 visits; and 6% had 4 or more visits.

Overall, 48% of children had at least 1 decayed, missing, or filled tooth, with 25% having at least 1 untreated decayed tooth by the time they started kindergarten. Kindergarten students who had 4 or more POHS visits had significantly fewer decayed, missing, and filled teeth than those who had none of these visits-1.8 versus 2.2 (Kranz AM, et al. Pediatrics. 2015;136[1]:107-114).

Commentary: If you or members of your staff screen for dental disease and apply fluoride varnish in the office, take a bow. This intervention has been shown to decrease the burden of dental caries, the most common chronic medical condition in US children. The next step is to ensure that children find a “dental home,” a task that in some communities is easier said than done. -Michael G Burke, MD   

Ms Freedman is a freelance medical editor and writer in New Jersey. Dr Burke, section editor for Journal Club, is chairman of the Department of Pediatrics at Saint Agnes Hospital, Baltimore, Maryland. The editors have nothing to disclose in regard to affiliations with or financial interests in any organizations that may have an interest in any part of this article.