Increased public reimbursement for prophylactic visits with dentists associated with increased receipt of preventive dental services in children.

OBJECTIVE: To determine whether higher reimbursement for children's preventive dentistry correlates with greater utilization of preventive dental care. METHODS: A cross-sectional analysis of National Survey of Children's Health 2011/2012 was conducted, combined with state Medicaid reimbursement rates for preventive dentistry. Analyses included prevalence, unadjusted odds ratios, and multivariable logistic regression for receipt of preventive dental services. RESULTS: Of all surveyed American children 1-17 years, almost 20 percent had not received preventive dental care in prior year; this percentage is even higher in those with public insurance. Each $10 increase in state reimbursement was associated with a 17 percent decrease in odds of children not receiving preventive services. CONCLUSIONS: Higher state reimbursement for preventive services may increase children's receipt of preventive dental care.

Envisioning success: the future of the oral health care delivery system in the United States.

The elimination of oral health disparities in the US will require enhancing access to oral health care services. The workshop convened in 2009 by the Institute of Medicine on the "US Oral Health Workforce in the Coming Decade" highlighted both the current workforce's failure to meet the nation's needs as well as the promising opportunities presented by various workforce strategies to significantly enhance access and improve oral health outcomes. In this article, we have briefly reviewed and expanded on the contributions in this special issue of the Journal of Public Health Dentistry, with the goal of identifying common themes and providing a framework for evaluation. There are several key areas where change is critically needed in order to ensure successful implementation of any new workforce models. These areas include a) the public and private financing of dental care, b) the dental educational system, and c) state and federal policies.

Case study of linking dental and medical healthcare records.

OBJECTIVE: To link the administrative data of a large dental carrier and an integrated health plan in Washington State to conduct an observational study of diabetes and periodontal disease. STUDY DESIGN: Evaluation of variable suitability, testing of linkage variables, and performing an n - 1 deterministic linkage strategy. METHODS: We examined a variety of administrative data variables for their consistency over time and their information richness to use as matching variables. After choosing social security number, date of birth, first name, and last name, we tested their reliability as linking variables among a population with dual dental and medical insurance. Lastly, we performed four n - 1 deterministic linkage steps to obtain our study population. RESULTS: With a success match rate of more than 96% with the 4 test variables, we extracted the entire population who met the study criteria with the understanding that only a subset would successfully link. We linked 78,230 individuals (55.2% of the Group Health Cooperative population). Of these matches more than 50% occurred within a last name-first name-birth date deterministic match. CONCLUSIONS: Employer groups who provide dental-medical benefits for their employees send identical administrative data to dental and healthcare plans. The n - 1 deterministic linkage was accomplished by using a relatively straightforward approach because these data were fairly homogeneous and of high quality. Until medical care and dental care are integrated, it is possible to link these data to assess the impact of oral disease on overall health.