Race and payor type for child visits with public health dental hygienist practitioners.

PURPOSE: To examine whether growth in visits to public health dental hygiene practitioners (PHDHPs) providing preventative dental services at a pediatric hospital clinic was predominantly among children receiving public insurance and children of minority background from 2013 to 2017. METHODS: Longitudinal descriptive data analysis from electronic health records for 6856 children under age 18 years who visited PHDHPs co-located at a hospital clinic in Pittsburgh, PA, from 2013 to 2017. We compared visits between white versus non-white children and between children with public, private, and no or missing insurance by year. RESULTS: Visit volume doubled from 2013 (n = 811) to 2017 (n = 1868). The proportion of PHDHP visits with non-white children increased from 77% (n = 625) in 2013 to 87% (n = 1472) in 2017 (p < 0.001). The proportion of PHDHP visits with children with public insurance increased from 72% (n = 585) in 2013 to 82% (n = 1377) in 2017 (p < 0.001). CONCLUSIONS: PHDHPs co-located at a pediatric hospital clinic saw a high proportion of visits from children of non-white race and with public insurance. Visits from children of minority race and with public insurance increased disproportionately as visit volume grew from 2013 to 2017, depicting a vehicle through which historically underserved children increasingly accessed preventive dental services.

Success rates of pediatric dental referrals made by public health dental hygiene practitioners.

OBJECTIVES: The purpose of this study was to evaluate whether Public Health Dental Hygiene Practitioner (PHDHP) referrals to pediatric dentists were more successful for children younger than 3 years old and those with dental caries. METHODS: We reviewed the electronic health records of 1,450 children, age 1 to 12 years, who completed a dental visit with a PHDHP in 2017 at UPMC Children's Hospital of Pittsburgh's (CHP) Primary Care Center. We tracked whether children who visited the onsite PHDHP accepted a referral to CHP pediatric dentists, and if so, whether they successfully completed the referral. RESULTS: Of the 1,450 children who visited the PHDHP, 67 percent (n = 973) accepted a referral to CHP pediatric dentists. Of these referrals, 32 percent (312/973) were successfully fulfilled. The proportions of accepted and fulfilled referrals were significantly higher for children older than 3 years old and those with dental caries. After controlling for child age, gender, and insurance status, children with dental caries had 5.7 times greater odds of successful referral from the PHDHP to the pediatric dentist compared to children without dental caries (95 percent CI 4.1-7.9). CONCLUSIONS: PHDHPs were more successful referring children older than 3 years old and those with dental caries to pediatric dentists. PHDHPs are allied dental health professionals that can be effective at referring children to pediatric dentists when they have dental caries. Additional strategies are needed to enhance the success rate of dental referrals for young children under 3 years old.