New Research Claims Early Preventative Care Leads to Greater Costs

March 27, 2017
Sarah Handzel, BSN, RN

The JAMA Pediatrics study suggests that children younger than 2 who receive preventative dental care have more frequent tooth decay treatments. These children, the research shows, see the dentist more often. Their parents are also spending more money on their dental care. The study, however, did not account for factors such as genetic predisposition to caries or brushing and flossing habits. As a result, the American Dental Association says no definitive conclusions can be drawn from the study.

A new study published in JAMA Pediatrics claims early preventative care for children enrolled in Medicaid in the state of Alabama could lead to more care in the long run.

The study suggests that children younger than 2 years old who receive preventative care from dentists have more frequent subsequent treatments for tooth decay. Ultimately, these children visit a dentist more often and have more money spent on their dental care. According to the study authors, rates of dental caries are on the rise in children under the age of 5, despite efforts to improve preventative care.

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This new research compared tooth decay-related treatments, visits, and dental expenditures in children that received early preventative care to children that received no such treatments. Data from 19,658 children enrolled in Medicaid in Alabama was collected. 25.8 percent of these children received early preventative care from a dentist. The data suggested that:

· Children who received early preventative dental care had more frequent tooth-decay related treatments (20.6 percent versus 11.3 percent).

· Children who received early preventative care had higher rates of visits to dentists.

· Children receiving early preventative care had higher annual dental expenditures ($168 vs. $87).

However, there were several limitations to the study. Other benefits from early preventative dental care, such as improved quality of life, were not measured. Also, the study did not include any information on other oral health behaviors, such as oral hygiene habits or access to fluoridated drinking water.

In response to the published research, the ADA and AAPD both reaffirmed their support for early dental visits to prevent childhood tooth decay.

Mia Geisinger, D.D.S., M.S. and member of the ADA’s Council on Scientific Affairs said, “As the authors state, this study design did not allow for evaluation of factors such as a genetic predisposition, previous disease and environmental considerations such as diet, frequency of brushing and flossing, the use of fluoride toothpaste and drinking fluoridated water, all of which are crucial in reducing the risk of cavities. Furthermore, there is no evaluation to determine if untreated cavities are present in those individuals who did not seek dental care for restorative treatment, so the data are incomplete. Because of this study’s limitations, we cannot make any definitive conclusions from the data provided and further research is necessary. This study highlights the need to invest in oral health research to address the epidemic levels of tooth decay in some populations of children.”

The ADA and AAPD re-emphasized their recommendation that children visit a dentist at least once before turning 1 year old. The ADA also noted that this study highlighted the importance of reducing cavities among underserved children, but that additional research was necessary to determine best practices for preventative services.

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