Dental Visits during Pregnancy: Pregnancy Risk Assessment Monitoring System Analysis 2012–2015

2021 ◽  
pp. 238008442110285
Author(s):  
H. Lee ◽  
E. Tranby ◽  
L. Shi
Keyword(s):  
Risk Assessment ◽  
Oral Health ◽  
Prenatal Care ◽  
Service Utilization ◽  
Dental Care ◽  
White Women ◽  
Dental Service ◽  
Pregnancy Risk ◽  
Lower Odds ◽  
Dental Visits

Objectives: This study aimed to update dental service utilization during pregnancy and to evaluate whether there are persistent disparities in dental care during pregnancy by race/ethnicity and Medicaid status. Methods: This retrospective secondary data analysis examined dental service utilization during and prior to pregnancy and met dental or oral health needs using the Pregnancy Risk Assessment Monitoring System (PRAMS) data sets on 75,876 women between 2012 and 2015. Results: Only about half of the women (51.7%) reported that they had at least 1 dental visit for cleaning during their most recent pregnancy. One of 5 women (19.7%) experienced dental problems during pregnancy, and 34.4% of these women did not visit dentists to address the problems. Non-Hispanic Black women had 14% lower odds of visiting dentists for cleaning during pregnancy compared to non-Hispanic White women (odds ratio [OR], 0.86; 95% CI confidence interval [CI], 0.80–0.92). There was no difference in dental visits prior to pregnancy between non-Hispanic Black and White women. Women enrolled in Medicaid showed significantly lower odds of visiting dentists for cleaning during pregnancy compared to women covered by private health insurance (OR, 0.55; 95% CI, 0.52–0.58). Conclusion for Practice: Oral health, as an integral part of primary care, needs to be included in the standard prenatal care through oral health education and timely dental care during pregnancy. With mounting evidence of persisting disparities in dental service utilization during pregnancy, both public and private prenatal programs and policies should address specific barriers in accessing and using dental care during pregnancy, especially for women from socially disadvantaged backgrounds. Knowledge Transfer Statement: The current study updated the previous findings with more recent multiyear PRAMS data (2012–2015) and found the Black-White disparity and disparity among Medicaid-enrolled women in visiting dentists during pregnancy persist. The results of this study can be used by policymakers and practitioners to integrate oral health into prenatal care for pregnant women from marginalized backgrounds to achieve oral health parity.

scholarly journals Oral Health Status and Patterns of Dental Service Utilization of Adolescents in Lesotho, Southern Africa

Children ◽  
2021 ◽  
Vol 8 (2) ◽  
pp. 120
Author(s):  
Abbas Jessani ◽  
Mir Faeq Ali Quadri ◽  
Pulane Lefoka ◽  
Abdul El-Rabbany ◽  
Kirsten Hooper ◽  
...  
Keyword(s):  
Public Schools ◽  
Health Status ◽  
Oral Health ◽  
Service Utilization ◽  
Southern Africa ◽  
Dental Care ◽  
Dental Treatment ◽  
Oral Health Status ◽  
Dental Service ◽  
Treatment Needs

This study aimed to characterize the best predictors for unmet dental treatment needs and patterns of dental service utilization by adolescents in the Kingdom of Lesotho, Southern Africa. A self-reported 40-item oral health survey was administered, and clinical oral examinations were conducted in public schools in Maseru from August 10 to August 25, 2016. Associations between psychosocial factors with oral health status and dental service utilization were evaluated using simple, bivariate, and multivariate regressions. Five hundred and twenty-six survey responses and examinations were gathered. The mean age of student participants was 16.4 years of age, with a range between 12 and 19 years of age. More than two thirds (68%; n = 355) of participants were female. The majority reported their quality of life (84%) and general health to be good/excellent (81%). While 95% reported that oral health was very important, only 11% reported their personal dental health as excellent. Three percent reported having a regular family dentist, with the majority (85%) receiving dental care in a hospital or medical clinic setting; only 14% had seen a dental professional within the previous two years. The majority of participants did not have dental insurance (78%). Clinical examination revealed tooth decay on 30% of mandibular and maxillary molars; 65% had some form of gingivitis. In multivariate analysis, not having dental education and access to a regular dentist were the strongest predictors of not visiting a dentist within the last year. Our results suggest that access to oral health care is limited in Lesotho. Further patient oral health education and regular dental care may make an impact on this population.

scholarly journals Oral Health Status and Patterns of Dental Service Utilization of Adolescents in Lesotho, Southern Africa

2020 ◽  
Author(s):  
Abbas Jessani ◽  
Faeq Quadri ◽  
Abdul El-Rabbany ◽  
Kirsten Hooper ◽  
Hyun Ja Lim ◽  
...  
Keyword(s):  
Public Schools ◽  
Health Status ◽  
Oral Health ◽  
Service Utilization ◽  
Southern Africa ◽  
Dental Care ◽  
Dental Treatment ◽  
Oral Health Status ◽  
Dental Service ◽  
Treatment Needs

Abstract Objectives: To identify the unmet dental treatment needs and patterns of dental service utilization by adolescents in the Kingdom of Lesotho, Southern Africa, and characterize the best predictors for perceived oral health status and dental visits for these adolescents. Method: A self-reported 40-item oral health survey was administered, and clinical oral examinations were conducted in public schools in Maseru from August 10 to August 25, 2016. Associations between psychosocial factors with oral health status and dental service utilization were evaluated using simple, bivariate and multivariate regressions. Results: Five hundred and twenty-six survey responses and examinations were gathered. The mean age of participants was 16.4 years of age, with a range between 12 and 19 years of age. More than two thirds (68%; n=355) of participants were female. The majority reported their quality of life (84%) and general health to be good/excellent (81%). While 95% reported that oral health was very important, only 11% reported their personal dental health as excellent. Three percent reported having a regular family dentist, with the majority (85%) receiving dental care in a hospital or medical clinic setting; only 14% had seen a dental professional within the previous 2 years. The majority of participants did not have dental insurance (78%). Clinical examination revealed tooth decay on 30% of mandibular and maxillary molars; 65% had some form of gingivitis. In multivariate analysis, not having dental education and access to a regular dentist were the strongest predictors of not visiting a dentist within the last year. Conclusion: Our results suggest that access to oral health care is limited in Lesotho. Dental decay on molars was prevalent. Further patient oral health education and regular dental care may make an impact on this population.

scholarly journals Disparities in Dental Service Utilization among Adults in Chinese Megacities: Do Health Insurance and City of Residence Matter?

2020 ◽  
Vol 17 (18) ◽  
pp. 6851
Author(s):  
Xiaomin Qu ◽  
Xiang Qi ◽  
Bei Wu
Keyword(s):  
Health Insurance ◽  
Service Utilization ◽  
Dental Care ◽  
Medical Insurance ◽  
Dental Service ◽  
Gdp Per Capita ◽  
Dental Visits ◽  
Basic Medical Insurance ◽  
Per Capita ◽  
Basic Medical

The aims of the study were to present the prevalence of dental service utilization among adults (age between 18 and 65) in Chinese megacities and to examine the associations of health insurance and city of residence with dental visits. This study was a cross-sectional analysis of the 2019 New Era and Living Conditions in Megacities Survey data with a sample of 4835 participants aged 18–65 from 10 different megacities in China. The data including gross domestic product (GDP) per capita of each megacity obtained from the National Bureau of Statistics of China as a city-level characteristic. After adjusting sampling weights, approximately 24.28% of the participants had at least one dental visit per year. Findings from multilevel mixed-effects linear models showed that participants residing in megacities with higher GDP per capita (β = 0.07, p < 0.001) who had Urban Employee Basic Medical Insurance (β = 0.25, p < 0.001) or Urban Resident Basic Medical Insurance (β = 0.19, p < 0.01) had more frequent dental visits after adjusting demographic characteristics, socioeconomic status, health status, health behavior and attitude, and oral health indicators. Margins post-estimation model results demonstrated disparities in the predicted probability of having never visited a dentist by types of health insurance and city of residence. In conclusion, the prevalence of dental visits in China was found to be low. This study highlights socioeconomic inequalities in dental service utilization. There is a great need to develop more dental care programs and services and expand health insurance to cover dental care in China.

scholarly journals A Cross-Sectional Analysis of Oral Health Spending Over the Lifespan in Commercial and Medicaid Insured Populations

2021 ◽  
Author(s):  
Eric Tranby ◽  
Julie Frantsve-Hawley ◽  
Myechia Minter-Jordan ◽  
James Thommes ◽  
Matt Jacob ◽  
...  
Keyword(s):  
Oral Health ◽  
Oral Cancer ◽  
Dental Care ◽  
Care Delivery ◽  
Health Spending ◽  
Dental Service ◽  
Fee For Service ◽  
Cross Sectional ◽  
Medical Spending ◽  
Ibm Watson

Background: Life course theory creates a better framework to understand how oral health needs and challenges align with specific phases of the lifespan, care models, social programs, and changes in policy. Methods): Data are from the 2018 IBM Watson Multi-State Medicaid Marketscan Database (31 million claims) and the 2018 IBM Watson Dental Commercial and Medicare Supplemental Claims Database (45 million claims). Analysis compares per enrollee spending fee-for-service dental claims and medical spending on dental care from ages 0 to 89. Results: Dental utilization and spending are lower during the first 4 years of life and in young adulthood than in other periods of life. Stark differences in the timing, impact, and severity of caries, periodontal disease, and oral cancer are seen between those enrolled in Medicaid and commercial dental plans. Early childhood caries and oral cancer occur more frequently and at younger ages in Medicaid populations. Conclusions: This unique lifespan analysis of the U.S. multi-payer dental care system demonstrates the complexities of the current dental service environment and a lack of equitable access to oral healthcare. Practical Implications: Health policies should be focused on optimizing care delivery to provide effective preventive care at specific stages of the lifespan.

scholarly journals Dental visits in Medicaid-enrolled youth with mental illness: an analysis of administrative claims data

2020 ◽  
Vol 20 (1) ◽  
Author(s):  
Erica L. Stockbridge ◽  
Eleena Dhakal ◽  
Stacey B. Griner ◽  
Abiah D. Loethen ◽  
Joseph F. West ◽  
...  
Keyword(s):  
Bipolar Disorder ◽  
Mental Illness ◽  
Oral Health ◽  
Dental Care ◽  
Service Use ◽  
Claims Data ◽  
The United States ◽  
Administrative Claims ◽  
Dental Visits ◽  
Administrative Claims Data

Abstract Background State Medicaid plans across the United States provide dental insurance coverage to millions of young persons with mental illness (MI), including those with attention deficit hyperactivity disorder (ADHD), depression, anxiety, bipolar disorder, and schizophrenia. There are significant oral health challenges associated with MI, and providing dental care to persons with MI while they are young provides a foundation for future oral health. However, little is known about the factors associated with the receipt of dental care in young Medicaid enrollees with MI. We aimed to identify mental and physical health and sociodemographic characteristics associated with dental visits among this population. Methods We retrospectively analyzed administrative claims data from a Medicaid specialty health plan (September 2014 to December 2015). All enrollees in the plan had MI and were ≥ 7 years of age; data for enrollees aged 7 to 20 years were analyzed. We used two-level, mixed effects regression models to explore the relationships between enrollee characteristics and dental visits during 2015. Results Of 6564 Medicaid-enrolled youth with MI, 29.0% (95% CI, 27.9, 30.1%) had one or more visits with a dentist or dental hygienist. Within youth with MI, neither anxiety (Adjusted odds ratio [AOR] = 1.15, p = 0.111), post-traumatic stress disorder (AOR = 1.31, p = 0.075), depression (AOR = 1.02, p = 0.831), bipolar disorder (AOR = 0.97, p = 0.759), nor schizophrenia (AOR = 0.83, p = 0.199) was associated with dental visits in adjusted analyses, although having ADHD was significantly associated with higher odds of dental visits relative to not having this condition (AOR = 1.34, p < 0.001). Age, sex, race/ethnicity, language, and education were also significantly associated with visits (p < 0.05 for all). Conclusions Dental utilization as measured by annual dental visits was lower in Medicaid-enrolled youth with MI relative to the general population of Medicaid-enrolled youth. However, utilization varied within the population of Medicaid-enrolled youth with MI, and we identified a number of characteristics significantly associated with the receipt of dental services. By identifying these variations in dental service use this study facilitates the development of targeted strategies to increase the use of dental care in – and consequently improve the current and long-term wellbeing of – the vulnerable population of Medicaid-enrolled youth with MI.

scholarly journals Effect of Copayment on Dental Visits: A Regression Discontinuity Analysis

2020 ◽  
Vol 99 (12) ◽  
pp. 1356-1362
Author(s):  
U. Cooray ◽  
J. Aida ◽  
R.G. Watt ◽  
G. Tsakos ◽  
A. Heilmann ◽  
...  
Keyword(s):  
Service Utilization ◽  
Universal Health Coverage ◽  
Service Use ◽  
Dental Treatment ◽  
Regression Discontinuity ◽  
Causal Effect ◽  
Dental Service ◽  
Health Coverage ◽  
Dental Visits ◽  
Universal Health

Despite their prevalence and burdens, oral diseases are neglected in universal health coverage. In Japan, a 30% copayment (out of pocket) by the user and a 70% contribution by Japan’s universal health insurance (JUHI) are required for dental and medical services. From the age of 70 y, an additional 10% is offered by JUHI (copayment, 20%; JUHI, 80%). This study aimed to investigate the effect of cost on dental service use among older adults under the current JUHI system. A regression discontinuity quasi-experimental method was used to investigate the causal effect of the JUHI discount policy on dental visits based on cross-sectional data. Data were derived from the 2016 Japan Gerontological Evaluation Study. This analysis contained 7,161 participants who used JUHI, were aged 68 to 73 y, and responded to questions regarding past dental visits. Analyses were controlled for age, sex, number of teeth, and equalized household income. Mean ± SD age was 72.1 ± 0.79 y for the discount-eligible group and 68.9 ± 0.78 y for the noneligible group. During the past 12 mo, significantly more discount-eligible participants had visited dental services than noneligible participants (66.0% vs. 62.1% for treatment visits, 57.7% vs. 53.1% for checkups). After controlling for covariates, the effect of discount eligibility was significant on dental treatment visits (odds ratio [OR], 1.36; 95% CI, 1.32 to 1.40) and dental checkups (OR, 1.49; 95% CI, 1.44 to 1.54) in the regression discontinuity analysis. Similar findings were observed in triangular kernel-weighted models (OR, 1.38 [95% CI, 1.34 to 1.44]; OR, 1.52 [95% CI, 1.47 to 1.56], respectively). JUHI copayment discount policy increases oral health service utilization among older Japanese. The price elasticity for dental checkup visits appears to be higher than for dental treatment visits. Hence, reforming the universal health coverage system to improve the affordability of relatively inexpensive preventive care could increase dental service utilization in Japan.

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