Established Evidence Results

Intervention Components (click on component to see a list of all articles that use that intervention): CAREGIVER, Home Visit (caregiver), Educational Material (caregiver), Oral Health Product, Patient Navigation (Assistance), PROVIDER/PRACTICE, Outreach (Provider), Education/Training (caregiver)

Intervention Description: The aim of this study was to determine the effect of a dental care coordinator intervention on increasing dental utilization by Medicaid-eligible children compared with a control group.

Intervention Results: Dental utilization during the study period was significantly higher in the intervention group (43 percent) than in the control group (26 percent). The effect was even more significant among children living in households well below the Federal Poverty Level. The intervention was effective regardless of whether the coordinator was able to provide services in person or via telephone and mail.

Conclusion: The dental care coordinator intervention significantly increased dental utilization compared with similar children who received routine Medicaid member services. Public health programs and communities endeavoring to reduce oral health disparities may want to consider incorporating a dental care coordinator along with other initiatives to increase dental utilization by disadvantaged children.

Study Design: RCT

Setting: Jefferson County in Louisville, KY

Population of Focus: Children aged 4-15 years who currently or for 2 years prior had Medicaid insurance but have not had Medicaid dental claims filed for the previous 2 years

Data Source: Medicaid claims

Sample Size: Intervention (n=68) Control (n=68)

Age Range: not specified

Intervention Components (click on component to see a list of all articles that use that intervention): PATIENT/CONSUMER, Oral Health Education, Oral Health Supplies, Assistance in Making Dental Appointment

Intervention Description: To test the effectiveness of an advanced practice nurse model of care to improve oral health in low-income pregnant women.

Intervention Results: At baseline, 30.1% of women in the control group and 27.4% of women in the experimental group had seen a dentist. At followup, the control group increased to 32.9% while the experimental group increased to 56.9% (p=0.006).

Conclusion: Implications for practice: Because adverse pregnancy outcomes have been linked to periodontitis in numerous research studies, pregnant women must be educated about the importance of oral health and the necessity of a check-up. APNs are in an ideal position to educate women and assist them to obtain necessary oral health services.

Intervention Components (click on component to see a list of all articles that use that intervention): PATIENT/CONSUMER, Oral Health Education, Oral Health Supplies, PROVIDER/PRACTICE, Designated Clinic/Extended Hours, Quality Improvement/Practice-Wide Intervention

Intervention Description: The state of New Hampshire created a pilot project to integrate preventive oral health care for low-income women and children through local sites of the Women, Infants and Children (WIC) program.

Intervention Results: Preliminary data suggest promising results. Among the approximately 3,900 children served by the three pilot locations, 573 children (14 percent) received an oral health screening; 175 (31 percent) of those children were under age one. Of those screened, 48 children (8 percent) had untreated decay, 490 (86 percent) received a fluoride varnish application, and 80 (14 percent) received a dental sealant. A total of 857 pregnant women are served in the WIC program across all three pilot locations. Out of those women, 123 (14 percent) received an oral health screening. Of those screened, 88 (72 percent) showed untreated decay, and 46 (37 percent) were referred to a dentist for urgent needs. Out of the women who received an oral health screening, 114 (93 percent) received a fluoride varnish application, and 92 (75 percent) received sealants.

Conclusion: This profile details New Hampshire’s experiences and offers considerations for state agencies, federal policymakers, and other interested stakeholders to explore alternative channels for reaching low-income populations with oral health care and education.

Intervention Components (click on component to see a list of all articles that use that intervention): PATIENT/CONSUMER, Oral Health Education, Oral Health Supplies, PROVIDER/PRACTICE, Designated Clinic/Extended Hours, Quality Improvement/Practice-Wide Intervention

Intervention Description: The state of New Hampshire created a pilot project to integrate preventive oral health care for low-income women and children through local sites of the Women, Infants and Children (WIC) program.

Intervention Results: Preliminary data suggest promising results. Among the approximately 3,900 children served by the three pilot locations, 573 children (14 percent) received an oral health screening; 175 (31 percent) of those children were under age one. Of those screened, 48 children (8 percent) had untreated decay, 490 (86 percent) received a fluoride varnish application, and 80 (14 percent) received a dental sealant. A total of 857 pregnant women are served in the WIC program across all three pilot locations. Out of those women, 123 (14 percent) received an oral health screening. Of those screened, 88 (72 percent) showed untreated decay, and 46 (37 percent) were referred to a dentist for urgent needs. Out of the women who received an oral health screening, 114 (93 percent) received a fluoride varnish application, and 92 (75 percent) received sealants.

Conclusion: This profile details New Hampshire’s experiences and offers considerations for state agencies, federal policymakers, and other interested stakeholders to explore alternative channels for reaching low-income populations with oral health care and education.

Intervention Components (click on component to see a list of all articles that use that intervention): PATIENT_CONSUMER, Oral Health Education

Intervention Description: Using a diverse, population-based sample of California women with a live birth, researchers examined whether medical providers' promotion of oral health and women's receipt of dental care during pregnancy has changed in recent years. Researchers used data from a population-based survey of postpartum women in 2009 and 2012 in California to compare the prevalence of women's self-reports that, during pregnancy, (a) their medical providers discussed oral health and/or suggested they see a dentist, and (b) they received dental care during pregnancy. Researchers also examined whether women's receipt of dental care during pregnancy was associated with whether their medical providers discussed oral health or suggested that they see a dentist.

Intervention Results: The proportion of women reporting that their medical providers talked about oral health or referred them to a dentist increased significantly overall (from 36 to 42%, and 21–26%, respectively, p < 0.001). The proportion of women with a dental visit during pregnancy also increased, from 38% in 2009 to 42% in 2012 (p < 0.005). Women whose medical providers promoted oral health care were approximately two times more likely to report having had a dental visit during pregnancy, even after adjusting for several potential confounders.

Conclusion: Medical provider promotion of oral health increases dental attendance of pregnant women. Characteristics of women reporting that their medical providers promoted, and that they received, dental care during pregnancy in 2012 suggests that the increases in promotion and use of oral health care were largely concentrated among Medi-Cal recipients. Further improvement is needed for all populations of pregnant women. Both public and private providers need to incorporate promotion of and referral for dental care into routine prenatal care protocols.

Setting: Clinic/Medical provider office

Population of Focus: Pregnant people

Intervention Components (click on component to see a list of all articles that use that intervention): PATIENT/CONSUMER, Oral Health Education, Assistance in Making Dental Appointment, Motivational Interviewing

Intervention Description: This study tested a behavioral intervention to increase dental attendance among rural Oregonian low-income women and their children.

Intervention Results: After the intervention, dental attendance for women in the prenatal period was 92.4% for those in the motivational interviewing (MI) group compared to 94.4% for those in the health education (HE) group (RR = 0.98; 95% CI = 0.93-1.04). No significant difference was observed between the two groups at follow-up.

Conclusion: High attendance may be attributable to the counselors' patient navigator function.