Find Established Evidence

NPM: 13-2: Oral Health in Childhood
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.
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
Significant Findings: Yes
Setting: Jefferson County in Louisville, KY
Target Audience: 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

NPM: 13-2: Oral Health in Childhood
Intervention Components (click on component to see a list of all articles that use that intervention): CAREGIVER, Education/Training (caregiver)
Intervention Description: The purpose of this randomized, controlled trial was to measure the impact of postcard mailings on dental utilization by low-income children through a dental society program designed to increase access to dental care.
Conclusion: Postcard mailings did not significantly increase utilization of preventive dental services. Other strategies to increase utilization of preventive oral health measures are needed.
Study Design: RCT
Significant Findings: No
Setting: Yakima County in WA
Target Audience: Children aged 12-36 months enrolled in Medicaid and Basic Health Plus as of September 30, 2002
Data Source: Medicaid claims
Sample Size: Group 1 (n=2,014) Group 2 (n=2,014) Group 3 (n=1,779)
Age Range: not specified

NPM: 13-2: Oral Health in Childhood
Intervention Components (click on component to see a list of all articles that use that intervention): CAREGIVER, Educational Material (caregiver), Motivational Interviewing/Counseling, Education/Training (caregiver)
Intervention Description: This study tested a behavioral intervention to increase dental attendance among rural Oregonian low-income women and their children.
Conclusion: Prenatal or postpartum motivational interviewing/counseling (MI) did not lead to greater attendance when compared to HE alone and cost more to implement. High attendance may be attributable to the counselors' patient navigator function.
Study Design: RCT
Significant Findings: No
Setting: Four rural counties in OR
Target Audience: Children of pregnant women aged ≥15 years in their first or second trimester eligible for Medicaid
Data Source: Medicaid claims; maternal self-report
Sample Size: Prenatal MI/Postpartum MI (n=121) Prenatal MI/Postpartum HE (n=50) Prenatal HE/Postpartum MI (n=134) Prenatal HE/Postpartum HE (n=44)
Age Range: not specified

NPM: 13-2: Oral Health in Childhood
Intervention Components (click on component to see a list of all articles that use that intervention): POPULATION-BASED SYSTEMS, STATE, Public Insurance (State)
Intervention Description: We used electronic health record (EHR) data to assess temporal patterns of healthcare utilization after Oregon's 2009-2010 CHIP expansion. We hypothesized increased post-expansion utilization among children who gained public insurance.
Conclusion: This study used EHR data to confirm that CHIP expansions are associated with increased utilization of essential pediatric primary and preventive care. These findings are timely to pending policy decisions that could impact children's access to public health insurance in the United States.
Study Design: QE: pretest-posttest nonequivalent control group
Significant Findings: Yes
Setting: Community health centers (CHC) in Oregon
Target Audience: Patients aged 2-18 years who were not pregnant and did not have insurance other than Medicaid/CHIP with ≥ 1 visit before and after their ‘start date’
Data Source: CHC EHR data; state administrative data
Sample Size: Newly insured (n=3,054) Continuously insured (n=10,946) Continuously uninsured (n=10,307)
Age Range: not specified

NPM: 13-2: Oral Health in Childhood
Intervention Components (click on component to see a list of all articles that use that intervention): POPULATION-BASED SYSTEMS, STATE, Public Insurance (State)
Intervention Description: Examine the extent to which enrollment in the State Children's Health Insurance Program (SCHIP) affects access to care and service use in 10 states that account for over 60 percent of all SCHIP enrollees.
Conclusion: Enrollment in SCHIP appears to be improving children's access to primary health care services, which in turn is causing parents to have greater peace of mind about meeting their children's needs.
Study Design: QE: pretest-posttest nonequivalent control group
Significant Findings: Yes
Setting: CA, CO, FL, IL, LA, MO, NJ, NY, NC, TX
Target Audience: Children older than 3 years enrolled in SCHIP in 2002
Data Source: Parent telephone survey
Sample Size: Intervention (n=4,953) Control (n=840)
Age Range: not specified

NPM: 13-2: Oral Health in Childhood
Intervention Components (click on component to see a list of all articles that use that intervention): POPULATION-BASED SYSTEMS, STATE, Medicaid Reform
Intervention Description: To measure the impact of Medicaid reforms, in particular increases in Medicaid dental fees in Connecticut, Maryland, and Texas, on access to dental care among Medicaid-eligible children.
Conclusion: Increasing Medicaid dental fees closer to private insurance fee levels has a significant impact on dental care utilization and unmet dental need among Medicaid-eligible children.
Study Design: QE: pretest-posttest nonequivalent control group
Significant Findings: Yes
Setting: Intervention: CT, MD, TX Control: CA, FL, HI, IL, MA, ME, MO, MI, ND, OR, PA, UT, WA, WI
Target Audience: Children aged 1-17 years eligible for Medicaid
Data Source: 2007 and 2011-2012 National Survey of Children’s Health
Sample Size: NR
Age Range: not specified

NPM: 13-2: Oral Health in Childhood
Intervention Components (click on component to see a list of all articles that use that intervention): POPULATION-BASED SYSTEMS, STATE, Public Insurance (State)
Intervention Description: We examine how access to and use of oral and dental care under the Children's Health Insurance Program (CHIP) compared to private coverage and being uninsured in 10 states.
Conclusion: Enrolling eligible uninsured children in CHIP led to improvements in their access to preventive dental care, as well as reductions in their unmet dental care needs, yet the CHIP program has more work to do to address the oral health problems of children.
Study Design: QE: nonequivalent control group
Significant Findings: Yes
Setting: AL, CA, FL, LA, MI, NY, OH, TX, UT, VA
Target Audience: Children aged 18 years or younger enrolled in CHIP
Data Source: Parent telephone survey
Sample Size: Established enrollees (n=5,518) Recent enrollees (n=4,142)
Age Range: not specified

NPM: 13-2: Oral Health in Childhood
Intervention Components (click on component to see a list of all articles that use that intervention): CAREGIVER, Outreach (caregiver), PROVIDER/PRACTICE, POPULATION-BASED SYSTEMS, STATE, Medicaid Reform, Education/Training (caregiver), Provider Training/Education
Intervention Description: This study aimed to determine the Washington State's Access to Baby and Child Dent stry (ABCD) Program's effect on children's dental utilization and dental fear, and on parent satisfaction and knowledge.
Conclusion: The authors conclude that the ABCD Program was effective in increasing access for preschool children enrolled in Medicaid, reducing dental fear, and increasing parent satisfaction.
Study Design: QE: nonequivalent control group
Significant Findings: Yes
Setting: Spokane County in WA
Target Audience: Children aged 12-36 months enrolled in Medicaid as of August 31, 1997
Data Source: Parent survey
Sample Size: Intervention (n=228) Control (n=237)
Age Range: not specified

NPM: 13-2: Oral Health in Childhood
Intervention Components (click on component to see a list of all articles that use that intervention): CAREGIVER, Outreach (caregiver), POPULATION-BASED SYSTEMS, STATE, Public Insurance (State)
Intervention Description: Three California counties (Los Angeles, San Mateo, and Santa Clara) expanded health insurance coverage for undocumented children and some higher income children not covered by Medi-Cal (Medicaid) or Healthy Families (SCHIP). This paper presents findings from evaluations of all three programs.
Study Design: QE: nonequivalent control group
Significant Findings: Yes
Setting: Los Angeles, San Mateo, and Santa Clara, CA
Target Audience: Children aged 1-5 years in Los Angeles and those aged 1-18 years in San Mateo and Santa Clara enrolled in the Healthy Kids program
Data Source: Parent telephone survey
Sample Size: Established enrollees (n=1,842) New enrollees (n=1,879)
Age Range: not specified

NPM: 13-2: Oral Health in Childhood
Intervention Components (click on component to see a list of all articles that use that intervention): SCHOOL, School-Based Dental Services
Intervention Description: To assess the effects of an elementary school-based health center (SBHC) on access to and the use of physical and mental health services by children aged 4 to 13 years.
Conclusion: Independent of insurance status and other confounding variables, underserved minority children with SBHC access have better health care access and use than children without SBHC access, signifying that SBHCs can be an effective component of health delivery systems for these children.
Study Design: QE: nonequivalent control group
Significant Findings: Yes
Setting: One intervention school and one comparison school in Denver, CO
Target Audience: All elementary school students (pre-K to fifth grade) enrolled in the schools
Data Source: Parent questionnaire
Sample Size: Intervention (n=728) Control (n=571)
Age Range: not specified

NPM: 13-2: Oral Health in Childhood
Intervention Components (click on component to see a list of all articles that use that intervention): POPULATION-BASED SYSTEMS, STATE, Public Insurance (State)
Intervention Description: This article examines experiences under Medicaid and the State Children's Health Insurance Program (SCHIP), drawing on surveys of over 3,000 enrollees in California and North Carolina in 2002.
Conclusion: Relative to being uninsured, Medicaid enrollment was found to improve access to care along a number of different dimensions, controlling for other factors. Furthermore, this study emphasizes the need for continued evaluation of access to care for both programs.
Study Design: QE: nonequivalent control group Kulkarni (2013) Canada City-operated child care centers or Ontario Early Years Centers in Toronto Young children (no exclusion criteria) Study group (n=161) Control group (n=181) Prospective coh
Significant Findings: Yes
Setting: CA and NC
Target Audience: Children older than 3 years enrolled in Medicaid or SCHIP in 2002
Data Source: Parent telephone survey
Sample Size: Established enrollees (n=830) Recent enrollees (n=332)
Age Range: not specified

NPM: 13-2: Oral Health in Childhood
Intervention Components (click on component to see a list of all articles that use that intervention): SCHOOL, Head Start Participation
Intervention Description: The purpose of this study was to assess differences in dental and medical care utilization for dental problems between rural Head Start (HS) participants and a nonexposed group.
Conclusion: Head Start participants accessed dental care with greater frequency than the nonexposed group. Findings provide evidence that Head Start grantees positively impact dental service utilization for their children. Future research should examine the programmatic features to which the outcomes can be attributed and whether utilization trends continue after Head Start completion.
Study Design: QE: nonequivalent control group
Significant Findings: Yes
Setting: 7 counties in SC
Target Audience: Children enrolled in Medicaid for at least 9 of 12 months for each year of the study period
Data Source: Medicaid claims and enrollment data
Sample Size: Exposed (n=985) Unexposed (n=1,969)
Age Range: not specified

NPM: 13-2: Oral Health in Childhood
Intervention Components (click on component to see a list of all articles that use that intervention): CAREGIVER, Outreach (caregiver), PROVIDER/PRACTICE, Outreach (Provider), POPULATION-BASED SYSTEMS, STATE, Medicaid Reform
Intervention Description: The authors obtained Medicaid eligibility, claims, and provider data before and after the fee increase, in 2006 and 2009 through 2012, respectively. Their analysis examined changes in utilization rates, service mix, expenditures, and dentists' participation. The authors qualitatively assessed the general impact of the recession on utilization rate changes.
Conclusion: The Medicaid fee increase, program improvements, and the recession had a dramatic impact on reducing disparities in children's access to dental care in Connecticut.
Study Design: QE: pretest-posttest
Significant Findings: No
Setting: Connecticut
Target Audience: Children continuously enrolled in Medicaid (Healthcare for UninSured Kids and Youth A program) for at least 11 months and 1 day within a calendar year
Data Source: Medicaid enrollment and encounter data
Sample Size: 2006 (n=161,130) 2009 (n=166,787) 2010 (n=204,550) 2011 (n=215,377) 2012 (n=214,680)
Age Range: not specified

NPM: 13-2: Oral Health in Childhood
Intervention Components (click on component to see a list of all articles that use that intervention): CAREGIVER, Patient Navigation (Assistance), PROVIDER/PRACTICE, Outreach (Provider), POPULATION-BASED SYSTEMS, STATE, Medicaid Reform
Intervention Description: To evaluate the effectiveness of an innovative reform in 2000 to the Dental Medicaid program in South Carolina.
Conclusion: The January 2000 dental Medicaid reform in South Carolina had marked impact on Medicaid enrollees' access to dental services.
Study Design: QE: pretest-posttest
Significant Findings: Yes
Setting: South Carolina
Target Audience: Children aged 2-21 years enrolled in Medicaid
Data Source: Medicaid claims
Sample Size: 1998 (n=377,690) 1999 (n=447,069) 2000 (n=504,642)
Age Range: not specified

NPM: 13-2: Oral Health in Childhood
Intervention Components (click on component to see a list of all articles that use that intervention): SCHOOL, School-Based Dental Services, CAREGIVER, Patient Navigation (Assistance), Educational Material (caregiver)
Study Design: QE: pretest-posttest
Significant Findings: Yes
Setting: All elementary schools in the Capital Health District of Nova Scotia
Target Audience: Students in grades primary to grade 4 in 2001 who progressed to grades 1 to 5 in 2002
Data Source: Parent self-report
Sample Size: n=105
Age Range: not specified

NPM: 13-2: Oral Health in Childhood
Intervention Components (click on component to see a list of all articles that use that intervention): CAREGIVER, Education/Training (caregiver)
Intervention Description: To determine the long-term effectiveness of comprehensive education given to parents and caregivers with respect to the incidence of preventable oral diseases, utilization of dental services, and retention of knowledge related to oral health.
Conclusion: While most knowledge is retained by parents, there is some attrition in the information retained over an 18-month time period. This emphasizes the importance of repeated reinforcement of the same concepts over a shorter time span.
Study Design: Prospective cohort
Significant Findings: Yes
Setting: City-operated child care centers or Ontario Early Years Centers in Toronto
Target Audience: Young children (no exclusion criteria)
Data Source: Parent questionnaire
Sample Size: Study group (n=161) Control group (n=181)
Age Range: not specified

NPM: 13-2: Oral Health in Childhood
Intervention Components (click on component to see a list of all articles that use that intervention): POPULATION-BASED SYSTEMS, STATE, Public Insurance (State)
Intervention Description: To determine the impact of children's health insurance programs on access to health care and on other aspects of the lives of the children and their families.
Conclusion: Extending health insurance to uninsured children had a major positive impact on children and their families. In western Pennsylvania, health insurance did not lead to excessive utilization but to more appropriate utilization.
Study Design: Time trend analysis
Significant Findings: Yes
Setting: Western PA
Target Audience: Children up to 19 years in families with incomes less than 235% FPL enrolled in the Children’s Health Insurance Program of Pennsylvania (BlueCHIP) and the Highmark Blue Cross Blue Shield Caring Program (Caring)
Data Source: Parent telephone survey
Sample Size: Study group (n=1,031) Comparison group (n=460)
Age Range: not specified

NPM: 13-2: Oral Health in Childhood
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. 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.

NPM: 13-2: Oral Health in Childhood
Intervention Components (click on component to see a list of all articles that use that intervention): CLASSROOM_SCHOOL, School-Based Dental Screening
Intervention Description: Researchers identified and searched multiple databases to search for randomized control trials that evaluated school dental screening compared with no intervention or with one type of screening compared with another.
Conclusion: The trials included in this review evaluated short‐term effects of screening. We found very low‐certainty evidence that is insufficient to allow us to draw conclusions about whether there is a role for traditional school dental screening in improving dental attendance. For criteria‐based screening, we found low‐certainty evidence that it may improve dental attendance when compared to no screening. However, when compared to traditional screening, there is no evidence of a difference in dental attendance (very low‐certainty evidence). We found low‐certainty evidence to conclude that personalised or specific referral letters may improve dental attendance when compared to non‐specific counterparts. We also found low‐certainty evidence that screening supplemented with motivation (oral health education and offer of free treatment) may improve dental attendance in comparison to screening alone. For children requiring treatment, we found very‐low certainty evidence that was inconclusive regarding whether or not a referral letter based on the 'common‐sense model of self‐regulation' was better than a standard referral letter. We did not find any trials addressing possible adverse effects of school dental screening or evaluating its effectiveness for improving oral health.
Significant Findings: No
Setting: School/preschool
Target Audience: Children and adolescents ages 4 to 15

NPM: 13-2: Oral Health in Childhood
Intervention Components (click on component to see a list of all articles that use that intervention): CLASSROOM_SCHOOL, School-Based Dental Screening
Intervention Description: Researchers identified and searched multiple databases to search for randomized control trials that evaluated school dental screening compared with no intervention or with another type of screening
Conclusion: The systematic review found there was very low certainty of evidence to support the role of school screening programmes in improving dental attendance. There was a low certainty of evidence to conclude that criteria-based screening, personalised referral letters or screening supplemented with motivation improve dental attendance.
Significant Findings: No
Setting: School/preschool
Target Audience: Children and adolescents ages 4 to 16