Evaluating The Effectiveness of the Texas Medicaid First Dental Home Program Regarding Parental Knowledge and Practice of Oral Health Care for Children
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Early childhood caries (ECC) is a problematic disease that has been on the rise in young pre-school age children within the last decade. Children who have untreated dental disease early in life, are at increased risk of having poor oral health throughout their lifetimes. Approximately 70% of dental disease is found in only 20% of the nation’s high-risk children. Professional organizations and governing bodies have formed several initiatives in order to help lower the prevalence of ECC in children. One such initiative, early preventive dental visits, i.e. dental home, has proven to be successful; yet, the evidence is limited in documenting its effectiveness. First Dental Home (FDH) is the state of Texas Medicaid initiative to improve access to care for children. FDH was initiated to improve oral healthcare for children aged 6 months to 35 months of age by providing simple, consistent messages regarding proper oral healthcare to the parents/caregivers of the children. Despite the large fiscal budget allocated towards the success of FDH, no studies regarding the program’s effectiveness have been published to date. This study aimed to evaluate the effectiveness of the FDH by comparing the knowledge, practice and opinions of participating vs. non-participating parents regarding their young children. A 29-question survey was given to mostly low-income parents who visited qualifying Medicaid clinics in North Texas (Dallas/Fort Worth) and South Texas (Harlingen). A total of 165 parents completed the survey. Several significant results emerged between the knowledge and practices responses of the parents sampled. On the knowledge section, FDH parents responded correctly more often than the non-FDH parents when asked about the recommended amount of toothpaste recommended for toddlers (p=0.023). In addition, 79.6% of FDH parents vs. 21.1% of non-FDH parents knew that tap water is a potential source of fluoride (p< 0.001). Regarding oral health practices, 80 % of FDH parents did not let their child go to sleep with anything such as a bottle, sippy cup or pacifier (p=0.01). Furthermore, FDH parents scored higher on the overall knowledge score (p<0.001) and practice score (p<0.001). Based on our preliminary findings, FDH visits are having a positive impact on parents by not only increasing their oral healthcare knowledge, but also helping them implement what they have learned.
Thompson, Charmaine (2015). Evaluating The Effectiveness of the Texas Medicaid First Dental Home Program Regarding Parental Knowledge and Practice of Oral Health Care for Children. Master's thesis, Texas A & M University. Available electronically from