| dc.description.abstract | This study examined the Texas Medicaid First Dental Home (FDH) program in rural and urban private pediatric dental practice settings and evaluated its five-year impact on caries severity, age of onset of decay, and treatment location. Comparisons were made between FDH participants and traditional Medicaid recall participants who were seen prior to the inception of the FDH program.
Statistical analysis of the total subject pool (N=492) demonstrated that the average age of the first dental visit differed significantly between recall and FDH groups, at 18.2 months and 13.4 months, respectively (p<0.0001). For those subjects with caries, both the average age and the average decayed, missing, filled teeth (dmft) score at the first decay episode differed significantly. The FDH children were 3 months younger (p=0.05) when decay was first identified, and their average dmft was 1 point higher (p=0.02). The location for providing treatment did not differ significantly between groups (p=0.3). The rural group on average visited the dentist for the first time 1.5 months later than the urban group (p=0.008), and the first decay episode on average occurred 6 months later in the rural subjects compared to the urban subjects (p=<0.0001).
Data were stratified based on the age of occurrence of the first decay episode, and significant results were found for the 0-36 month age group (N=68). In this age group, no significant difference was found between rural and urban practice settings. There was a significant difference between dmft scores for the recall and FDH groups (6.0 for recall and 3.7 for FDH, p=0.007). The location of treatment also differed significantly between the recall and FDH groups, with 15 subjects (65%) of the recall group and 15 subjects (33%) of the FDH group requiring treatment in the operating room rather than in-office (p=0.012).
These results suggest that for those Medicaid patients who did experience decay episodes before the age of 36 months, the FDH program is reducing the severity of decay as judged by dmft. Additionally, the FDH program resulted in a reduction in the use of the operating room for treatment of those decay episodes. | en |
