Research Activities April 2013, No. 392
Most children can delay their first dental visit until age 3 without affecting later dental outcomes
To prevent later costs for dental treatment visits, some Medicaid programs have promoted preventive dental visits by 1 year of age. The North Carolina Medicaid Program recommends the first visit take place by 1 year of age, but allows it to be put off until 3 years because of the limited number of dentists. A new study suggests this may not be a bad strategy. It found that children insured through North Carolina Medicaid who had their first preventive dental visit by 18 months did not have a lower rate of treatment visits at age 43–72 months.
Researchers at the University of North Carolina at Chapel Hill analyzed claims data for nearly 20,000 children enrolled in North Carolina Medicaid from October 1999 through December 2006. The 7 percent of the children who had a first preventive dental visit by 18 months did not differ significantly in the rate of treatment at age 43–72 months from the 35 percent of children whose initial preventive visits occurred at 37–42 months. The early treatment group was also not significantly different from those in the other age categories in the likelihood or amount of treatment-related expenditures. However, higher-risk children older than 18 months whose preventive care coincided with a visit to treat existing caries (tertiary preventive care) had higher rates of subsequent treatment and significantly higher predicted expenditures at age 43-72 months (as much as $529 for those first seen at 25-30 months) than children who had a tertiary prevention visit by 18 months ($391). The findings were based on analysis of data from North Carolina Medicaid files for 19,888 children enrolled in North Carolina Medicaid before their first birthday. The study was funded by AHRQ (HS18076).
More details are in "Effect of early preventive dental visits on subsequent dental treatment and expenditures," by Heather Beil, Ph.D., M.P.H., Richard Gary Rozier, D.D.S., M.P.H., John S. Preisser, Ph.D., and others in the September 2012 Medical Care 50(9), pp. 749-756.