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Research Studies is a monthly compilation of research articles funded by AHRQ or authored by AHRQ researchers and recently published in journals or newsletters.
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1 to 16 of 16 Research Studies DisplayedYan CH, Ramanathan S, Suda KJ
Barriers to and facilitators of opioid prescribing by dentists in the United States: a qualitative study.
In this study, a national sample of US dentists was interviewed to understand the barriers and facilitators to opioid prescribing. Findings showed that dentists' opioid decision making is influenced by a range of real-world practice experiences and patient and clinic factors. Recommendations included targeting knowledge gaps in dentistry for education, clinical guidelines, and policy interventions in order to ensure safe and appropriate prescribing of opioids.
AHRQ-funded; HS025177.
Citation: Yan CH, Ramanathan S, Suda KJ .
Barriers to and facilitators of opioid prescribing by dentists in the United States: a qualitative study.
J Am Dent Assoc 2022 Oct;153(10):957-69.e1. doi: 10.1016/j.adaj.2022.05.009..
Keywords: Dental and Oral Health, Opioids, Medication
Lipton BJ, Decker SL, Stitt B
Association between Medicaid dental payment policies and children's dental visits, oral health, and school absences.
The purpose of this cross-sectional study was to assess the relationship between the ratio of Medicaid payment rates to dentist charges and children's preventive dental visits, oral health, and school absences. The researchers conducted a difference-in-differences analysis of 15,738 Medicaid-enrolled children and a control group of 16 867 privately insured children aged 6 to 17 years who participated in the 2016-2019 National Survey of Children's Health. The study found that 87% and 48% of Medicaid-enrolled children had at least 1 and at least 2 past-year dental visits, respectively, and 29% had parent-reported excellent oral health. Increasing the fee ratio by was associated with increases in at least 1 and 2 visits and in excellent oral health. Increases in at least 2 visits were larger for Hispanic children than for White children. By weighted baseline estimates, 28% and 15% of Medicaid-enrolled children had at least 4 and at least 7 past-year school absences, respectively. The researchers concluded that Medicaid policies with higher payments were associated with modest increases in children's preventive dental visits and excellent oral health.
AHRQ-authored.
Citation: Lipton BJ, Decker SL, Stitt B .
Association between Medicaid dental payment policies and children's dental visits, oral health, and school absences.
JAMA Health Forum 2022 Sep 2;3(9):e223041. doi: 10.1001/jamahealthforum.2022.3041..
Keywords: Children/Adolescents, Dental and Oral Health, Medicaid, Payment, Policy
Kalenderian E, Lee JH, Obadan-Udoh EM
Development of an inventory of dental harms: methods and rationale.
The authors sought to standardize the language of dental adverse events (AEs). Using a multimodal approach, they developed a broad list of dental AEs in which the AEs were classed into 12 categories, with hard tissue injury being noted frequently. Pain was the unexpected AE that was consistently identified with every modality used.
AHRQ-funded; HS024406.
Citation: Kalenderian E, Lee JH, Obadan-Udoh EM .
Development of an inventory of dental harms: methods and rationale.
J Patient Saf 2022 Sep 1;18(6):559-64. doi: 10.1097/pts.0000000000001033..
Keywords: Dental and Oral Health, Patient Safety, Research Methodologies
Khouja T, Polk DE, Suda KJ
Opioid prescribing by oral and maxillofacial surgeons in the United States, 2016-2019.
The objective of this study was to describe opioid prescribing trends among oral and maxillofacial surgeons (OMFS). The IQVIA Longitudinal Prescription Dataset, 2016-2019, was used to identify prescriptions written by OMFS. The results indicated that while OMFS-prescribed hydrocodone and oxycodone decreased in most states, 12 percent of states showed increases. Tramadol and codeine prescriptions also increased. From these findings, the authors concluded that targeted interventions are warranted in some areas.
AHRQ-funded; HS025177.
Citation: Khouja T, Polk DE, Suda KJ .
Opioid prescribing by oral and maxillofacial surgeons in the United States, 2016-2019.
J Public Health Dent 2022 Sep;82(4):491-94. doi: 10.1111/jphd.12544..
Keywords: Opioids, Medication, Practice Patterns, Orthopedics, Surgery, Dental and Oral Health, Provider: Physician
Khouja T, Zhou J, Gellad WF
Serious opioid-related adverse outcomes associated with opioids prescribed by dentists.
This study’s objective was to evaluate adverse outcomes and persistent opioid use (POU) after opioid prescriptions by dentists, based on whether opioids were overprescribed or within recommendations. A cross-sectional analysis of adults with dental visit and corresponding opioid prescription from 2011 to 2017 within a nationwide commercial claims database was conducted. As per CDC guidelines, opioid overprescribing was defined as >120 morphine milligram equivalents. Of 633,387 visits, 16.6% had POU and 2.6% experienced an adverse outcome. POU was higher when opioids were overprescribed with visits associated with mild pain and those with substance use disorders having the highest risk of both outcomes.
AHRQ-funded; HS025177.
Citation: Khouja T, Zhou J, Gellad WF .
Serious opioid-related adverse outcomes associated with opioids prescribed by dentists.
Pain 2022 Aug 1;163(8):1571-80. doi: 10.1097/j.pain.0000000000002545..
Keywords: Opioids, Dental and Oral Health, Substance Abuse, Behavioral Health, Practice Patterns, Pain, Medication, Adverse Drug Events (ADE), Adverse Events
Shenkman E, Mistry KB, Davis D
Stakeholder engagement: bridging research and policy to improve measurement and dental care for children in Medicaid.
The University of Florida Child Health Quality (CHeQ) initiative, funded by the Agency for Health Care Research and Quality (AHRQ)/Centers for Medicare and Medicaid Services (CMS) Pediatric Quality Measurement Program, examined measures that states use to evaluate quality of oral health care for children in Medicaid and the Children’s Health Insurance Program (CHIP). This paper discusses stakeholder engagement in bridging research and policy to improve measurement and dental care for children in Medicaid.
AHRQ-authored; AHRQ-funded; HS025298.
Citation: Shenkman E, Mistry KB, Davis D .
Stakeholder engagement: bridging research and policy to improve measurement and dental care for children in Medicaid.
Acad Pediatr 2022 Apr;22(3S):S65-S67. doi: 10.1016/j.acap.2021.08.012..
Keywords: Children/Adolescents, Dental and Oral Health, Medicaid, Children's Health Insurance Program (CHIP), Quality Measures, Quality Improvement, Quality of Care
Harris S, Farah W, Snitchler C. S, Farah W, Snitchler C
Screening and interventions to prevent dental caries in children younger than five years.
This case study concerns Hispanic parents new to a practice who bring in their two children, two years of age and four months of age, for routine wellness visits. The parents have questions about dental care for their children. Three case study questions are provided along with answers. Bonus digital content provides an information sheet with a Clinical Summary of the USPSTF Recommendation.
AHRQ-authored.
Citation: Harris S, Farah W, Snitchler C. S, Farah W, Snitchler C .
Screening and interventions to prevent dental caries in children younger than five years.
Am Fam Physician 2022 Mar;105(3):299-300..
Keywords: Children/Adolescents, Dental and Oral Health, Screening, Guidelines, Evidence-Based Practice, Case Study
Decker SL, Lipton BJ
Do Medicaid benefit expansions have teeth? The effect of Medicaid adult dental coverage on the use of dental services and oral health.
This article examines the effect of Medicaid adult dental coverage on use of dental care and dental health outcomes using state-level variation in dental coverage during 2000-2012. Its findings imply that dental coverage is associated with an increase in the likelihood of a recent dental visit, with the size of the effect increasing with Medicaid payment rates to dentists, and a reduction in the likelihood of untreated dental caries.
AHRQ-authored.
Citation: Decker SL, Lipton BJ .
Do Medicaid benefit expansions have teeth? The effect of Medicaid adult dental coverage on the use of dental services and oral health.
J Health Econ 2015 Dec;44:212-25. doi: 10.1016/j.jhealeco.2015.08.009.
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Keywords: Access to Care, Dental and Oral Health, Health Insurance, Healthcare Utilization, Medicaid, Outcomes
Fingar KR, Smith MW, Davies S
Medicaid dental coverage alone may not lower rates of dental emergency department visits.
This study examined county-level rates of ED visits for nontraumatic dental conditions in twenty-nine States in 2010 in relation to dental provider density and Medicaid coverage of nonemergency dental services. It found that county-level Medicaid-funded dental ED visit rates were lower in states where Medicaid covered nonemergency dental services than in other states, although this difference was not significant after other factors were adjusted for.
AHRQ-authored; AHRQ-funded; 290201200003I; HS021700.
Citation: Fingar KR, Smith MW, Davies S .
Medicaid dental coverage alone may not lower rates of dental emergency department visits.
Health Aff 2015 Aug;34(8):1349-57. doi: 10.1377/hlthaff.2015.0223..
Keywords: Dental and Oral Health, Emergency Department, Healthcare Cost and Utilization Project (HCUP), Comparative Effectiveness, Medicaid
Malecki K, Wisk LE, Walsh M
Oral health equity and unmet dental care needs in a population-based sample: findings from the Survey of the Health of Wisconsin.
The authors explored individual-, psychosocial-, and community-level predictors of oral health status in the Survey of the Health of Wisconsin Oral Health Screening project. Their results suggested that costs were a primary predictor of access to care and poor oral health status, underscoring the role that primary care, in conjunction with dental health care providers, could play in promoting oral health care, particularly in reducing barriers and promoting preventive health behaviors.
AHRQ-funded; HS000063.
Citation: Malecki K, Wisk LE, Walsh M .
Oral health equity and unmet dental care needs in a population-based sample: findings from the Survey of the Health of Wisconsin.
Am J Public Health 2015 Jul;105 Suppl 3:S466-74. doi: 10.2105/ajph.2014.302338.
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Keywords: Access to Care, Dental and Oral Health, Disparities, Healthcare Costs, Health Services Research (HSR)
Horner-Johnson W, Dobbertin K, Beilstein-Wedel E
Disparities in dental care associated with disability and race and ethnicity.
The purpose of this study was to determine how the combination of disability and race and ethnicity is associated with dental examinations, delays in receiving needed care, and inability to obtain needed care among noninstitutionalized working-age adults in the United States. It found that, compared with non-Hispanic whites, other racial and ethnic groups were less likely to receive annual dental examinations.
AHRQ-funded; HS022981.
Citation: Horner-Johnson W, Dobbertin K, Beilstein-Wedel E .
Disparities in dental care associated with disability and race and ethnicity.
J Am Dent Assoc 2015 Jun;146(6):366-74. doi: 10.1016/j.adaj.2015.01.024..
Keywords: Racial and Ethnic Minorities, Medical Expenditure Panel Survey (MEPS), Dental and Oral Health, Disparities
Dumas SA, Polk D
Pediatric dental clinic location and utilization in a high-resource setting.
This study examined dental utilization by Medicaid-insured children living in a high-resource area and characterized distance and travel-related variables to accessing care. It concluded that closer proximity may contribute to the higher utilization of services observed compared with national rates.
AHRQ-funded; HS019486.
Citation: Dumas SA, Polk D .
Pediatric dental clinic location and utilization in a high-resource setting.
J Public Health Dent 2015 Summer;75(3):183-90. doi: 10.1111/jphd.12086.
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Keywords: Children/Adolescents, Healthcare Utilization, Dental and Oral Health, Access to Care, Medicaid
Mody L
Preventing aspiration pneumonia in high-risk nursing home residents: role of chlorhexidine-based oral care questioned again.
This commentary discusses a study by Juthani-Mehta et al in this issue of Clinical Infectious Diseases that adds more steam to the ongoing controversy of the value of chlorhexidine-based oral care by challenging an earlier study. That study found that the odds of dying from pneumonia in those who did not receive oral care was >3 times that of the group receiving oral care. By contrast, the Juthani-Mehta et al study finds no benefit to chlorhexidine use.
AHRQ-funded; HS019979.
Citation: Mody L .
Preventing aspiration pneumonia in high-risk nursing home residents: role of chlorhexidine-based oral care questioned again.
Clin Infect Dis 2015 Mar 15;60(6):858-9. doi: 10.1093/cid/ciu941..
Keywords: Nursing Homes, Dental and Oral Health, Elderly, Patient Safety
Manski RJ, Moeller JF, Chen H
Dental use and expenditures for older uninsured Americans: the simulated impact of expanded coverage.
The purpose of this paper is to empirically determine if insurance alone would close the current gaps in dental use and expenditures between insured and uninsured older Americans. Comparing simulated dental use and expenditures rates of newly insured persons against the corresponding rates for those previously insured, the authors found that it would close previous gaps in use and expense.
AHRQ-authored.
Citation: Manski RJ, Moeller JF, Chen H .
Dental use and expenditures for older uninsured Americans: the simulated impact of expanded coverage.
Health Serv Res. 2015 Feb;50(1):117-35. doi: 10.1111/1475-6773.12205..
Keywords: Medical Expenditure Panel Survey (MEPS), Dental and Oral Health, Health Insurance, Elderly, Healthcare Costs
Smith W, Brach C, Horowitz AM
Poor oral health literacy: why nobody understands you.
The authors examined the mistaken interpretation of the word “individuals” to be limited almost exclusively to citizens and patients. They identified gaps in knowledge, understanding, and practices regarding caries prevention among the public and all provider groups.
AHRQ-authored.
Citation: Smith W, Brach C, Horowitz AM .
Poor oral health literacy: why nobody understands you.
J Dent Hyg 2015 Feb;89 Suppl 1:36-8.
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Keywords: Dental and Oral Health, Health Literacy, Prevention
Kranz AM, Rozier RG, Preisser JS
Examining continuity of care for Medicaid-enrolled children receiving oral health services in medical offices.
To understand continuity of oral health services for Medicaid-enrolled children utilizing the North Carolina (NC) Into the Mouths of Babes (IMB) preventive oral health program, the researchers examined the time to a dentist visit after a child’s third birthday. They found that children with only IMB visits compared to only dentist visits before age 3 had lower rates of dentist visits after their third birthday.
AHRQ-funded; HS000032.
Citation: Kranz AM, Rozier RG, Preisser JS .
Examining continuity of care for Medicaid-enrolled children receiving oral health services in medical offices.
Matern Child Health J 2015 Jan;19(1):196-203. doi: 10.1007/s10995-014-1510-3..
Keywords: Access to Care, Children/Adolescents, Community-Based Practice, Dental and Oral Health, Medicaid
