Integrating Dental Screening and Fluoride Varnish Application into a Pediatric Residency Outpatient Program: Clinical and Financial Implications

Delivery of preventive oral health services (POHS) has been embraced by many pediatric and family medical practices in North Carolina (NC). The outcome of implementing a state-wide Medicaid-supported oral health prevention initiative, "Into the Mouth of Babes Varnish and Screening Program (IMB), in an academic medical residency setting is described.

Retrospective chart audit of encounter forms and collection of administrative records related to POHS provided by pediatric medical residents for Medicaid recipients less than 3 years of age at the University of North Carolina pediatric continuity care clinic over 31 months were examined. A total of 1,081 visits and 655 patients were documented during the study period accounting for 36.6% of all children aged 6-36 months seen in the clinic during the period of this study. Thirty-eight percent of the patients received one or more IMB follow-up visits. Twenty-nine (4.4%) children were reported to have one or more carious teeth and 94 children (14.1%) were referred to a dentist. The IMB program provides an oral screening, parent oral health counseling and application of fluoride varnish to the teeth at the medical appointment by non-dental personnel. Following a cost/revenue analysis it was concluded that a preventive oral health initiative in an academic setting provides an additional access to oral health preventative services for underserved children and contributes to the financial viability of the clinic.

infant oral health, medical residency, dental care for children, dental caries

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