March 2019 Volume LIV Number 2

 
 
 
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Pediatric Oral Health Research and Policy Center

May 2016 Volume LI Number 3

Caries, Calories, and Kids: New Survey of Pediatric Dentists through the Policy Center 

As a part of its Robert Wood Johnson Foundation grant, the Policy Center conducted a new survey with AAPD members to discover their attitudes, experiences and interests in talking to parents and conducting other interventions related to healthy weight for children and the consumption of sugar-sweetened beverages. Based on an exhaustive literature search, empirically-supported behavioral theory, and input from grant partners, the survey analyzes how often and why pediatric dentists offer healthy weight and nutritional counseling to parents, as well as the barriers and incentives to a pediatric dental office as a setting for obesity and sugared-beverage-related interventions. The survey will be administered to general dentists this summer, and the results will be presented at a meeting of oral health shareholders in November in Washington, D.C.

 

Pediatric Dental Research Results on the Effects of the ACA

The Harris Fellow research project by Dr. Scott Schwartz evaluates the effect of the Affordable Care Act on practicing pediatric dentists by examining their attitudes toward, perceptions of, and experience with the legislation. According to the results of this national survey of AAPD members, patients are deferring treatment due to high out-of-pocket costs. Pediatric dental providers report that patients do not have enough information to understand their benefits. In addition, the providers report not having enough information to understand how these benefits affect their practices. According to the results of the research project, insurance plans should be simplified and legal details must be clarified for the Essential Health Benefit provision of the ACA to provide real value to both patients and practitioners.

 

Research-Based Action Plan for Public Policy Advocates

The research project of Harris Fellow Dr. Benjamin Curtis analyzes the efforts of the AAPD Public Policy Advocates (PPAs) regarding their levels of training in advocacy skills, knowledge of health reform issues, and empowering change at national, state and local levels. With evolving legislation and the state of oral health care, the PPA position was created in 2012 to strengthen and coordinate advocacy efforts by AAPD state chapters. Based upon research with current PPAs, an action plan and recommendations will be developed to help create a stronger network of PPAs equipped and empowered to advocate for children within their home state, as well as neighboring states and the nation.

 

AAPD Represented at National Oral Health Conference

The Policy Center represented the AAPD at the National Oral Health Conference (NOHC) on April 17 – 20, 2016, in Cincinnati, Ohio. Sponsored by the Association of State and Territorial Dental Directors and American Association of Public Health Dentistry, this premier meeting for dental public health was attended by approximately 800 dentists, dental hygienists, dental students, health researchers, legislators and others interested in the oral health of the public. Dr. Paul Casamassimo presented information on the Policy Center’s research project of medically specific factors that correlate to caries risk in young children and a prototype caries-prediction tool within electronic health record systems for primary care providers. The project was well received and many attendees expressed interest in the common risk factor approach to improving oral health promotion in primary care.

 

Policy Center Awarded Third Year of Funding For Oral Health Research 

The AAPD Policy Center was granted another year of funding from the DentaQuest Foundation for its research project, "Interprofessional Study of Oral Health in Primary Care: Common Risk Factor Study II." 

In 2015, the Policy Center conducted a study at Nationwide Children’s Hospital (NCH) in Columbus, Ohio, to identify medically specific factors that correlate to caries risk in young children. Whether or not toddlers developed cavities or were high risk was compared to approximately 40 independent variables pertaining to nutrition, safety, development, demographic information and other screening-related variables already embedded within the 12- and 15-month well-child examination templates. The results supported the growing consensus of health research that different diseases share common risk factors.

The 2016 phase of the study will further validate the medical factors identified as correlating to caries risk – and explore other potentially significant variables – through an analysis of electronic medical and dental records of additional US child populations. In addition, a caries-prediction tool will be pilot tested at NCH. A caries-risk assessment based on information routinely gathered from well-baby visits means oral health promotion and necessary dental referrals may be delivered more efficiently by primary care providers.

 

Retrospective Study at Nationwide Children’s Hospital and Marshfield Clinic 

To further validate the significant variables identified in Year Two, as well as to increase and diversify the study population, patient data will be analyzed from Marshfield Clinic in Marshfield, WI. Additional data analysis of new patient populations and previously non-extractable variables will be conducted at NCH. 

 

Concurrent Study of a Medically Oriented Caries-Prediction Tool 

A prototype caries-prediction model with scoring criteria will be embedded within well-child templates for 24 months of age or less. The model will include a Dental Caries Risk Alert similar to other Best Practice Alerts already available on the NCH EpicCare Ambulatory Electronic Health Record. The alert will offer medical teams several preventive intervention options in addition to a referral to the NCH’s dental clinic. All patients referred from primary care to the dental clinic will receive a screening appointment for dental validation of the medically oriented caries-prediction tool. 

Such a tool carries the potential to further engage primary care medical providers in oral health promotion and encourage needed referrals to a Dental Home. Research investigators are eager to embark upon this final year of the project and excited about the implications this type of tool could have on improving the overall health of children.

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