A Survey of Cleft Team Patient Experience in Obtaining Dental Care

• Published in: The Cleft palate-craniofacial journal 2009-07, Vol.46 (4), p.444-447
• Main Authors: Becker, Devra B., Lee, Frances, Hill, Sean, Nissen, Richard, Huebener, Donald, Scheve, Sibyl, Gordon, Shayna, Kane, Alex A.
• Format: Article
• Language: English
• Subjects: Biological and medical sciences; Birth defects; Child; Cleft Lip - complications; Cleft Lip - epidemiology; Cleft Palate - complications; Cleft Palate - epidemiology; Dental care; Dental Care for Children - utilization; Dentistry; Facial bones, jaws, teeth, parodontium: diseases, semeiology; Female; Health Services Accessibility; Humans; Male; Medicaid; Medical sciences; Mouth; Non tumoral diseases; Otorhinolaryngology. Stomatology; Studies; United States - epidemiology
• ISSN: 1055-6656; 1545-1569
• DOI: 10.1597/07-187.1

Objective: To assess patient experiences in obtaining dental care in a team setting without an affiliated dental school. Design and participants: Three hundred seventy-four patients in the cleft team database met inclusion criteria of diagnosis of cleft lip and/or palate, and current age of 7 to 12 years. Demographic information and experiences in obtaining dental care were ascertained using a standardized series of questions. A callback protocol was employed to maximize response rate. Results were analyzed with t-tests using contingency tables. Outcome measures and results: One hundred seventy-one parents/caregivers were interviewed of a possible 374 (response rate 45.7%). Mean age was 9.87 years. The insurance distribution was as follows: 113 private insurance (66.1%), 35 Medicaid (20.5%), and 23 had no insurance (13.5%). The dental checkup distribution was as follows: 145 regular dental checkups (84.8%) and 26 no regular checkups (15.2%). Patients with private insurance were more likely to obtain dental care than were patients with Medicaid (p  =  .002) or patients without insurance (p  =  .0027). Patients with Medicaid were more likely to report provider refusal of care than were patients with private insurance (p  =  .0001) or patients without insurance (p  =  .0001). Patients with private insurance were more likely to report satisfaction with their dental care than were patients with Medicaid (p  =  .0003). Conclusions: We report an 84.8% regular checkup rate among our study population and a significantly different reported experience in obtaining care depending on insurance type. The reasons underlying the differences between privately insured patients and Medicaid patients appear multifactorial.