Treatment Outcomes and Costs of Dental Sealants Among Children Enrolled in Medicaid

• Published in: American journal of public health (1971) 2001-11, Vol.91 (11), p.1877-1881
• Main Authors: Weintraub, Jane A, Stearns, Sally C, Rozier, R. Gary, Huang, Cheng-Chung
• Format: Article
• Language: English
• Subjects: Age; Biological and medical sciences; Child; Child, Preschool; Children; Children & youth; Childrens health insurance programs; Clinical outcomes; Cohort analysis; Cost control; Costs; Dental care; Dental Care for Children - economics; Dental Care for Children - statistics & numerical data; Dental caries; Dental Caries - economics; Dental Caries - epidemiology; Dental Caries - therapy; Dental sealants; Dental treatment; Dentists; Enrollments; Ethnicity; Expenditures; Facial bones, jaws, teeth, parodontium: diseases, semeiology; Female; Foster care; Health Expenditures - statistics & numerical data; Humans; Insurance, Dental - statistics & numerical data; Likelihood Functions; Longitudinal Studies; Male; Medicaid; Medicaid - statistics & numerical data; Medical sciences; Molar - pathology; Non tumoral diseases; North Carolina; North Carolina - epidemiology; Otorhinolaryngology. Stomatology; Outcomes; Pit and Fissure Sealants - economics; Pit and Fissure Sealants - therapeutic use; Public health; Regression Analysis; Reimbursement; Retrospective Studies; Risk Factors; Teeth; Treatment; Treatment Outcome; Unemployment; USA
• ISSN: 0090-0036; 1541-0048
• DOI: 10.2105/AJPH.91.11.1877

This retrospective cohort analysis of children enrolled in the North Carolina Medicaid program compared the likelihood of restorative treatments and associated cumulative Medicaid expenditures for teeth with or without dental sealants. We assessed the dental experience of the cohort of 15 438 children from 1985 to 1992 on the basis of enrollment and claims files. We conducted regression analyses for outcomes (caries-related services involving the occlusal surface [CRSOs] of permanent first molars) and cumulative expenditures, controlling for characteristics of the child, the treating dentist, and the child's county of residence. Overall, 23% of children received at least 1 sealant and 33% at least 1 CRSO. Sealants were effective in preventing CRSOs, although the degree of effectiveness was highest for children with the greater levels of CRSOs before sealant placement. Estimated cumulative Medicaid expenditures indicated expenditure savings from sealants within 2 years of application for children with 2 or more prior CRSOs. Sealant placement was associated with expenditure savings to Medicaid for certain high-risk children, so Medicaid and, more broadly, society will benefit by providing for sealant placement in these children.