Sociodemographic Characteristics of Mission of Mercy Attendees in Wisconsin.

OBJECTIVE: Mission of Mercy (MoM) events are scheduled to provide care to populations suffering from urgent needs and inadequate access to dental care in the United States. This study examined individual and county-level characteristics of MoM attendees and the factors associated with changes in the rate of attendance. METHODS: Deidentified archival data for MoM events available from the America's Dentists Care Foundation (2013-2016) were analyzed. Summary statistics were calculated separately for each year. Chi-square test was performed to identify changes in attendance distribution over time. Poisson regression analyses were conducted to test changes in the rate of attendance with and without adjustment for county-level characteristics and history of prior MoM events. RESULTS: Total numbers of attendees at Wisconsin MoM events were 1,560, 1,635, 1,187, and 951 in 2013, 2014, 2015, and 2016, respectively. Attendees were mostly female (>50%) and White (58%-81%), and mean age ranged between 36.5 and 39.2 y. The average travel distance ranged between 27 and 80 miles. Residents of counties where MoM events were held in previous years were more likely to attend another MoM event after adjusting for county distance to current location. After adjusting for dentists-to-population ratio, event history, and county distance to event location, we found that there was no statistically significant change in the rate of attendance from 2013 to 2016. CONCLUSIONS: Previous attendees with experience of attending a MoM event in their counties of residence were more likely to attend another MoM event. Higher rates of attendance were associated with shorter travel distances to MoM events. KNOWLEDGE TRANSFER STATEMENT: The Mission of Mercy (MoM) events are promoted by local dental organizations to highlight the issue of access to dental care and bring greater awareness to the problem by providing urgent dental care to populations in need. Through the data-sharing practices and analyses, policy makers, dental health advocates, and program organizers will have a better understanding of the impact and reach of the program. Findings from this study will help to expand program practices, promote efficiency, and aid in the identification of appropriate event locations, innovative strategies, and public policies relevant to addressing access to dental care.

Billed and Paid Amounts for Preventive Procedures in Dental Medicaid.

OBJECTIVE: To examine trends and variations in billed and paid amounts for preventive dental procedures by race/ethnicity, age, and sex in Wisconsin dental Medicaid. METHODS: We analyzed data from the 2001 to 2013 Wisconsin Medicaid claims database for preventive dental procedures for children and adults. Billed and paid amounts for preventive dental procedures were aggregated over a visit and adjusted for inflation based on the Medical Care Consumer Price Index produced by the Bureau of Labor Statistics for 2013. Quantile regression was used to examine the trends over time and the effect of patient demographics. RESULT: At the 50th and 75th percentiles, the overall billed amounts for preventive dental procedures were $84.97 and $105.53, and the paid amounts were $35.80 and $41.66, respectively. At the 75th percentile, there was a $2.24 increase per year in the billed amount and a $26.88 overall increase from 2001 to 2013. In the paid amount, there was a $1.34 decrease per year for an overall $16.07 decrease from 2001 to 2013. Billed and paid claims for racial/ethnic minority enrollees were $1 to $3 higher per visit at the 75th percentile when compared with those of Whites. Regarding the billed:paid ratio, White, African American, and Hispanic enrollees had values of 50% to 52%, whereas American Indians had the lowest value at 47.7%. At the 75th percentile, children aged 10 to 19 y had significantly higher billed ($26.73) and paid ($9.92) amounts than did adults aged 20 to 69 y. CONCLUSION: The billed amount increased over time, and the paid amount decreased after adjustment for inflation. In addition, there was a wide gap between billed and paid amounts over time. KNOWLEDGE TRANSFER STATEMENT: This study highlights clear differences between paid and billed amounts in Wisconsin dental Medicaid. The financial health of dental practices is dependent on appropriate reimbursement for dental services provided; thus, information of this nature could serve as a proxy performance measure for access to preventive dental care. Findings from this study could be used by policy makers and dental Medicaid program managers to develop outcome metrics to improve access to preventive dental services.

Opioid Analgesic Prescribing Practices of Dental Professionals in the United States.

The prescription of opioid analgesics by dental professionals is widespread in the United States. Policy makers, government agencies, and professional organizations consider this phenomenon a growing public health concern. This study examined trends in the prescription of opioid analgesics for adults by dental professionals and associated factors in the United States. Data from the Medical Expenditure Panel Survey (1996-2013) were analyzed. Descriptive statistics were calculated separately for each year. Logistic regression analyses were conducted to estimate the overall trend during the period with and without adjusting for dental procedures and personal characteristics. Survey weights were incorporated to handle the sampling design. The prescription of opioid analgesics following dental care increased over time. After adjusting for sociodemographic factors, source of payment, and type of dental procedure, the odds ratio (OR) of prescribing opioid analgesics following a dental visit per each decade difference was 1.28 (95% confidence interval [CI], 1.19-1.38). Surgical, root canal, and implant procedures had the highest rates of opioid prescriptions and the greatest increases in rates over the study period. After adjusting for personal characteristics and type of dental procedure, the OR of receiving a prescription for opioids comparing blacks, Asians, and Hispanics to whites was 1.29 (95% CI, 1.17-1.41), 0.57 (95% CI, 0.47-0.70), and 0.84 (95% CI, 0.75-0.95), respectively. Opioid analgesic prescriptions following dental visits increased over time after adjusting for personal characteristics and type of dental procedure. The odds of receiving a prescription for opioids were higher for certain racial/ethnic minority groups. Knowledge Transfer Statement: This study highlights dental professionals prescribing practices of opioid analgesics by following dental treatments in the United States. With this knowledge, appropriate guidelines, protocols, and policies can be developed and implemented to address any inappropriate prescribing practices of opioid analgesics. In addition, this information could lead to an improvement in the prescribing practices of dental professionals and to evidence-based therapeutic decision making.

Erosive tooth wear and consumption of beverages among children in the United States.

BACKGROUND/AIM: Experimental studies have identified differences in the effect of physicochemical properties of beverages on the etiology of erosive tooth wear (ETW). Little is known from epidemiological studies about the relationship between ETW and consumption of juices, drinks and milk. This study examined the relationship between the consumption of juices, drinks, milk and ETW in children in the United States. METHODS: The National Health and Nutrition Examinations Survey data for 2003-2004 was analyzed. Trained and calibrated examiners used the modified Smith and Knight Tooth Wear Index from a 1998 United Kingdom Adult Health Survey to measure ETW. Beverage consumption collected via a Food Frequency Questionnaire was processed with Diet*Calc software to obtain the average daily consumption frequency for all queried juice categories, milk and carbonated beverages. Survey-weighted descriptive and multivariable analyses were performed. RESULTS: Prevalence of ETW was highest in children aged 18-19 years (56%), males (49%), and lowest in Blacks (31%). Milk and soft drinks (0.85 times a day) and fruit drinks (0.69) were the most consumed products by children. Children with ETW had significantly higher odds of being frequent consumers of apple juice after adjusting for age, gender, and race/ethnicity. Blacks had the highest mean daily apple juice consumption, but the mean difference between those with ETW and those without ETW was not significant. CONCLUSION: ETW was associated with frequent intake of apple juice, but the mean difference in consumption between groups with ETW versus those without ETW within racial/ethnic groups was not significant.