Evaluating Access to Pediatric Dental Services via Clinic Referrals

Hypothesis and Objective: The purpose of this study was to characterize the patients presenting to UIC Pediatric Dentistry Clinic and to identify differences in oral health status and treatment needs between patients who were referred by outside dentists and those who were not. Methods: We obtained chart numbers of patients with Medicaid insurance presenting for initial comprehensive exams from 2019 through 2021. We stratified the chart numbers by year and randomly selected 200 per year for analysis. Data were abstracted from each chart, including demographic characteristics, referral status, history of and need for preventive and restorative dental services, and the number of carious teeth. Descriptive and inferential statistical analyses were performed with SPSS version 28 (IBM Statistics, Armonk, NY). Results: The mean age of subjects was 5.7 years (SD 3.0), which did not differ significantly between patients who had been referred by outside dentists (5.6 ± 2.99) and those who had not (5.5 ± 3.23). 329 (55%) had been referred by outside dentists, and 271 (45%) had not. Compared with non-referred patients, referred patients had a higher mean number of carious teeth (6.93 ± 4.32 v. 5.41 ± 4.45; p<.001), were more likely to have received a dental cleaning (60.2% v. 45.8%; p<.001) and fluoride varnish (56.8% v. 42.4%; p<.001), but were not more likely to have had sealants placed (12.5% v. 9.2%; p=.207). Conclusions: The data suggest that outside dentists frequently complete basic prophylactic services and then refer pediatric patients under Medicaid insurance for restorative care. This may be attributable to their lack of comfort in providing restorative care for pediatric patients, high reimbursement rates for preventive services, or low rates for restorative care.