Search

The article focuses on the need for the use of quality improvement (QI) methods in dentistry. It states the goal of QI is to improve population health status, reduce per capita cost of care, and better patient experiences. It comments on the development of a disease management approach in reducing early childhood dental caries through caries risk assessment, engaging caregivers and patients in managing oral health, fluoride use, and more.

Purpose: The purpose of this study was to investigate the trends of pediatric dental rehabilitation in hospital outpatient departments (HOPDs) and ambulatory surgery centers (ASCs) during the COVID-19 public health emergency (PHE) from 2019 to 2021 across states and demographic groups. Methods: This cross-sectional study utilized the 2019 to 2021 Transformed Medicaid Statistical Information System Analytical Files to examine trends in dental rehabilitation for children ages 12 years and younger enrolled in Medicaid or the Children's Health Insurance Program. The final analytic sample included 20,508,093 beneficiaries from 2019, 19,436,957 beneficiaries from 2020, and 20,416,440 beneficiaries from 2021. Chi-square tests were used to compare dental rehabilitation usage across groups (age, sex, race/ethnicity, and place of service). Results: Rehabilitation of Medicaid beneficiaries performed in HOPDs showed a decrease year over year (51 to 34 to 30; P<0.001), while the usage in ASCs increased (1,307 to 1,310 to 1,367; P<0.001). For all three years, the highest usage was seen in Non-Hispanic (NH) American Indian/Alaskan Native children (154, 66, 74; P<0.001), while the lowest usage was seen in NH Black children (21, 16, 17; P<0.001). Rehabilitation for Hispanic children had the greatest relative recovery over the three years (39 to 34 to 38; P<0.001). Conclusions: Dental rehabilitation usage in ambulatory surgery centers showed continued growth through the public health emergency. There was significant variation in rates across states and demographics. [ABSTRACT FROM AUTHOR]

Purpose: To evaluate 1) if glass ionomer interim temporary restorations (ITR) placed for 1-3 months prior to vital pulp therapy (VPT) improved accuracy of diagnosing the pulp's clinical status and subsequent VPT success, and 2) the effect of the location of the carious lesion on VPT. Methods: Primary molars (N=117) receiving pulp therapy with or without ITR were evaluated retrospectively. All teeth had caries extending >50 percent into dentin; caries lesion location was identified (proximal or non-proximal). Two examiners rated pulp status assessment, caries location, and pulp treatment, and correlated treatment outcomes after a mean of 34.7 months to these factors. Results: VPT failed more often in first primary molars (Pk.001) than in second primary molars. Using ITR improved diagnosis of the pulp status, clinical success of VPT, (P=.013) and first molar VPT success (P=.02). First primary molars had more proximal lesions than second molars (P<.001). Failure of VPT was greater for teeth with proximal lesions (P=.03). Use of ITR significantly improved VPT in teeth with proximal lesions (P=.007) but not non-proximal lesions (P=38). Conclusions: ITR placed prior to VPT improved pulpal diagnosis and VPT outcomes. Vital pulp therapy was less successful in primary molars with proximol lesions, and ITR significantly improved the success. [ABSTRACT FROM AUTHOR]