Department of Health Policy and Management
School of Public Health and Health Sciences
University of Massachusetts
Promoting children's oral health: Identifying provider-, practice-, and community-level characteristics associated with delivery of fluoride varnish in medical offices
An NIH-funded project led by Dr. Ashley Kranz at RAND, a non-profit research organization, in collaboration with Dr. Sarah L. Goff and colleagues at the University of Massachusetts-Amherst.
Study Years: 2020-2024
Dental caries, commonly called tooth decay, is a preventable, but common disease (CDC Division of Oral Health 2019). There are widespread racial/ethnic inequities in oral health, with non-White children and adults more likely to experience caries and have worse oral health than White children and adults. Oral disorders/dental treatment is the seventh most costly health condition, leading to health care spending of $66.4 billion in 2013 (Dieleman et al 2016). Timely receipt of oral health services is important for promoting oral health. However, rates of dental visits remain low, with only 43% of the US population making a dental visit in 2015 (Manski & Rohde 2017).
This study will analyze health care claims data to identify factors associated with providers’ delivery of and individuals’ receipt of oral health services. The specific aims ofthis study are to: 1) Describe utilization of oral health services, including by insurance-type (e.g., private and Medicaid), setting of care (e.g., medical and dental offices and EDs), and timing of care (e.g., time since ED visit for dental problem to dental office visit); 2) Estimate the causal impact of changes in insurance coverage and policies on receipt of oral health services; 3) Examine the mechanisms affecting receipt of oral health services, including provider characteristics (e.g., specialty, years since training), organizational characteristics (e.g.,size, patient sharing with other providers), and community characteristics (e.g., rurality, neighborhood SES, dentist supply); and 4) Identify organizational strategies and contextual factors that may promote or inhibit delivery of oral health services using a qualitative positive deviance approach.
