P0788 - Dental Screening of Pediatric Inpatients

Background: Dental screening is recommended to start at the time of tooth eruption. However, for a variety of reasons, many children do not receive recommended dental care. Hospitalized children represent an at-risk population for medical issues and a significant subset of pediatric inpatients have complex medical needs for which access to dental care may even be more difficult to obtain. In Massachusetts universal coverage includes dental insurance although children may not have a dental home. Hospitalization of a child should present an opportunity to review the child's overall health care and that can include a dental screen.

Objective: To review the results of offering routine dental screening to pediatric inpatients
Design/

Methods: Our university affiliation includes a dental school with a pediatric dental residency. In 2019 the dental residents started rounding on the pediatric inpatient service one day per week, offering dental screening to children with teeth. This consisted of reviewing the medication list and an exam. Caries were assessed using a Decayed-Missing-Filled Tooth (DMFT) score and gingival health was assessed using a Dental Plaque Index (DPI). Parents could refuse the screen and no child was examined without parental permission. Any identified dental issues were described to the parents and an attempt was made to ensure appropriate dental follow-up. The dental residents shared their findings with the medical team and provided brief dental education for the pediatric residents.

Results: Of 128 patients approached, 53 were screened (aged 7m-18y). 59 parents refused, 13 parents were unavailable, and 5 children were unavailable. Patients whose parents refused were no different from those whose parents consented. Of those screened 25% (13) had caries and 25% had a DMFT score >1 (range 2-12). 4 of those lacked a dental home. 49% (26) had gingivitis and 53% (28) had a DPI of 1-3. No parent reported problems with access to dental care.
Conclusion(s): Many parents refused screening (46%, 59/128) and another group (14%, 18/128) were not screened due to the parents or child being unavailable. Those who were examined appreciated being offered dental screening and a significant burden of dental disease was identified in >50%. Although all children had dental insurance, 4 were first referred to a dental home and others were given new care recommendations. Next steps will be to better understand why there was a high rate of refusal and to investigate ways to expand the service to capture those children who might have been examined that day or to add additional days.