Other
Kayla G. Kopczynski, DDS (she/her/hers)
Resident
The Ohio State University/ Nationwide Children's Hospital
The Ohio State University
Columbus, Ohio, United States
Paul S. Casamassimo, DDS, MS
Professor Emeritus
The Ohio State University College of Dentistry
The Ohio State University
Columbus, Ohio, United States
Homa Amini, DDS, MS, MPH
Nationwide Children's Hospital and Ohio State University
Jin Peng, MD, MS, PhD
Nationwide Children's Hospital
Tyler Gorham, PhD, MPH
Nationwide Children's Hospital
Beau D. Meyer, DDS, MPH
Assistant Professor
The Ohio State University
Columbus, Ohio, United States
Beau D. Meyer, DDS, MPH
Assistant Professor
The Ohio State University
Columbus, Ohio, United States
Kim Hammersmith, DDS, MPH, MS
Program Director
The Ohio State University
Columbus, Ohio, United States
Purpose: Increasing evidence supports influence of neighborhood factors on health utilization and outcomes. This study measured the association between area-level social determinants of health (SDH) and dental utilization among Ohio pediatric Medicaid beneficiaries.
Methods: A retrospective dental claims analysis was completed for children ages 1-5 enrolled in Ohio Medicaid from 2017-2021. Four visit-level outcomes were defined according to CDT descriptions: 1) Preventive, 2) Caries-treatment, 3) Dental general anesthesia (GA), and 4) Dental emergency department (ED) visit. The Ohio Children’s Opportunity Index (COI) was used to define area-level SDH. Subjects were geocoded to census tracts and assigned COI scores. Analysis included descriptive statistics, Poisson regression, and spatial analysis of area-level SDH for each outcome.
Results: Most children utilized preventive services in the study period (n=17,442/17,675, 99%). Fifty-six percent of children had a caries-treatment visit. A small percentage of children utilized ED and GA services. Overall area-level SDH was associated with preventive (IRR=1.002, 95%CI: (1.002, 1.003)), caries-treatment (IRR=1.004, 95%CI: (1.002, 1.005)), and dental GA visits (IRR=1.011, 95%CI: (1.001, 1.021)). Most subdomains were positively associated with preventive, caries treatment, and dental GA visits; however, some were negatively associated. Infant health was negatively associated with dental GA use (IRR=0.890, 95%CI: (0.826, 0.960)). As this measure improved, the likelihood of dental GA decreased.
Conclusions: Receipt of dental treatment was related to neighborhood quality. Children with preventive, caries-treatment, and dental GA visits were more likely to live in higher opportunity neighborhoods. Future efforts should investigate the mechanisms by which area-level factors influence dental access and utilization.