Project Triples Dental Care for Underserved Children in Los Angeles

06 Jul 2016
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The UCLA-First 5 LA 21st Century Dental Homes Project, which serves low-income and uninsured children in Los Angeles, has more than tripled preventive dental visits for children from birth to the age of 5 years, according to the University of California Los Angeles (UCLA) Center for Health Policy Research.

Some parents believe they don’t need to take children who still have their primary teeth to see the dentist because those teeth will fall out eventually. Yet the American Academy of Pediatric Dentistry recommends a first dental exam between the eruption of the first tooth and the first birthday, along with daily brushing for all children.

Also, about half of the children in the United States have not seen a dentist in the past year, according to the Agency for Healthcare Research and Quality. In Los Angeles County, 530,000 children age 5 years and younger covered by Medi-Cal, California’s dental Medicaid program, have not seen a dentist within the past year. Plus, more than 50% of children in the state have tooth decay before they enter kindergarten, reports the Dental Health Foundation.

“The majority of young children aren’t receiving crucial preventive and oral health services that they need,” said Nadereh Pourat, director of research at the Center for Health Policy Research. “Avoiding cavities in primary teeth promotes healthy teeth for the rest of their lives.”

During a 2-year period, the 12 health centers participating in the project increased the number of preventive visits for cleaning teeth, applying fluoride, and other procedures for children up to 5 years old from about 3,000 to more than 10,000. They also doubled the number of pediatric treatments like fillings and diagnostics.

“Oral health is an essential part of a child’s development, and this program is key to supporting health systems to better meet those needs,” said Kim Belshé, executive director of First 5 LA. “The learning from this program will help to address barriers that limit children’s access to necessary dental services.”

Launched in 2012 and ending this year, the project was funded by a $9.3 million contract from First 5 LA and is being evaluated by the center. Its strategies included outreach to parents, improvements in clinic infrastructure, and training of childcare workers, dental professionals, and medical professionals to deal with young and sometimes apprehensive patients. All of the involved centers offer dental and primary care services, making it easier for parents to schedule both medical and dental visits.

“Although the project served children in low-income areas, the methods it used to overcome barriers to delivering dental care can be applied universally,” said Dr. Jim Crall, professor and chair of the public health and community dentistry division at the UCLA School of Dentistry.

The project also examined other barriers to care, including a lack of Medi-Cal dental providers and low levels of confidence among dental providers in dealing with young patients. The project responded by providing technical expertise, developing infrastructure, training providers in care for young children, teaching childcare workers how to train parents, and more.

The results were reported in a policy brief, “An Innovative Project Breaks Down Barriers to Oral Health Care for Vulnerable Young Children in Los Angeles County,” by the UCLA Center for Health Policy Research.

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