Although new, effective technologies have emerged for controlling varies in children, only a minority of dentists have adopted them. To increase dentist adoption, Washington Dental Service (WD) has developed a 2-part intervention composed of provider education and fee-for-service reimbursement for providing a package of cries-control services to at risk children with capitation benefits.
Study aims are: 1) to determine the effect of the intervention on dentist adoption of caries-control services for children; 2) among at risk children, to determine the effect of caries-control services on the incidence of dental caries and use of restorative services; and 3) to determine the cost effectiveness of the intervention. The population consists of 16,404 children dependents of Boeing employees covered by the (WDS) capitation program. Dentists with 30 or more capitation children (N=91) will be invited to participate in the study, and at least 50 dentists are expected to participate. Consenting dentists will be randomized into intervention and control groups. Dentists in the intervention group will provide aries control services to 900 at risk children and collect dmfs/DMFS scores at baseline and 1- and 2-year follow-ups (n=900). Control group dentists will be reimbursed for collecting dmfs/DMFS scores at identical periods for at risk children (n=900), who will receive usual care. Dentist and child use of caries-control services will be measured through WDS records for 2 years.
Aim 1 will be assessed partly by dentist participation in the study, and by comparing dentist use of caries-control services between groups.
Aim 2 will compare caries incidence and restorative between groups.
Aim 2 will compare caries incidence and restorative between groups. If beneficial effects are detected, a cost-effectiveness analysis will be performed in Aim 3. The study complements other elements of the Center application. Just as it is important to identify children most susceptible to oral disease, so it is equally important for providers to adopt new, cost-effective technologies that can best detect and prevent disease. By addressing this purpose, the study fosters integrated behavioral, social science and health services research in daily practice, and contributes directly to Aims 5 and 6 of the Center application.
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