Early childhood caries is a public health concern with high rates of untreated carious lesions among children being a burden for missed school days as well as pain and suffering. Public health dental hygienists are poised to manage the disease burden by providing care and referrals for further treatment. In a study published in 2020 in the Journal of Public Health Dentistry the authors aimed to “evaluate whether Public Health Dental Hygiene Practitioner (PHDHP) referrals to pediatric dentists were more successful for children younger than 3 years old and those with dental caries.”1
Electronic health records of 1,475 children aged 1 to 12 years of age who attended dental visits with a PHDHP from January through December 2017 were reviewed for this study. The authors tracked whether the children referred to a pediatric dentist by the PHDHP were completed. Some data was missing therefore the sample size of the study was reduced to 1,450 children.
This study was done within a pediatric hospital clinic that had co-locations of multiple pediatric medical disciplines including primary care physicians and pediatric dentists. The access to care may be a limitation when extrapolating these results to more rural communities with a lack of access to care.
The results of the study showed in 2017, 1,450 children visited a PHDHP, 67% of the patients (family) accepted a referral to a pediatric dentist (n=973). Of the children with dental caries, 99% accepted a referral to a pediatric dentist. Families were more likely to accept a referral if their child was over the age of 3. Of the children with dental caries 48% completed their visit with the pediatric dentists, while only 13% of those without dental caries completed the referral to the pediatric dentist.
The results of this study show PHDHP were more successful when referring children older than 3 years of age and those with dental caries. Additional strategies and studies should be done to better understand and overcome the obstacles preventing completion of referrals in children 3 and under. As well as family’s motivations and the success of PHDHP referrals in a variety of healthcare settings.
The authors conclude by stating, “From a clinical and dental public health perspective, the results of this study are testament to the effectiveness of allied dental health professionals to coordinate efforts across medical and dental settings in order to decrease barriers to accessing care by pediatric dentists. In this study, families obtained pediatric dental referrals from the PHDHP in a pediatric hospital clinic, which is a medical setting frequented by families with children. This improved access to care by pediatric dentists for children with dental caries. To continue decreasing the prevalence of dental caries in American children, dental public health stakeholders can consider the use of PHDHPs in medical settings to increase referrals of children with dental caries to pediatric dentists.”
Do you see value in a PHDHP? Do you think PHDHP can bridge the gap between medicine and dentistry? Do you think PHDHP are a good resource to utilize when trying to reach rural communities with a lack of access to care? Do you think the results would be the same if the setting were in a more rural area without such easy access to other providers?
Burgette JM, Mestre Y, Martin B, Ray KN, Stiles A, Hoberman A. Success rates of pediatric dental referrals made by public health dental hygiene practitioners. J Public Health Dent. 2021;81(3):169-177. doi:10.1111/jphd.12428
