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Cited by 10Dental Health and Care UtilizationChild and Adolescent HealthSchool Health and Nursing Education

Access to preventive services after the integration of oral health care into early childhood education and medical care

Open access
Burgette, Jacqueline M., Preisser, John S., Rozier, R. Gary·2018·The Journal of the American Dental Association
DOI 10.1016/j.adaj.2018.07.019PMC PMC7239644
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Abstract

BACKGROUND The effect of Early Head Start (EHS) on receipt of preventive oral health services (POHS) from both oral and medical health care providers is not known. METHODS The authors compared children enrolled in North Carolina EHS programs with similar children enrolled in Medicaid but not EHS on the use of POHS. They analyzed 4 dependent variables (oral assessment by medical health care provider, oral assessment by oral health care provider, fluoride application by medical health care provider, fluoride application by oral health care provider) by using multivariate logistic regression that controlled for covariates. RESULTS Primary caregivers of children enrolled in EHS (n = 479) and Medicaid (n = 699) were interviewed when children were approximately 10 and 36 months of age. An average of 81% of EHS and non-EHS children received POHS from an oral or medical health care provider at follow-up. EHS children had greater odds of receiving an oral health assessment (odds ratio [OR], 2.33; 95% confidence interval [CI], 1.74 to 3.13) and fluoride (OR, 1.53; 95% CI, 1.16 to 2.03) from an oral health care provider than children not enrolled. EHS children had decreased odds (OR, 0.73; 95% CI, 0.54 to 0.99) of receiving fluoride from a medical health care provider. CONCLUSIONS Both children enrolled in EHS and community control participants had high rates of POHS, but the source of services differed. EHS children had greater odds of receiving POHS from oral health care providers than non-EHS children. EHS and non-EHS children had equal rates for fluoride overall because of the greater percentage of non-EHS children with medical fluoride visits. PRACTICAL IMPLICATIONS The integration of POHS in early education and Medicaid medical benefits combined with existing dental resources in the community greatly improves access to POHS.

Integrity signals

Registry

Crossref · 10.1016/j.adaj.2018.07.019

Cites

21 of 21 references verified0 citation errors · 0 not checkable

Statistics

Nothing to recompute.

Claims the paper makes

0 of 43 cited sources checked · 0 supported · 0 flagged

  • Findingown data

    On average, 81% of children received preventive oral health services from either a dental or medical provider at the two-year follow-up.

    “An average of 81% of children received POHS from either a dental or medical provider at the two-year follow-up.”
    Quote in the paperSubstantial claim
  • Findingown data

    After controlling for parent health literacy, parent overall health, survey language, and propensity score, Early Head Start children had greater odds of dental fluoride than non-Early Head Start children (OR=1.53; 95% CI=1.16-2.03).

    “After controlling for parent health literacy, parent overall health, survey language and the propensity score, children in EHS had a greater odds of having had a dental assessment (OR=2.33; 95% CI=1.74–3.13) and dental fluoride (OR=1.53; 95% CI=1.16–2.03) at the follow-up compared to children not enrolled in EHS.”
    Quote in the paperSubstantial claim
  • Findingown data

    A large percentage of children had medical fluoride visits around one year of age: 36.3% in Early Head Start and 30.2% in non-Early Head Start.

    “We found a large percentage of medical fluoride visits around 1 year of age (EHS=36.3%; non-EHS=30.2%) (Table 1).”
    Quote in the paperNot a substantial claim
  • Findingown data

    Early Head Start children had decreased odds of receiving medical fluoride compared with non-Early Head Start children (OR=0.73; 95% CI=0.54-0.99).

    “Children enrolled in EHS had a decreased odds of receiving a medical fluoride treatment compared to children not enrolled in EHS (OR=0.73; 95% CI=0.54–0.99).”
    Quote in the paperSubstantial claim
  • Findingown data

    Within the non-Early Head Start group, there was no difference in the odds of receiving fluoride treatment by provider type (OR=0.86; 95% CI=0.50, 1.46).

    “Within the Non-EHS group, we found no difference in the odds of receiving an oral health assessment (OR=1.45; 95% CI=0.86, 2.43) or fluoride treatment (OR=0.86; 95% CI=0.50, 1.46) by provider type.”
    Quote in the paperNot a substantial claim
  • May combine two claims. 18
  • Classified as probably not a substantial claim. 14

  • May combine two claims.

    Findingown data

    Dental assessment was highly associated with dental fluoride, and the two services tended to be bundled together.

    “Results of the ALR analysis also showed that dental assessment was highly associated with dental fluoride in the sense that these two services tended to be bundled together (Supplemental file; Table A.2).”
    Quote in the paperNot a substantial claim

  • May combine two claims.

    Findingown data

    The study enrolled 60% (n=634) of an estimated 1,054 eligible North Carolina Early Head Start participants and 9% (n=927) of 9,967 Medicaid-enrolled children not in Early Head Start.

    “We enrolled 60% (n=634) of an estimated 1,054 eligible participants enrolled in NC EHS programs and 9% (n=927) of the 9,967 children enrolled in Medicaid but not EHS.”
    Quote in the paperNot a substantial claim

  • May combine two claims.

    Findingown data

    Early Head Start children were less likely to identify as white and more likely to have been homeless sometime during their first three years than non-Early Head Start children (p<0.01).

    “EHS enrolled children were less likely to identify as white than those not enrolled and more likely to have been homeless sometime during their first 3 years of life (p<0.01) (Table 1).”
    Quote in the paperNot a substantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Premisecitation

    Major pediatric health care organizations' clinical practice guidelines recommend starting dental visits before age one and continuing them on a routine schedule.

    “Clinical practice guidelines published by major pediatric health care organizations recommend that dental visits be initiated before the first birthday and continue on a routine schedule.1, 2”
    Quote in the paperNot a substantial claim0 of 2 sources checked
    • cites [1] Hagan JF, Shaw JS, Duncan P, eds. Bright Futures: Guidelines for Health Supervision of Infants, Children, and Adolescents. 3rd ed Elk Grove Village, IL: American Academy of Pediatrics; 2008.

      Not checked in the free run.

    • cites [2] American Academy of Pediatric Dentistry. Definition of Dental Home. Reference Manual. Pediatric Dentistry 2017; 39(6): 29– 30.29179309

      Not checked in the free run.

  • Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.

    Premisecitation

    Support for integrating oral health into well-child visits has developed over time, and this integration is now considered an essential part of well-child visits.

    “Support for this strategy has evolved over many years, and it now is considered an essential part of the well-child visits.1, 6, 10–13”
    Quote in the paperNot a substantial claim0 of 6 sources checked
    • cites [1] Hagan JF, Shaw JS, Duncan P, eds. Bright Futures: Guidelines for Health Supervision of Infants, Children, and Adolescents. 3rd ed Elk Grove Village, IL: American Academy of Pediatrics; 2008.

      Couldn’t be matched to a paper in Crossref, so it can’t be checked.

    • cites [6] Institute of Medicine. Improving Access to Oral Health Care for Vulnerable and Underserved Populations. Washington, DC: National Academies Press; 2011.

      Couldn’t be matched to a paper in Crossref, so it can’t be checked.

    • cites [10] U.S. Department of Health and Human Services. Integration of Oral Health and Primary Care Practice. Rockville, MD: U.S. Department of Health and Human Services, Health Resources and Services Administration; 2014 Available at: https://www.hrsa.gov/sites/default/files/hrsa/oralhealth/integrationoforalhealth.pdf Accessed February 23, 2018.

      Couldn’t be matched to a paper in Crossref, so it can’t be checked.

    • cites [11] Douglass AB, Douglass JM, Krol DM. Educating pediatricians and family physicians in children’s oral health. Acad Pediatr 2009; 9(6): 452– 6. 19853551 source

      Not checked in the free run.

    • cites [12] Moyer VA, US Preventive Services Task Force. Prevention of dental caries in children from birth through age 5 years: US Preventive Services Task Force recommendation statement. Pediatrics 2014; 133(6): 1102– 11. 24799546 source

      Not checked in the free run.

    • cites [13] American Academy of Pediatrics. Recommendations for preventive pediatric health care. 2017 “ https://www.aap.org/en-us/documents/periodicity_schedule.pdf“. Accessed March 27 2018.

      Couldn’t be matched to a paper in Crossref, so it can’t be checked.

  • Classified as probably not a substantial claim.

    Study design and conductnone given

    The analysis was performed as an intent-to-treat analysis, with the treatment indicator as assigned.

    “We performed an intent-to-treat analysis in which the treatment indicator (EHS enrolled or not) was as assigned.”
    Quote in the paperSubstantial claim

  • May combine two claims.

    Premisecitation

    Public knowledge about dental visit schedules is low, and health literacy limits families' ability to learn this or navigate the health care system.

    “General knowledge about visit schedules among the public is low and health literacy levels interfere with families’ ability to gain this knowledge or navigate the healthcare system.6”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [6] Institute of Medicine. Improving Access to Oral Health Care for Vulnerable and Underserved Populations. Washington, DC: National Academies Press; 2011.

      Not checked in the free run.

  • Classified as probably not a substantial claim.

    Study design and conductcitation

    Parent health literacy was measured at baseline with the SAHL-S&E, an 18-item validated word recognition and comprehension test with a cut-off of 14 or less for low health literacy.

    “Parent health literacy was measured at baseline using the Short Assessment of Health Literacy – Spanish and English (SAHL-S&E), an 18-item word recognition and comprehension test validated in a low-income population with an established cut-off to identify families with low health literacy (SAHL-S&E≤14).21”
    Quote in the paperSubstantial claim0 of 1 sources checked
    • cites [21] Lee SY, Stucky BD, Lee JY, Rozier RG, Bender DE. Short Assessment of Health Literacy-Spanish and English: a comparable test of health literacy for Spanish and English speakers. Health Serv Res 2010; 45(4): 1105– 20. 20500222 PMC2910571 source

      Not checked in the free run.

  • May combine two claims.

    Premisecitation

    Barriers exist that are difficult for the public to overcome and that might negatively affect continuity of care.

    “However, a number of barriers exist that are difficult for the public to overcome that might negatively affect continuity of care.26, 27”
    Quote in the paperNot a substantial claim0 of 2 sources checked
    • cites [26] Long CM, Quinonez RB, Rozier RG, Kranz AM, Lee JY. Barriers to pediatricians’ adherence to American Academy of Pediatrics oral health referral guidelines: North Carolina general dentists’ opinions. Pediatr Dent 2014; 36(4): 309– 15. 25197996 PMC4523089

      Not checked in the free run.

    • cites [27] Harnagea H, Couturier Y, Shrivastava R, Barriers and facilitators in the integration of oral health into primary care: a scoping review. BMJ Open 2017; 7(9): e016078. PMC5623507 28951405

      Not checked in the free run.

  • May combine two claims.

    Study design and conductown data

    Follow-up interviews were completed with 479 Early Head Start and 699 non-Early Head Start parent-child dyads, a 75% follow-up rate in both groups.

    “Follow-up interviews were completed with 479 EHS and 699 non-EHS parent-child dyads, a 75% follow-up rate for both groups.”
    Quote in the paperSubstantial claim

  • May combine two claims.

    Premisecitation

    By 2006, the rate of preventive oral health visits in medical offices was 40 per 100 enrollees, nearly four times the dentist visit rate of 11 per 100 enrollees.

    “By 2006 the rate of POHS visits in medical offices was 40 per 100 enrollees, almost four times larger than the rate of dentist visits at 11 per 100 enrollees.15”
    Quote in the paperSubstantial claim0 of 1 sources checked
    • cites [15] Rozier RG, Stearns SC, Pahel BT, Quinonez RB, Park J. How a North Carolina program boosted preventive oral health services for low-income children. Health Aff (Millwood) 2010; 29(12): 2278– 85. 21134930 PMC5702492 source

      Not checked in the free run.

  • Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.

    Premisecitation

    A previous ZOE publication reported that Early Head Start enrollment increased the likelihood of any dental visit by 17.2% and of a preventive dental visit by 19.0% compared with non-enrolled community controls.

    “In a previous publication from the ZOE study, we reported that enrollment in EHS increased the likelihood of a dental visit of any type by 17.2% and a preventive dental visit by 19.0% compared to non-enrolled community controls.18”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [18] Burgette JM, Preisser JS Jr., Weinberger M, Impact of Early Head Start in North Carolina on Dental Care Use Among Children Younger Than 3 Years. Am J Public Health 2017; 107(4): 614– 20. 28207343 PMC5343690 source

      Not checked in the free run.

  • May combine two claims.

    Premisecitation

    The percentage of Early Head Start children with a preventive dental visit by age 3 was 79%, compared with 56% for non-enrolled children.

    “The percentage of EHS children with a preventive dental visit by 3 years of age was 79% in EHS compared to 56% for those not enrolled.18”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [18] Burgette JM, Preisser JS Jr., Weinberger M, Impact of Early Head Start in North Carolina on Dental Care Use Among Children Younger Than 3 Years. Am J Public Health 2017; 107(4): 614– 20. 28207343 PMC5343690 source

      Not checked in the free run.

  • Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.

    Premisecitation

    The child study subjects averaged about one year of age at baseline, which is the recommended age for the first dental visit.

    “Child study subjects averaged about 1 year of age at baseline, which is the age recommended for the first dental visit.1, 2”
    Quote in the paperNot a substantial claim0 of 2 sources checked
    • cites [1] Hagan JF, Shaw JS, Duncan P, eds. Bright Futures: Guidelines for Health Supervision of Infants, Children, and Adolescents. 3rd ed Elk Grove Village, IL: American Academy of Pediatrics; 2008.

      Not checked in the free run.

    • cites [2] American Academy of Pediatric Dentistry. Definition of Dental Home. Reference Manual. Pediatric Dentistry 2017; 39(6): 29– 30.29179309

      Not checked in the free run.

  • May combine two claims.

    Premisecitation

    Studies suggest that physician-delivered preventive oral health services reduce inequities in access to these services and improve population oral health.

    “Studies suggest that physician-delivered POHS reduce inequities in access to POHS and improve population oral health.16, 17”
    Quote in the paperSubstantial claim0 of 2 sources checked
    • cites [16] Achembong LN, Kranz AM, Rozier RG. Office-based preventive dental program and statewide trends in dental caries. Pediatrics 2014; 133(4): e827– 34. 24685954 PMC5002973 source

      Not checked in the free run.

    • cites [17] Braun PA, Cusick A. Collaboration Between Medical Providers and Dental Hygienists in Pediatric Health Care. J Evid Based Dent Pract 2016; 16 Suppl: 59– 67. 27236997 source

      Not checked in the free run.

  • Classified as probably not a substantial claim.

    Study design and conductcitation

    Four baseline covariates were included because of their potential impact on all four dependent variables: parent health literacy, parent overall health, survey language, and a propensity score derived from 47 socio-demographic characteristics and Early Head Start enrollment criteria.

    “We included four baseline covariates in the analyses because of their potential impact on all four dependent variables: parent health literacy, parent overall health, survey language and a generalized boosted model propensity score derived from 47 socio-demographic characteristics and EHS enrollment criteria.20”
    Quote in the paperSubstantial claim0 of 1 sources checked
    • cites [20] Burgette JM, Preisser JS, Rozier RG. Propensity score weighting: an application to an Early Head Start dental study. J Public Health Dent 2016; 76(1): 17– 29. 26086447 PMC4684474 source

      Not checked in the free run.

  • May combine two claims.

    Premisecitation

    Evidence is lacking on how often dental referral activities occur within primary care and on their effectiveness.

    “Evidence is lacking on the extent to which these activities take place within primary care or their effectiveness.12, 25”
    Quote in the paperNot a substantial claim0 of 2 sources checked
    • cites [12] Moyer VA, US Preventive Services Task Force. Prevention of dental caries in children from birth through age 5 years: US Preventive Services Task Force recommendation statement. Pediatrics 2014; 133(6): 1102– 11. 24799546 source

      Not checked in the free run.

    • cites [25] Quinonez RB, Pahel BT, Rozier RG, Stearns SC. Follow-up preventive dental visits for Medicaid-enrolled children in the medical office. J Public Health Dent 2008; 68(3): 131– 8. 18179471 source

      Not checked in the free run.

  • Classified as probably not a substantial claim. May combine two claims.

    Premisecitation

    Dental caries can start at a very young age, progress quickly, and cause pain, infection, and other negative outcomes for the child and family.

    “Dental caries can begin at a very young age in children, progress rapidly, and lead to pain, infection and other outcomes that negatively affect the child and family.3, 4”
    Quote in the paperSubstantial claim0 of 2 sources checked
    • cites [3] American Academy of Pediatric Dentistry Council on Clinical Affairs. Policy on early childhood caries (ECC): Classifications, consequences, and preventive strategies. Pediatric Dentistry. 2017; 39(6): 59– 61. 29179321

      Not checked in the free run.

    • cites [4] Oral Health in America: A Report of the Surgeon General. Rockville, MD: U.S. Department of Health and Human Services, National Institute of Dental and Craniofacial Research, National Institutes of Health; 2000.

      Not checked in the free run.

  • May combine two claims.

    Interpretationreasoning

    The findings demonstrate the potential for a social services program like Early Head Start to contribute to oral health through staff support of parents, as well as added contributions from integrating oral health into primary health care.

    “This finding demonstrates not only the potential for a social services program like EHS to contribute to oral health through staff support of parents, but the added contributions derived from the integration of oral health into primary health care.”
    Quote in the paperSubstantial claim

  • Classified as probably not a substantial claim.

    Study design and conductnone given

    The main independent variable, Early Head Start enrollment, was supplied by Early Head Start staff and confirmed by the parent at baseline screening and interview.

    “The main independent variable, EHS enrollment, was supplied by EHS staff and confirmed by the parent at the baseline enrollment screening and interview.”
    Quote in the paperSubstantial claim

  • Classified as probably not a substantial claim.

    Premisecitation

    The ZOE evaluation found that enrollment in Early Head Start increased dentist visits compared with non-enrollment.

    “An evaluation of the impact of the intervention, known as Zero-out Early Childhood Caries (ZOE) found that enrollment in EHS increased dentist visits compared to non-enrollment.18”
    Quote in the paperSubstantial claim0 of 1 sources checked
    • cites [18] Burgette JM, Preisser JS Jr., Weinberger M, Impact of Early Head Start in North Carolina on Dental Care Use Among Children Younger Than 3 Years. Am J Public Health 2017; 107(4): 614– 20. 28207343 PMC5343690 source

      Not checked in the free run.

  • May combine two claims.

    Premisecitation

    In 2009, only 7.6% of US children under age 3 had a dental visit, and only 1.7% received topical fluoride.

    “In 2009, only 7.6% of children younger than 3 years of age had a dental visit in the United States, and only 1.7% received a topical fluoride treatment.9”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [9] Griffin SO, Barker LK, Wei L, Use of dental care and effective preventive services in preventing tooth decay among U.S. Children and adolescents--Medical Expenditure Panel Survey, United States, 2003–2009 and National Health and Nutrition Examination Survey, United States, 2005–2010. MMWR Suppl 2014; 63(2): 54– 60. 25208259

      Not checked in the free run.

  • May combine two claims.

    Premisecitation

    The dental workforce is not adequately prepared, and in some cases not willing, to provide dental care for young children.

    “The dental workforce overall is not prepared adequately or willing in some cases, to provide dental care for young children.6–8”
    Quote in the paperSubstantial claim0 of 3 sources checked
    • cites [6] Institute of Medicine. Improving Access to Oral Health Care for Vulnerable and Underserved Populations. Washington, DC: National Academies Press; 2011.

      Not checked in the free run.

    • cites [7] Garg S, Rubin T, Jasek J, How willing are dentists to treat young children?: a survey of dentists affiliated with Medicaid managed care in New York City, 2010. J Am Dent Assoc 2013; 144(4): 416– 25. 23543696

      Not checked in the free run.

    • cites [8] Seale NS, Casamassimo PS. Access to dental care for children in the United States: a survey of general practitioners. J Am Dent Assoc 2003; 134(12): 1630– 40. 14719761

      Not checked in the free run.

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Study design and conductreasoning

    The high utilization rates could be due partly to the way the rates were calculated.

    “Finally, the high utilization rates could be due partly to the way in which we calculated rates.”
    Quote in the paperNot a substantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Study design and conductreasoning

    The results may be subject to reporting bias.

    “Our results may be subject to reporting bias.”
    Quote in the paperNot a substantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Premisecitation

    A number of organizations have promoted integrating oral health into primary care as a method to improve access to preventive oral health services.

    “A number of organizations have promoted the integration of oral health into primary care as one method to improve access to POHS.1, 10, 12, 13, 28–31”
    Quote in the paperNot a substantial claim0 of 8 sources checked
    • cites [1] Hagan JF, Shaw JS, Duncan P, eds. Bright Futures: Guidelines for Health Supervision of Infants, Children, and Adolescents. 3rd ed Elk Grove Village, IL: American Academy of Pediatrics; 2008.

      Couldn’t be matched to a paper in Crossref, so it can’t be checked.

    • cites [10] U.S. Department of Health and Human Services. Integration of Oral Health and Primary Care Practice. Rockville, MD: U.S. Department of Health and Human Services, Health Resources and Services Administration; 2014 Available at: https://www.hrsa.gov/sites/default/files/hrsa/oralhealth/integrationoforalhealth.pdf Accessed February 23, 2018.

      Couldn’t be matched to a paper in Crossref, so it can’t be checked.

    • cites [12] Moyer VA, US Preventive Services Task Force. Prevention of dental caries in children from birth through age 5 years: US Preventive Services Task Force recommendation statement. Pediatrics 2014; 133(6): 1102– 11. 24799546 source

      Not checked in the free run.

    • cites [13] American Academy of Pediatrics. Recommendations for preventive pediatric health care. 2017 “ https://www.aap.org/en-us/documents/periodicity_schedule.pdf“. Accessed March 27 2018.

      Couldn’t be matched to a paper in Crossref, so it can’t be checked.

    • cites [28] Grantmakers in Health. Returning the mouth to the body: Integrating oral health & primary care. Grantmakers in Health Issue Dialogue Brief Issue Brief No. 40; 2012 “ http://www.gih.org/files/FileDownloads/Returning_the_Mouth_to_the_Body_no40_September_2012.pdf“. Accessed June 21, 2017). 23033564

      Not checked in the free run.

    • cites [29] McGinnis T, Crawford M, Somers SA. A State Policy Framework for Integrating Health and Social Services. New York, NY: The Commonwealth Fund; 2014. 25065021 source

      Not checked in the free run.

    • cites [30] Reimbursing physicians for fluoride varnish. Philadelphia, PA: The Pew Charitable Trusts 2011 “ http://www.pewtrusts.org/en/research-and-analysis/analysis/2011/08/29/reimbursing-physicians-for-fluoride-varnish“. Accessed March 6, 2018.

      Couldn’t be matched to a paper in Crossref, so it can’t be checked.

    • cites [31] Brownlee B. White paper: oral health integration in the patient-centered medical home (PCMH) environment: case studies from community health centers. Paper commissioned by the Funders Oral Health Policy Group; 2012 “ http://dentaquestfoundation.org/sites/default/files/resources/Oral%20Health%20Integration%20in%20the%20Patient-Centered%20Medical%20Home,%202012.pdf“ Accessed June 21, 2017.

      Couldn’t be matched to a paper in Crossref, so it can’t be checked.

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Interpretationnone given

    The results are unlikely to be generalizable to states where integration of oral health services into primary health care is less widespread than in North Carolina.

    “The results also are unlikely to be generalizable to states where the integration of oral health services into primary health care is not as widespread as in North Carolina.”
    Quote in the paperNot a substantial claim

  • May combine two claims.

    Premisecitation

    In 2016, 15.3% of enrolled children younger than 3 years had one or more preventive visits to a dental provider, and 8.2% received oral health services from a non-dentist provider.

    “In 2016, 15.3% of enrolled children younger than 3 years of age had 1 or more preventive visits to a dental provider; 8.2% received oral health services from a non-dentist provider.32”
    Quote in the paperSubstantial claim0 of 1 sources checked
    • cites [32] Early and Periodic Screening, Diagnostic, and Treatment: Annual EPSDT Reporting Using the Form CMS 416, FY2016. Baltimore, MD: Centers for Medicare & Medicaid Services; 2016 “ https://www.medicaid.gov/medicaid/benefits/epsdt/index.html“. Accessed May 24 2018.

      Not checked in the free run.

28 of 28

  • The authors state this as an assumption.

    The medical fluoride services observed at baseline were provided as part of the Into the Mouths of Babes program.

    “We assume that these services were provided as part of the IMB program.”

  • The paper relies on this without support.

    No prior study has investigated the role of Early Head Start on the use of preventive oral health services in the context of a statewide program like Into the Mouths of Babes where oral health is integrated into primary health care.

    “To our knowledge, no study has investigated the role of EHS on the use of POHS in the context of a statewide program like IMB, where oral health is integrated into primary health care.”

  • The paper relies on this without support.

    Few rigorous evaluations have been conducted of the effects of integrating oral health into primary care on access to dental care or oral health status.

    “Although the rationale for these programs is strong, few rigorous evaluations of the effects of these programs on access to dental care or oral health status have been conducted.”

  • The paper relies on this without support.

    Early Head Start has oral health performance standards that promote the establishment of a dental home.

    “because EHS has oral health performance standards that promote the establishment of a dental home.”

  • The paper relies on this without support.

    Early Head Start programs have resources and experience to coordinate services between medical and dental delivery systems.

    “Further, EHS programs have resources and experience to coordinate services between medical and dental delivery systems.”
5 of 5

Claims other papers make about this one

Each is checked against this paper’s own text: does it say what the citing paper says it does?

  • Most oral health disparities research has focused on specific age groups, particular vulnerable populations, or traditional socioeconomic variables.

    “Most oral health disparities research has focused on specific age groups (such as children or older adults) (8–10), particular vulnerable populations (e.g., pregnant women and people with disabilities) (11), or traditional socioeconomic variables such as income, insurance status, or healthcare workforce distributions (12).”

    From Access to oral health care and its social determinants across the lifespan in the United States (2025) · cites this paper as [8]

Cites

Flagged first, then by citations

1 of the 22 references couldn’t be matched to a known paper.

Research works printed but not linked: 1

  1. 2017, Policy on the dental home, Pediatr Dent, 39, 29

Cited by

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Related

Authors
Burgette, J. M., Preisser, J. S., & Rozier, R. G.
Affiliations
University of North Carolina at Chapel Hill (US)
Corresponding author
Burgette, Jacqueline M.
ORCID
Venue
The Journal of the American Dental Association
Publisher
Elsevier BV
Published
2018-12
Volume
149
Issue
12
Pages
1024-1031.e2
ISSN
0002-8177 (ISSN-L)
DOI
10.1016/j.adaj.2018.07.019
PMC
PMC7239644
OpenAlex
W2892171944
Semantic Scholar
25e5f7a636fe686e506d70f20338328c8c5ad85d
Cited by
9
References
22
Citations by year
2025: 2 · 2024: 1 · 2023: 1 · 2021: 3 · 2020: 1 · 2019: 1
FWCI
1.44
Type
journal article
Language
en
Open access
Licence
www.elsevier.com/tdm/userlicense/1.0/ (tdm)
Locations
  • The Journal of the American Dental Association (publishedVersion)
  • PubMed (publishedVersion)
  • PubMed Central (acceptedVersion)
Funders
National Institute of Dental and Craniofacial Research, Bethesda, MD, (T32-HS000032)
Topics
  • Health Sciences › Dentistry › Periodontics › Dental Health and Care Utilization
  • Health Sciences › Health Professions › General Health Professions › Child and Adolescent Health
  • Health Sciences › Health Professions › Speech and Hearing › School Health and Nursing Education
Keywords
Early Head Start, Medicaid, early childhood education, fluoride application, oral health assessment, access to dental care, young children, primary caregivers
MeSH terms
Child, Child, Preschool, Fluorides, Health Services Accessibility, Humans, Infant, Medicaid, North Carolina, Oral Health, United States, Dental Care for Children

About these checks

Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.

Claims read by deepseek-v4.1-flash under definition version 3 (extract-v3) on 2026-10-05.

Classified by jev-1.13-20260917 (gold-guideline-v0.2) on 2026-10-05.

Statistics and arithmetic are recomputed, not judged.

Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.

What counts as a claim ›How we measure confidence ›How we check this ›

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