Beyond ECC - Pediatric Dental Treatment Patterns

Objectives: Understanding patterns of pediatric dental caries is essential in targeting preventive strategies in dental and medical settings. Objective: To assess the pattern of dental treatment (as a surrogate for caries experience) and costs in children insured by North Carolina Medicaid before and after age 6. Before age 6, caries experience in children is defined as Early Childhood Caries (ECC). In contrast, we are defining Late Childhood Caries (LCC) as the caries pattern in children ages 6 to 12.
Methods: Methods: Claims data from 2011 to 2017 from approximately 900,000 Medicaid-insured children, aged 1-12 years, were retrieved. Treatment ascertained included resins, amalgams, stainless steel crowns (SSCs) and extractions for the anterior and posterior dentition for the following age categories 1-2, 3-5, 6-9 and 10-12.
Results: Results: On average 200,000 children received restorative dental care including extractions yearly from 2011 to 2017. Each annual expenditure for ECC was approximately $21,000,000. In comparison the annual costs to treat LCC increased during the study period from $15,000,000 to $20,500,000, almost equal to ECC. The predominant treatment for anterior teeth during the ECC period was restoration versus extraction during the LLC period. SSCs were the most common therapy for posterior teeth during the ECC period; whereas resins and amalgams were more prevalent than SSCs in the LCC period. During the ECC risk period the ratio of anterior restorations to posterior restorations was consistently 25% to 75% versus 5% to 95% during LCC period.
Conclusions: Conclusions: The expenditures for ECC have remained steady over the 7 years. The amount of treatment and cost to treat children in the LCC risk period has increased and almost equals the cost of ECC. Given the increasing expenditures for treating children ages 6 to 12, future studies should focus on the risk factors for the LCC pattern and provide age-specific prevention strategies.