School screening and parental reminders in increasing dental care for children in need: a retrospective cohort study

Objective: The objective of this study is to assess follow‐up dental care received by children given baseline screening and referrals as part of an ongoing clinical trial. Methods: A retrospective study with two cohorts of kindergarten children who had baseline and follow‐up (9 months later) dental exams was used. The parents/caregivers of children with routine restorative or urgent needs at baseline received a referral letter and telephone reminders to seek care for their child. Children with referrals were evaluated at follow‐up exam for the receipt of care. A baseline caregiver questionnaire provided information on the individual and family characteristics of the children. Results: A total of 303 children had dental exams at both time periods. At baseline, 42 percent (126/303) received referrals and among the referred group19 percent (24/126) received follow‐up care. A greater proportion with urgent referrals (10/30, 33 percent) received care than those with routine referrals (14/96, 15 percent). Baseline dmft decayed, missing, filled primary teeth and DMFT decayed, missing, filled permanent teeth was similar between children who did/did not receive follow‐up care (P = 0.178 and 0.491, respectively). Children receiving referrals had caregivers with less education, higher Medicaid participation, fewer routine care visits, poorer self‐rating of teeth, and a higher proportion of children reporting tooth pain. Children without receipt of follow‐up care had caregivers who were more likely to report not visiting a dentist within the last 5 years and a greater number of missed days from work because of tooth problems. Conclusion: The rate of dental utilization was low even with school screening, referral and parental reminders among poor, largely minority inner‐city kindergarten children.