Dental Sealants and Restorative Treatment for First Molars Among Medicaid Enrollees

Authors

Christopher Okunseri, Marquette UniversityFollow
Brian D. Hodgson, Marquette UniversityFollow
Elaye Okunseri, Marquette UniversityFollow
Raul Garcia, Boston UniversityFollow
Alexis D. Visotcky, Medical College of Wisconsin
Aniko Szabo, Medical College of Wisconsin

Document Type

Article

Language

eng

Publication Date

12-2020

Publisher

Wiley

Source Publication

Community Dentistry and Oral Epidemiology

Source ISSN

0301-5661

Abstract

Objectives

To assess the association between dental sealant placement and subsequent restorative treatment of permanent first molars over time.

Methods

We analysed Wisconsin Medicaid claims data from 2001 to 2009 for children aged 6-16 years. Children entered the study cohort at age 6 and were censored if Medicaid eligibility was lost for >31 days. A fixed effects analysis via a Cox proportional hazards model, stratified by individual, was used to estimate the time-averaged and time-dependent effects of sealant placement on dental treatment defined as any restorative, endodontic or surgical procedure.

Results

A total of 185,262 children with permanent first molars who turned 6 years enrolled in Medicaid were examined. Sealant placement was higher for teeth #16 and 26 (5.42 and 5.46 per 100 person-years (100PY), versus 5.29 and 5.31/100PY for #36 and 46, respectively. The average rate for restorative treatments had the opposite pattern, with lower rate for teeth #16 and 26 (1.78 and 1.72/100PY) versus teeth #36 and 46 (2.14 and 2.12/100PY), respectively. In the fixed effects regression model, the hazard of dental treatment was substantially lower after sealant placement on a tooth, with time-averaged hazard ratio HR = 0.23 (95% CI 0.21-0.25, P < .001) versus before sealant. The largest effect was in the first year after sealant placement (HR = 0.13, 95% CI: 0.11-0.14), which decreased over time (HR = 0.50, 0.59 and 0.74 in years 2, 3 and 4, respectively), and was not statistically significant in later years.

Conclusions

This study demonstrates that permanent first molar sealant placement delayed subsequent dental treatments in children enrolled in Medicaid.

Comments

Accepted version. Community Dentistry and Oral Epidemiology, Vol. 48, No. 6 (December 2020): 487-492. DOI. © 2020 Wiley. Used with permission.

Recommended Citation

Okunseri, Christopher; Hodgson, Brian D.; Okunseri, Elaye; Garcia, Raul; Visotcky, Alexis D.; and Szabo, Aniko, "Dental Sealants and Restorative Treatment for First Molars Among Medicaid Enrollees" (2020). School of Dentistry Faculty Research and Publications. 392.
https://epublications.marquette.edu/dentistry_fac/392