Preventive oral health program improves quality of life and often is cost-saving, study finds

August 28, 2012
A program that invests in preventive oral health care for young children at risk of dental disease not only improves overall oral health of the general public and likely improves quality of life for families but has a good chance of paying for itself in reduced hospitalizations and future dental costs, and may even be cost-saving.
Dr. Sally C. Stearns

Dr. Sally C. Stearns
Dr. Gary Rozier

Dr. Gary Rozier

Sally C. Stearns, PhD, and R. Gary Rozier, DDS, MPH, both professors in the Department of Health Policy and Management in UNC’s Gillings School of Global Public Health, led a study of the cost-effectiveness of Into the Mouths of Babes, a Medicaid program operating in North Carolina since 2000. Their results were published online Aug. 27 in Archives of Pediatrics & Adolescent Medicine. The article will appear in print in the journal’s October 2012 issue.

The study by Stearns, an economist, and Rozier, a dentist, demonstrated that early intervention can prevent hospitalization, which is a major cost driver in treating severe dental disease in young children. The complex calculations of balancing the cost of the program with the future money it saves by avoiding the need for treatment later on showed that the program was 32 percent likely to be cost-saving, with the discounting of benefits and payments. When giving equal value to current and future dollars, the program was nearly 50 percent likely to break even, Stearns said.
“If the prevention costs likely will be covered by reduced treatment costs, and health is improved,” Stearns said, “it’s a no-brainer that state Medicaid plans would be well-advised to move forward with this program.”
Into the Mouths of Babes focused on Medicaid patients, often considered at high risk for dental disease. Physicians seeing Medicaid patients younger than age 6 for well-child visits conducted dental screening, applied topical fluoride, counseled parents about oral hygiene and, when necessary, helped find a dentist to provide follow-up care. Dental decay can lead to abscesses, infections and pain great enough to interfere with a child’s eating, sleeping, talking and learning.
Into the Mouths of Babes drastically increased access to preventive services for children younger than age 3. Oral health care, beginning as soon as teeth appear in a baby, as early as 6 months, can prevent dental disease or slow serious problems until a child is old enough to be treated in a dentist’s office, rather than under general anesthesia in a hospital.
The primary reason for hospitalizing young children for treating severe dental disease is behavior management, Rozier said.
“You can’t sit a 2-year-old in a dentist’s chair and provide a lot of treatment,” Rozier said. Yet hospitalization can be upsetting to parents as well as their child.
Having physicians conduct the interventions during routine well-child visits addresses another obstacle to early dental care: a shortage of pediatric dentists in some parts of the state.
“We’re 47th in the country in dentist-to-population ratio,” Rozier said. “General and pediatric dentists supported the strategy of physicians doing screenings and risk assessments, and physicians valued spending time on interventions that will show impact.”
Rozier noted there are a lot of quality-of-life issues associated with dental disease. “Some things, like good health, you value enough that you’re willing to pay for them,” he said.


UNC Gillings School of Global Public Health contact: Linda Kastleman, communications editor, (919) 966-8317 or