Use of Environmental Lead Surveillance System to Improve Dental Caries Risk Assessment in Primary Medical Setting
Grant
Overview
abstract
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Dental care for young children often requires use of general anesthesia. In North Carolina, $16.7 million per year is spent in the Medicaid program for dental services performed under general anesthesia.1 Dental caries in children has been linked to lead exposure at levels below those that require an environmental investigation by public health officials.2 Environmental lead surveillance is a basic component of a strong public health infrastructure. In North Carolina, over 100,000 children ages 1 and 2 years old are tested for lead poisoning each year. These data are reported to the state?s Childhood Lead Poisoning Prevention Program. North Carolina Medicaid reimburses physicians for application of fluoride varnish (FV) up to six times for children ages 12 months to 42 months. A premise of this study is that linkages between the existing FV delivery system with the environmental surveillance system will enhance prevention of dental decay in young children. This pilot project is a partnership with a ECU Pediatrics and the ECU School of Dental Medicine. The pilot project has two specific aims. Aim1: Assess fluoride varnish use in a large pediatric medical practice to identify gaps in care delivery and determine the impact on dental caries 3 to 5 years after eligibility for fluoride varnish program ends. Aim 2: Evaluate the utility of the childhood lead surveillance system to efficiently stratify risk for dental caries based on blood lead values collected for childhood lead surveillance.
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