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Pediatr Dent. 2012 Sep-Oct;34(5):107-11.

Differences in dental service utilization by rural children with and without participation in Head Start.

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SC Rural Health Research Center and Department of Health Services Policy and Management, Arnold School of Public Health University of South Carolina, Columbia, SC, USA.



The purpose of this study was to assess differences in dental and medical care utilization for dental problems between rural Head Start (HS) participants and a nonexposed group.


A matched retrospective cohort study was conducted using chi-square, Poisson, and logistic regression models. We linked Medicaid claims and HS enrollment data for 7 rural counties in South Carolina to examine oral health service utilization in dental, primary care (PC), and emergency room (ER) settings. The exposed group included 985 HS participants during the 2007/2008 school year and the nonexposed group included 1,969 children enrolled in Medicaid but not HS.


HS participants were more than twice as likely to visit dentists for preventive, diagnostic, and restorative care (P<.001). The odds ratio of HS participants relative to the nonexposed group for PC visits for oral health problems was 1.94 (P=.03). No differences between HS participants and the nonexposed group for oral health-related ER visits were observed (P=0.33).


Head Start participants accessed dental care with greater frequency than the nonexposed group. Findings provide evidence that Head Start grantees positively impact dental service utilization for their children. Future research should examine the programmatic features to which the outcomes can be attributed and whether utilization trends continue after Head Start completion.

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