EVALUATION AND OUTCOMES

Washington Dental Service Foundation continues to evaluate the impact of the ABCD programs it funds through analysis of:

• Medicaid data
• Surveys
• Feedback from stakeholders

The Department of Dental Public Health Sciences at the University of Washington School of Dentistry has evaluated the original Spokane County ABCD Program since it began in 1995. They have also done a randomized clinical trial of ABCD services in Stevens County.

List of published papers.

MEDICAID DATA

Medicaid Clients
Data for calendar year 2004 and 2005 indicate that counties with the ABCD program experience significant increases in access for very young children.

• Medicaid dental utilization for children under age 6 in ABCD counties is 35.5% (representing over 62,000 patients), while utilization is only in non-ABCD  counties is 30.6% (FY 2005).
• In ABCD counties, 13.3% of children age two and under received dental services as compared with 8.7%in non-ABCD counties   (FY 2004).
• The  most recent dental utilization rates for both the Yakima and Chelan-Douglas-Okanogan programs are approaching 50% (Yakima 46%, CDO 46.7%). (FY 2005)
• Since inception, the ABCD program has enrolled over 58,000 statewide

Medicaid Providers

• Statewide, the number of dental providers treating Medicaid patients under 18 decreased by 14.2%, but the rate of reduction was twice as high in non-ABCD counties (21.8%) as in ABCD counties (10.7%).
• Over 550 dentists statewide have been trained in early pediatric techniques through the ABCD program.

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SURVEYS

Surveys, funded by Washington Dental Service Foundation and conducted by an outside firm in 2000-2001, measured the attitudes and behaviors of:

• participating families (clients) in five ABCD programs prior to entering the programs
• participating and non-participating dentists (providers) in ABCD program counties.

The baseline client surveys yielded the following insights:

• Parents value good oral health
• Parents do not know:
• how to check their children for cavities
• about fluoride sources
• Other problem areas include:
• putting babies to bed with a bottle filled with liquids other than water (30%)
• the low number of parents taking their child to a dentist (only 38%)
• limited access to care - parents reporting they cannot find dentist (31%)
• Parents most often obtained oral health information from the following sources:
• WIC
• Dental and medical offices

The baseline provider surveys yielded the following insights:

• 39% of the ABCD-trained providers felt comfortable treating children under the age of one, compared to only 12% of non-trained providers.
• 84% of the ABCD-trained dentists reported treating children age 2 years or younger at least once per month. Among dentists who had not participated in ABCD training, 40% treated this age group at least once per month.
• 73% of ABCD-trained dentists provide services to Medicaid patients more than once per month; 61% of non-trained dentists provide services to Medicaid patients more than once per month.
• Roughly 49% felt dentists should provide treatment to Medicaid patients; there was little difference between ABCD-trained and non ABCD-trained providers.

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