# Reducing Oral Health Disparities in Children: Assessing the Multilevel Impact of a Standardized Preventive Dental Care System

> **NIH NIH R01** · UNIVERSITY OF CALIFORNIA, SAN FRANCISCO · 2023 · $643,456

## Abstract

Summary (Abstract)
Our long-term goal is to improve dental care quality through evidence-based prevention and treatment as a key
component in the overall strategy to reduce disparities in children's oral health. Universal pediatric dental
coverage has been enabled under the Affordable Care Act (ACA), and achieving access for Medicaid children
equal to privately insured children is within reach, yet strong income-related oral health disparities remain.
Understanding the dental care system's role in creating or mitigating oral health disparities or improving oral
health has been limited to simplistic access metrics (e.g., annual dental visit) and procedures billed (e.g.,
dental treatment) which only allow general comparisons heavily confounded by quality of care and insurance
type. We know little about how caries risk status, diagnoses, preventive therapies, and interventions are linked
to oral health in specific individuals and in populations over time. This gap in knowledge can now be overcome
through our proposed study of a caries prevention program implemented at a dental accountable care
organization serving both commercially insured and Medicaid patients. The program is built into a system that
includes a standardized model of diagnosis-driven, risk-based, clinical-decision-supported care documented in
an electronic health record (EHR). The objective of this study is to assess the impact of this evidence-based
care delivery approach on reducing pediatric oral health disparities and improving children's oral health over
time. This study will leverage sophisticated dental informatics allowing us to use big data to measure and
comparatively examine untreated caries and new caries incidence over time in the context of real-world clinical
care. Additionally, using Oregon Medicaid claims data we can assess the delivery system impact; utilizing
national cost data we can model cost-effectiveness and sustainability; and using interviews we can identify
impactful patient-centered care considerations that can potentially predict the success of the program – all
critical information to inform future translation and implementation efforts. The expected outcome will be the
empirical foundation of a sustainable, scalable roadmap for the delivery system and benefit design called for by
policy makers to achieve health equity and meet the Quadruple Aim in dentistry: better population health,
better care experience, lower cost per capita, and an engaged workforce.

## Key facts

- **NIH application ID:** 10534175
- **Project number:** 5R01MD013719-05
- **Recipient organization:** UNIVERSITY OF CALIFORNIA, SAN FRANCISCO
- **Principal Investigator:** Elizabeth Mertz
- **Activity code:** R01 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2023
- **Award amount:** $643,456
- **Award type:** 5
- **Project period:** 2019-03-01 → 2024-11-30

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10534175

## Citation

> US National Institutes of Health, RePORTER application 10534175, Reducing Oral Health Disparities in Children: Assessing the Multilevel Impact of a Standardized Preventive Dental Care System (5R01MD013719-05). Retrieved via AI Analytics 2026-05-23 from https://api.ai-analytics.org/grant/nih/10534175. Licensed CC0.

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