# Evaluation of Geographic Variation in Pediatric Preventive Dental Services

> **NIH NIH R03** · UNIVERSITY OF IOWA · 2020 · $154,500

## Abstract

PROJECT SUMMARY/ABSTRACT
Over half of low income children in the U.S. have experienced tooth decay, one-third of whom have untreated
decay. Tooth decay in children is largely preventable with routine dental care that includes professionally applied
topical fluoride and dental sealants. However, low income children who are at the greatest risk of developing
tooth decay are the least likely to receive these services – even if they do see a dentist for routine care. A large
body of previous research has examined barriers to dental care and factors associated with preventive dental
utilization from the patient perspective; limited research has focused on how dentist treatment patterns contribute
to disparities. In this study, we will evaluate how regional patterns in clinical dental practice affect dentists' rates
of providing preventive dental services to children who are at elevated risk for tooth decay. The outcome of
interest is the proportion of children treated by each dentist who received preventive dental services, including
rates of topical fluoride and dental sealant placement. Dentists' service patterns will be explored in the context
of dental service areas – regional markets identified based on where patients travel to receive care. Variation in
rates of preventive dental services will be examined at the individual dentist level, and variation within and among
service areas will be estimated. The project aims are to: (1) assess provider-level variation in the provision of
preventive dental services, (2) evaluate clinical practice variation within and across geographical regions, and
(3) identify factors associated with increased preventive dental service rates. Our long-term goal is to explore
the mechanisms by which local clinical treatment patterns develop in order to identify modifiable factors that can
be leveraged by educational interventions to increase use of science-based information by dentists. The long-
term impact of these interventions would be to increase use of preventive dental services and reduce oral health
disparities in high risk populations. This proposed project addresses NIDCR's 2014-2019 Strategic Plan goal to
overcome disparities in dental, oral, and craniofacial health. It also addresses Healthy People 2020 Oral Health
Objectives 8, 12, and 14, which aim to increase the proportion of children and adolescents who receive
preventive dental services. Dentists' propensity to provide evidence-based preventive dental services is
potentially modifiable; findings from this study will support design of tailored educational interventions and policy.
Targeting behavior change at the provider level could offer a cost-effective method to reduce oral health
disparities in children by shifting treatment patterns towards prevention.

## Key facts

- **NIH application ID:** 9964768
- **Project number:** 5R03DE028963-02
- **Recipient organization:** UNIVERSITY OF IOWA
- **Principal Investigator:** Susan C McKernan
- **Activity code:** R03 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2020
- **Award amount:** $154,500
- **Award type:** 5
- **Project period:** 2019-07-01 → 2021-06-30

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/9964768

## Citation

> US National Institutes of Health, RePORTER application 9964768, Evaluation of Geographic Variation in Pediatric Preventive Dental Services (5R03DE028963-02). Retrieved via AI Analytics 2026-05-24 from https://api.ai-analytics.org/grant/nih/9964768. Licensed CC0.

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