Briefly describe a specific question, or set of related questions, about a health care test or treatment that this program should consider.

Does diagnosis, prevention, and treatment of dental caries in children/adolescents affect physical health including septicemia, bone infections, pain, headaches, nutritional diseases, and respiratory disease. Does prevention of dental caries in children/adolescents reduce emergency room use for pain and infection?

Does your question include a comparison of different health care approaches? (If no, your topic will still be considered.)

yes

If yes, explain the specific technologies, devices, drugs, or interventions you would like to see compared:

Dental services and physical health care outcomes

What patients or group(s) of patients does your question apply to? (Please include specific details such as age range, gender, coexisting diagnoses, and indications for therapy.)

Children and adolescents

Are there subgroups of patients that your question might apply to? (For example, an ethnic group, stage or severity of a disease.)

All patients

Describe the health-related benefits you are interested in. (For example, improvements in patient symptoms or problems from treatment or diagnosis.)

General overall health, including fewer infections and pain from caries. In addition, better school attendence and achievement as a result of better oral health/fewer dental caries.

Describe any health-related risks, side effects, or harms that you are concerned about.

Infections, death, pain, poor quality of life, poor school attendance and learning.

Appropriateness for EHC Program

Does your question include a health care drug, intervention, device, or technology available (or likely to be available) in the U.S.?

yes

Which priority area(s) and population(s) does this topic apply to? (check all that apply)

EHC Priority Conditions (updated in 2008)

None

AHRQ Priority Populations

None

Federal Health Care Program

None

Importance

Describe why this topic is important.

Many children and adolescents have limited access to dental care. This is particularly true for low-income children. Limited access to dental care and poor oral health may result in short term physical problems like infections, higher medical costs from using emergency rooms for care, and potentially long term problems like diabetes and cardiovascular disease. Education and learning may also be adversely affected if children or adolescents have untreated dental disease which causes pain, inflammation, or other health problems.

What specifically motivated you to ask this question? (For example, you are developing a clinical guideline, working with a policy with large uncertainty about the appropriate approach, costly intervention, new research you have read, items in the media you may have seen, a clinical practice dilemma you know of, etc.)

My concerns about children and access to dental care especially with the US economy in a recession. In addition, there have been some highly publicized cases of low income children dying because of dental infections such as the case of a child named Deamonte Driver in Maryland. While deaths may not be frequent, many other health consequences may be caused by poor oral health.

Does your question represent uncertainty for clinicians and/or policy-makers? (For example, variations in clinical care, controversy in what constitutes appropriate clinical care, or a policy decision.)

yes

If yes, please explain:

In what ways does oral health affected physical health and learning?

Potential Impact

How will an answer to your research question be used or help inform decisions for you or your group?

What dental services should be covered for children and adolescents.

Describe the timeframe in which an answer to your question is needed.

Describe any health disparities, inequities, or impact on vulnerable populations your question applies to.

Low income children and minorities may be adversely affected by poor access to dental care

Nominator Information

Other Information About You: (optional)

Please choose a description that best describes your role or perspective: (you may select more than one category if appropriate)

What dental services should be covered for children and adolescents.

Are you making a suggestion as an individual or on behalf of an organization?

Individual

Please tell us how you heard about the Effective Health Care Program

None