Assessing Pediatric Endodontic Referrals to University-Based Clinics: A Retrospective Chart Review.

Area of Science:

• Pediatric Dentistry
• Dental Public Health
• Endodontics

Background:

• Timely dental care is vital for children, but Medicaid-enrolled children face barriers like inefficient referrals and low reimbursement.
• Inappropriate referrals for pediatric root canal therapy (RCT) can lead to delayed or unnecessary treatments, impacting access and efficiency.
• This study investigates the appropriateness of RCT referrals to an Advanced Education in General Dentistry (AEGD) program for pediatric patients.

Purpose of the Study:

• To assess the appropriateness of RCT referrals for pediatric patients in Nevada.
• To examine diagnostic and treatment characteristics of referred cases.
• To identify factors influencing referral appropriateness and treatment outcomes.

Main Methods:

• Retrospective review of 154 pediatric patients (aged 6-17) referred for endodontic evaluation between February and August 2024.
• Analysis of demographic, tooth-type, pulp-status, and treatment outcome data.
• Statistical methods included descriptive statistics, chi-square tests, Kruskal-Wallis, and multivariable logistic regression.

Main Results:

• 96.8% of referred patients were Medicaid beneficiaries.
• Only 37.2% of 247 evaluated teeth required RCT; 41.3% had healthy pulps.
• Older age predicted appropriate referral (adjusted OR = 1.18); 53.4% of teeth completed treatment, 9.3% had no follow-up.

Conclusions:

• A high rate of referrals for pediatric RCT were potentially avoidable, indicating diagnostic gaps at the primary care level.
• Enhancing diagnostic training and decision support for general dentists is recommended.
• Improving Medicaid reimbursement and standardizing referral protocols can enhance system efficiency and access to pediatric dental care.