Browsing by Author "Downey, Timothy"

Now showing 1 - 6 of 6
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    Financial Impact of COVID-19 on Dental Care for Pediatric Patients: a Dental Claims Review
    (American Academy of Pediatric Dentistry, 2023-02) Rector, Julia M.; Scully, Allison C.; Yepes, Juan F.; Jones, James E.; Eckert, George; Downey, Timothy; Maupome, Gerardo; Pediatric Dentistry, School of Dentistry
    Purpose: The purpose of this study was to quantify the impact of the COVID-19 pandemic on private dental insurance claims for pediatric dental care. Methods: Commercial dental insurance claims for patients in the United States ages 18 and younger were obtained and analyzed. The claims dates ranged from January 1, 2019, to August 31, 2020. Total claims paid, average paid amount per visit, and the number of visits were compared between provider specialties and patient age groups from 2019 to 2020. Results: Total paid claims and total number of visits per week were significantly lower in 2020 compared to 2019 from mid-March to mid-May (P<0.001). There were generally no differences from mid-May through August (P>0.15), except for significantly lower total paid claims and visits per week for "other" specialists in 2020 (P<0.005). The average paid amount per visit was significantly higher during the COVID shutdown period for 0-5 year-olds (P<0.001) but significantly lower for all other ages. Conclusions: Dental care was greatly reduced during the COVID shutdown period and was slower to recover for "other" specialties. Younger patients ages zero to five years had more expensive dental visits during the shutdown period.
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    Survival analysis of metal crowns versus restorations in primary mandibular molars
    (ADA, 2017-10) Maupomé, Gerardo; Yepes, Juan F.; Galloway, Madison; Tang, Qing; Eckert, George J.; Downey, Timothy; Vinson, LaQuia; Cariology, Operative Dentistry and Dental Public Health, School of Dentistry
    Background The effectiveness of stainless steel crowns (SSCs) versus direct restorations when placed in primary mandibular molars (teeth nos. L and S) is uncertain. The authors evaluated effectiveness by gauging longevity of treatment. Methods The authors obtained private dental insurance claims (2004-2016) from a national dental data warehouse. Paid insurance claims records (n = 1,323,489) included type of treating dentist, treatment placed, and patient age. Results Dentist specialty, type of treatment, and patient age were significant in predicting failure after the first restoration. The authors found high survival rates for all treatments (> 90%) after 5 years; however, as soon as within 3 years after treatment, SCCs had approximately 6% better survival. Conclusions Teeth nos. L and S first treated with SSCs lasted longer without new treatment compared with teeth first treated with direct restorations; the difference was small. Teeth treated by pediatric dentists had better survival rates. Practical Implications Primary mandibular first molars initially treated with SSCs lasted longer without new treatment compared with direct restorations. Overall dental care costs of the former were considerably higher.
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    Trends in dental insurance claims in the United States before and during the SARS-CoV-2 pandemic in 2020
    (Wiley, 2022) Maupome, Gerardo; Scully, Allison C.; Yepes, Juan F.; Eckert, George J.; Downey, Timothy; Global Health, School of Public Health
    Objectives: The SARS-CoV-2 pandemic disrupted health care services. Previous reports estimated reductions in demand and supply of dental care services, but actual changes have not been reported. The present report depicts a perspective of trends in claims from private dental practice in the United States during 2019 and 2020. Methods: Private dental insurance paid claims data from a data warehouse (encompassing 66+ carriers in the United States) were obtained for children and adults (treatments identified by their American Dental Association Code of Dental Procedures and Nomenclature [CDT]), encompassing a 5% random sample of all records between January 2019 and December 2020. A market-based treatment classification placed CDT codes into one of four categories based on the likelihood of being associated with urgent/emergency care. Results: Claims for 3.8 million patients constituted the 5% random sample for analyses. Substantial drops in the provision of treatment items were quantified for a large segment of private dental insurance plans at a national level, showing differential impacts in dental care categories. Conclusions: Week-by-week, detailed descriptions of demand/availability changes in dental care throughout the first year of the 2020 SARS-CoV-2 pandemic were obtained through contrasting perspectives in 2019. Provision of dental care and associated impacts fluctuated over time subject to treatment urgency, but also modified as the weeks/months of dental office lockdowns ebbed in and out of the dental market.
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    Trends in dental insurance claims in the United States in the context of the COVID-19 pandemic: A 3-year perspective (2019–2022)
    (Wiley, 2023) Maupome, Gerardo; Scully, Allison C.; Yepes, Juan F.; Eckert, George J.; Downey, Timothy; Epidemiology, Richard M. Fairbanks School of Public Health
    Objectives We showed in a previous analysis the patterns of disruption for private dental insurance claims in the United States caused by the SARS-CoV-2 pandemic in 2020. The present report examines trends during 2020 and 2021, that is, contrasting perspectives during 2019 with the acute phase of the pandemic in 2020, and 2021. Methods Private dental insurance paid claims from a data warehouse were obtained, encompassing a 5% random sample of records between January 2019 and December 2021 for child and adult insureds who filed a claim in 2019, 2020, and 2021. We classified claims into one of four categories based on the likelihood of being associated with urgent/emergency care. Results The precipitous reduction in dental care claims in March–June 2020 recovered to almost pre-pandemic levels by the fall of 2020. However, a downward decline in private dental insurance claims started in the late fall of 2020 and continued through 2021. Differential impacts in dental care categories—in terms of urgency of care—were evident 2021, closely resembling previous trends in 2020. Conclusions Dental care claims from the first year of the 2020 SARS-CoV-2 pandemic were contrasted with perspectives in 2021. A downward trend in demand/availability changes in dental care insurance claims set in for 2021, perhaps linked to perceptions of the overall economic situation. Such downward trend has continued overall, even after considering seasonal changes and the acceleration of the pandemic during the Delta, Omicron, and other variants.
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    Utilization of Silver Diamine Fluoride by Dentists in the United States: A Dental Claims Review
    (American Academy of Pediatric Dentistry, 2020) Scully, Allison; Yepes, Juan F.; Tang, Qing; Downey, Timothy; Maupome, Gerardo
    Purpose: A Current Dental Terminology (CDT) code, D1354, for silver diamine fluoride was made effective on January 1, 2016. The purpose of this study was to investigate the utilization of silver diamine fluoride (SDF) by pediatric dentists (PDs) and general dentists (GDs) in the United States. Methods: Data were obtained from a commercial dental insurance claims warehouse in the United States. Deidentified data for CDT code D1354 were collected from January 2016 to July 2019. Descriptive statistics and chi-square tests were used. Results: A total of 321,726 D1354 claims were found. Data showed that SDF use measured by average monthly claims, unique number of dentists, and percent of paid claims increased each year. Patients zero to nine years old were the most likely to receive SDF treatment. SDF was significantly more likely to be placed on posterior teeth and in children zero to eight years old (P<0.001). PDs were more likely than GDs to submit claims for SDF in children (P<0.001). Conclusions: Silver diamine fluoride use is increasing, especially in patients age zero to nine years. Pediatric dentists are more likely to use SDF in children than general dentists. Posterior teeth receive the majority of SDF treatment.
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    Utilization of Stainless Steel Crowns by Pediatric and General Dentists
    (American Academy of Pediatric Dentistry, 2019) Shelton, Andrea; Yepes, Juan F.; Vinson, LaQuia A.; Jones, James E.; Tang, Qing; Eckert, George J.; Downey, Timothy; Maupome, Gerardo
    Purpose: Dental caries affects 23% of US children aged two to five 1. Extensive caries in children should be treated with stainless steel crowns (SSC); however, disparity exists between pediatric and general dentists in restoration type provided. The purpose of the study was to evaluate utilization of SSCs by pediatric and general dentists through insurance claims. Methods: Data was obtained from a commercial dental insurance claims data warehouse from more than 50 dental insurance plans and multiple carriers in the U.S. A generalized linear mixed effects model tested differences in the utilization of SSCs by the general dentist versus the pediatric dentist. Results: The data included 107,487 general dentists and 5,395 pediatric dentists. The records included 2,555,726 claims for restorations and 440,423 claims for the SSC. Pediatric dentists are more likely to place SSCs compared to the general dentist. The tooth most often to receive a SSC was a primary second molar. The majority of SSCs were placed in children aged six years old. Conclusions: Pediatric dentists are more likely to restore carious primary dentition with SSCs compared to general dentists. Perhaps increasing training at the dental undergraduate level would increase the utilization of SSCs.