87 - Referral Source and Establishment of a Dental Home

Introduction: Referral pathways are essential to pediatric oral health care. Children are referred from multiple sources, yet follow-up and treatment completion are often inconsistent. The Columbia University Pediatric Dental Clinic (CUPDC) receives referrals from multiple internal sources, but the effectiveness of each is not well defined. This study evaluates whether referred children established a dental home and examines differences in outcomes by referral source.

Objectives: To evaluate the proportion of children internally referred to the CUPDC who established a dental home and completed follow-up care, and to assess whether referral source and primary language were associated with dental home establishment, as well as the prevalence of special health care needs and treatment modalities utilized.

Materials &

Methods: This retrospective chart review included pediatric patients referred to CUPDC between January 1, 2022, and August 31, 2025, from: (1) Columbia University Mobile Unit, (2) College of Dental Medicine’s Vanderbilt Clinic, (3) New York-Presbyterian Ambulatory Care Network (ACN), and (4) all other hospital providers. Dental home establishment was operationally defined as at least one completed visit, with six-month recall completion evaluated as a continuity measure. Sociodemographic variables and clinical variables were abstracted from the electronic dental record. Descriptive statistics were calculated, and chi-square tests assessed associations between referral source and dental home establishment, and between primary language and dental home establishment (α=0.05).

Results &

Conclusions: Among 2,538 referred patients (mean age 5.8 years), 765 (30.1%) established a dental home and 477 (18.8% overall; 62.4% of established patients) completed six-month recall. Mean time from referral to first visit was 150 days (median 73; IQR 29–210). Establishment rates differed significantly by referral source (χ²(7)=302.6, p<0.001), ranging from 4.4% (Head Start Mobile Unit referrals) to 68.9% (Vanderbilt Clinic referrals). Time to establishment was similar across referral sources. Establishment did not differ by primary language (χ²(2)=1.38, p=0.50). Among referred patients, special health care needs included neurodevelopmental (241, 9.5%), syndromic (80, 3.2%), cardiac (61, 2.4%), asthma (68, 2.7%), obesity (41, 1.6%), and diabetes (2, 0.1%) conditions. Treatment modalities utilized included general anesthesia (29; 3.8%), oral sedation (56; 7.3%), and nitrous oxide (243; 31.8%).


Discussion: Dental home establishment varied substantially by referral source, with higher conversion among in-system referrals and lower rates among mobile and community programs, suggesting that patients already engaged in clinical care are more likely to complete linkage. Establishment did not differ by primary language, indicating language was not a primary barrier within this system. A notable proportion of referrals were for patients with special health care needs. Referred patients often required sedation or advanced behavior guidance, highlighting the clinic’s role in serving a medically complex population. Strengthening referral coordination, particularly for community-based programs, may improve conversion and continuity of care.