11 - Physician and Dentist Caries Charting Concordance: A Retrospective Chart Review

Abstract:

Purpose: Early childhood caries is the most prevalent chronic disease affecting children in the United States. The American Academy of Pediatrics recommends pediatricians perform oral health risk assessments at every well-child visit beginning at age 6 months. The aim of this study is to evaluate the concordance between pediatrician and dentist documentation of dental caries in children aged 0-18 years.

Methods: This study is a retrospective chart review conducted at Boston Medical Center including patients aged 0-18 years who had both a dental examination at the BMC Shapiro Pediatric Dental Clinic between May 9, 2023 and May 21, 2025, and a comprehensive physical examination at BMC Pediatrics within one year prior. Data were obtained through manual chart review and included demographic information, DMFT values, documentation of caries in physician notes, and potential modifying factors.

Results: A total of 226 eligible subjects were included. Among these patients, 29% (n=66) had dental caries diagnosed by a dentist. Only 2% (n=5) of pediatrician charts documented checking for dental caries. Of the five pediatrician examinations that mentioned dental assessment, three accurately detected caries, therefore the overall sensitivity of caries detection was 4.5%. One accurately identified absence of caries, and one was a false negative. Overall concordance was limited by low documentation rates.

Conclusion: The vast majority of pediatricians did not document dental caries screen despite AAP recommendations. These findings highlight the need for enhanced oral health training and improved integration of dental screening into routine pediatric care.

Identify Supporting Agency and Grant Number: Research supported by the resources of Boston Medical Center.