Preventive dental care includes routine prophylactic cleaning and the application of fluoride by a dentist.
The researchers used state Medicaid claims (2005-2010), birth records (2000-2010), and data from the 2010 American Community Survey. Children who were born in Pennsylvania and enrolled in Medicaid for at least 10 months of any calendar year were eligible for the study sample. The final sample comprised 371,381 children.
“We know that dental caries, also known as tooth decay, is the most common chronic pediatric disease in the US,” said Katherine Yun, MD, MHS, the study’s lead author, attending pediatrician and faculty member at PolicyLab. “We also know that it disproportionally affects poor and minority children, and children in immigrant families.”
Coverage for preventive dental care is available for Medicaid-enrolled children through Medicaid’s Early and Periodic Screening, Diagnosis, and Treatment (EPSDT) benefit. However, despite this coverage, wide-scale utilization of preventive dental care has lagged in many states. Increasing utilization of preventive dental care by Medicaid-enrolled children has been a public health priority in Pennsylvania.
“Dental care is an incredibly important part of EPSDT,” explained Yun. “Mouth pain can make it hard for children to pay attention in school, and unhealthy baby teeth increase the chances that children will have unhealthy adult teeth.”
Researchers looked at different groups of children to see if their use of preventive dental care had increased, decreased, or plateaued from 2005 to 2010. The authors also focused on US-born children whose mothers were born outside of the U.S., as prior research has suggested that the children of immigrants have difficulty accessing preventive healthcare. They found that in Pennsylvania disadvantage was not concentrated among the US-born children of immigrants. Latino children in immigrant families were more likely than their peers in non-immigrant families to receive preventive dental care (72% and 61%, respectively, in 2010). White children in immigrant families were more likely to receive preventive dental care than their peers in non-immigrant families (62% and 51%, respectively, in 2010). African American children in immigrant and non-immigrant families had moderate rates of preventive dental utilization and were comparable to each other (e.g. 60% and 59%, respectively, in 2010). Asian children in both immigrant and non-immigrant families showed relatively high rates of preventive dental utilization at each time point and were also comparable to each other (e.g. 69% and 63%, respectively, in 2010).
“We now need to identify the factors responsible for increasing utilization overall and understand why some groups of children have accessed preventive dental care services more than others,” said Yun. “This is just the first step in ensuring that all children have access to preventive dental services.”
For more information about the study on PolicyLab’s website, visit: http://policylab.chop.edu/project/increasing-oral-health-care-services-medicaid-enrolled-children.
To access a blog post on the study written by lead investigator, Dr. Katherine Yun, visit: http://policylab.chop.edu/blog/whos-using-preventive-dental-care-pennsylvania.
About PolicyLab at The Children’s Hospital of PhiladelphiaPolicyLab develops evidence-based solutions for the most challenging health-related issues affecting children. PolicyLab engages in research that is both responsive to community needs and relevant to policy priorities, partnering with practitioners, policymakers, and families throughout the research process. Through its work, PolicyLab identifies the programs, practices, and policies that support the best outcomes for children and their families, disseminating its findings beyond research and academic communities as part of its commitment to transform evidence to action. www.research.chop.edu/PolicyLab
About The Children’s Hospital of PhiladelphiaThe Children’s Hospital of Philadelphia was founded in 1855 as the nation’s first pediatric hospital. Through its long-standing commitment to providing exceptional patient care, training new generations of pediatric healthcare professionals and pioneering major research initiatives, Children’s Hospital has fostered many discoveries that have benefited children worldwide. Its pediatric research program receives the highest amount of National Institutes of Health funding among all U.S. children’s hospitals. In addition, its unique family-centered care and public service programs have brought the 535-bed hospital recognition as a leading advocate for children and adolescents. For more information, visit http://www.chop.edu.
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