A study conducted by PolicyLab researchers shows the proportion of US-born, Medicaid-enrolled children in Pennsylvania who utilized preventive dental care rose significantly for children ages 5-10 years from 2005-2010, with marked gains among Latino children. The study, published recently in the American Journal of Public Health, found that while overall preventive dental care utilization increased from 2005 to 2010, utilization remained less than 60 percent overall. Latino children in non-immigrant families demonstrated the largest gains over time, with 63 percent of children ages 5-10 years receiving preventive dental care in 2010 compared to 35 percent in 2005.
“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 and an attending pediatrician and faculty member at PolicyLab. “We also know that it disproportionally affects poor and minority children, and children in immigrant families.”
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.
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 Dr. 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.”
The study team 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 percent, 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 percent, 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 percent, 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 percent, 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 Dr. Yun. “This is just the first step in ensuring that all children have access to preventive dental services.”
For more information about the study, see PolicyLab’s website. And to access a blog post on the study written by Dr. Yun, visit: http://policylab.chop.edu/blog/whos-using-preventive-dental-care-pennsylvania.