Preventive Dental Care for Young, Medicaid-Insured Children in Washington State

Division of General Pediatrics, Department of Pediatrics, Child Health Institute, School of Public Health, University of Washington, Seattle, Washington 98195, USA.
PEDIATRICS (Impact Factor: 5.47). 08/2009; 124(1):e120-7. DOI: 10.1542/peds.2008-3089
Source: PubMed


Children from low-income families face barriers to preventive dental care (PDC) and are disproportionately affected by dental caries. The Access to the Baby and Childhood Dentistry (ABCD) program of Washington State is targeted to Medicaid-insured children <6 years of age to improve their access to PDC.
To test the hypothesis that residing in an ABCD county improves the likelihood of receiving PDC and, to compare PDC use among young, Medicaid-insured children in Washington to national statistics.
We extracted 2003 Washington Medicaid dental claims for continuously enrolled children <or=6 years of age. Multivariable analysis was performed to identify variables independently associated with >or=1 preventive dental visit (PDV) in 2003. For national comparison, we used the 2003 Medical Expenditure Panel Survey (MEPS).
Among Medicaid-insured children <or=6 yrs of age from WA counties with ABCD program, 45% had at least 1 PDV compared with 36% from non-ABCD counties (P < .001) and 37% of US children with continuous private insurance (P < .001). There were significantly higher adjusted odds of a PDV for children from ABCD counties relative to non-ABCD counties (odds ratio: 1.30 [95% confidence interval: 1.05-1.60]).
We confirmed our hypothesis that residing in an ABCD county was associated with a higher likelihood of having >or=1 PDV in 2003. We also found that significantly more children in established ABCD counties received PDC compared with privately insured US children. These findings provide additional evidence that the ABCD program reduces disparities in dental care access among young, Medicaid-insured children in Washington and point to the importance of expanding the ABCD program to other states.

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    • "Pediatricians and general physicians are major players in referring Medicaid-eligible children to dentists for PDC. It has been suggested that it is difficult for pediatricians to comply with EPSDT if each and every single community does not have enough dentists who accept Medicaid beneficiaries [34]. "
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    International Journal of Dentistry 03/2012; 2012:348237. DOI:10.1155/2012/348237
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    American Journal of Public Health 11/2010; 100(11):2262-9. DOI:10.2105/AJPH.2009.184747 · 4.55 Impact Factor
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    ABSTRACT: Using qualitative methods, the purpose of this study was to understand low-income parents' experiences and how these influenced their oral health-related behavior toward their children. Twenty-eight parents were recruited from 7 sites that serve low-income families. Interviews, which were audiotaped and transcribed, were comprised of mostly open-ended questions. Transcripts were analyzed for common themes. Parents' experiences influenced their oral health-related beliefs, intentions, and behaviors. Finding dentists who accept Medicaid was the greatest barrier to realizing intended preventive dental care. Physicians appeared to have relatively little impact on these families' oral health care, even though parents believed that oral health is part of overall health care. WIC (the Supplemental Nutrition Program for Women, Infants and Children) played an important role in facilitating oral health knowledge and access to dental care. Most low-income parents had received little attention to their own oral health, yet wanted better for their children. This motivated the high value placed on their children's preventive oral health. Parents faced challenges finding dental care for their children. Difficulty finding a regular source of dental care for low-income adults, however, was nearly universal. The authors identified strategies, which emerged from their interviews, to improve the oral health knowledge and dental care access for these low-income families.
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