Assessment of Dentist Participation in Public Insurance Programs for Children in the US

Serban, Nicoleta; Anderson, Annalea; Oberst, Grace; Edupuganti, Neel; Ramachandran, Rohit; Solipuram, Shalini R; Lu, Tina

doi:10.1001/jamanetworkopen.2022.21444

Cited by 11 publications

(9 citation statements)

References 13 publications

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“…Table 1 documents regional disparities in access to or utilization of dental care that warrant further investigation. Recent literature has noted Alaska has a discrepancy among the statewide percentage of dentists participating in public insurance and the percentage participating at the borough level (Alaska's county‐level equivalent), suggesting some boroughs have a low percentage of dentists accepting or seeing Medicaid patients [33]. It is not known if this also applies to pediatric dentists or whether this influences the disparities in access or utilization of care that were noted here in Alaska's interior regions of the FNSB and the Other Interior Region.…”

Section: Discussionmentioning

confidence: 99%

Exploring factors associated with parent‐reported early childhood caries with Alaska's childhood understanding behaviors survey data

Grage,

Wise,

Meyer

2023

J Public Health Dent

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ObjectivesEarly Childhood Caries (ECC) can negatively impact the lives of young children, despite being preventable. The purpose of this study was to utilize available data in Alaska to describe changes in parent reports of ECC, and identify factors related to ECC.MethodsThe Childhood Understanding Behaviors Survey (CUBS) is a population‐based survey of parents of 3‐year‐old children and was utilized to describe changes in: parent‐reported ECC among children with a dental visit, access to and or utilization of dental care, and consumption of three or more cups of sweetened beverages between 2009–2011 and 2016–2019. Logistic regression modeling was used to explore factors associated with parent‐reported ECC among children with a dental visit.ResultsOver time, a significantly smaller proportions of parents whose 3‐year‐old child had seen a dental professional reported ECC. Additionally, a smaller proportion of parents reported three or more cups of sweetened beverage consumption by their child, while larger proportions had seen a dental professional by age 3. Factors associated with parent‐reported ECC included consumption of three or more cups of sweetened beverages, and enrollment in Medicaid or Tribal health care insurance, while protective factors included a parent earning a college degree, and military insurance.ConclusionsAlthough at the statewide level, improvements were observed in parent‐reported measures over time, regional disparities were apparent. Social and economic factors as well as excessive consumption of sweetened beverages appear to play important roles in ECC. CUBS data can help identify trends in ECC within Alaska.

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Section: Discussionmentioning

confidence: 99%

Exploring factors associated with parent‐reported early childhood caries with Alaska's childhood understanding behaviors survey data

Grage,

Wise,

Meyer

2023

J Public Health Dent

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“…6,7,10,22,23 A recent study reported that in California 5% of dentists in suburban areas and 3% in rural areas participated in Medicaid program. 24 Only 11% of pediatric dentists in California participated in state's Medicaid program, which is one of the lowest in the USA. 24 This further exacerbates the access to oral health care for children on government insurance.…”

Section: Discussionmentioning

confidence: 99%

Oral hygiene practice and home‐care challenges in children with autism spectrum disorder in San Francisco: Cross‐sectional study

Nagda,

Le,

Lin

et al. 2023

Special Care in Dentistry

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IntroductionAutism spectrum disorder (ASD) is characterized by challenges in social interaction, communication, and stereotypical patterns of behavior. They are more likely to have tooth brushing issues and need help with routine dental care. Children with ASD could face difficulty in accessing dental care as the parents have a challenging task in finding a dentist that would treat the child with special needs. As a result, dental care is often neglected. The aims of this study are to evaluate oral hygiene practices and challenges in children with ASD and compare it with typically developing peers (TDP).MethodThe sample size of the study was 60. Parents of children aged 3–10 were recruited and divided in 2 groups with 30 in each group. Age and gender of children were matched. ASD group included children with medical diagnosis of ASD only and no other co‐morbidities. Children in TDP group had no diagnosis of ASD, and reported no disability, or any other diagnosis. Parents were asked to complete the questionnaire which asked about their demographic information, child's oral care regimens, and their knowledge about dental care. Chi‐squared tests and t‐test were used for statistical analysis. A p‐value of .05 was used for determining statistical significance.ResultsMany children with ASD (47%) had to travel more than 20 miles for their dental home compared to 13% with TDP (p < .05). Only 60% of children with ASD brushed twice a day with 70% of parents reporting that it is difficult to brush their child's teeth compared to TDP with 93% of children brush twice daily (p < .05). Significantly a smaller number of children with ASD (47%) allowed their parent to brush their teeth as compared to 93% of TSD children (p < .001).ConclusionParents of children with autism spectrum disorder travel longer distance to find a dental home and face more difficulty in maintaining their child's daily oral hygiene.

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“…18 Moreover, not all dentists accept insurance, and fewer yet accept patients enrolled in Medicaid. [19][20][21] Public policies improving the affordability and availability of dental care remain warranted. Addressing the volatility of Medicaid dental systems is most urgent for low-income adults, who bear the greatest burden of oral cancer amidst a widening gap in dental service utilization trends among poor and nonpoor adults.…”

Section: Introductionmentioning

confidence: 99%

“…Sixty million adults live in counties designated as dental professional shortage areas; requiring an influx of over ten thousand new dental practitioners to address the unmet need 18 . Moreover, not all dentists accept insurance, and fewer yet accept patients enrolled in Medicaid 19–21 . Public policies improving the affordability and availability of dental care remain warranted.…”

Section: Introductionmentioning

confidence: 99%

Eliminating Medicaid dental benefits and early‐stage oral cancer diagnoses

Semprini,

Reynolds,

Zahnd

et al. 2024

Cancer Medicine

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BackgroundDespite the importance of regular dental visits for detecting oral cancer, millions of low‐income adults lack access to dental services. In July 2009, California eliminated adult Medicaid dental benefits. We tested if this impacted oral cancer detection for Medicaid enrollees.MethodsWe analyzed Surveillance, Epidemiology, and End Results‐Medicaid data, which contains verified Medicaid enrollment status, to estimate a difference‐in‐differences model. Our design compares the change in early‐stage (Stages 0–II) diagnoses before and after dropping dental benefits in California with the change in early‐stage diagnoses among eight states that did not change Medicaid dental benefits. Patients were grouped by oropharyngeal cancer (OPC) and non‐OPC (oral cavity cancer), type, and the length of Medicaid enrollment. We also assessed if the effect of dropping dental benefits varied by the number of dentists per capita.ResultsDropping Medicaid dental benefits was associated with a 6.5%‐point decline in early‐stage diagnoses of non‐OPC (95% CI = −14.5, −3.2, p = 0.008). This represented a 20% relative reduction from baseline rates. The effect was highest among beneficiaries with 3 months of continuous Medicaid enrollment prior to diagnosis who resided in counties with more dentists per capita. Specifically, dropping dental coverage was associated with a 1.25%‐point decline in the probability of early‐stage non‐OPC diagnoses for every additional dentist per 5000 population (p = 0.006).ConclusionsEliminating Medicaid dental benefits negatively impacted early detection of cancers of the oral cavity. Continued volatility of Medicaid dental coverage and provider shortages may be further delaying oral cancer diagnoses. Alternative approaches are needed to prevent advanced stage OPC.

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Assessment of Dentist Participation in Public Insurance Programs for Children in the US

Cited by 11 publications

References 13 publications

Exploring factors associated with parent‐reported early childhood caries with Alaska's childhood understanding behaviors survey data

Exploring factors associated with parent‐reported early childhood caries with Alaska's childhood understanding behaviors survey data

Oral hygiene practice and home‐care challenges in children with autism spectrum disorder in San Francisco: Cross‐sectional study

Eliminating Medicaid dental benefits and early‐stage oral cancer diagnoses

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