Oral Health Care Needs of Young Adults Transitioning from Foster Care

Abstract

Children who have aged out of the foster care system face considerable barriers in accessing oral health care. Although this population of foster care alumni may have Medicaid insurance while they are in care to cover dental care, 39 percent of youths who have aged out of foster care do not have dental insurance. This mixed methods study examines factors that contribute to the oral health care disparities of children who have transitioned from foster care. Multivariate analysis revealed that foster care alumni without dental insurance are 93.5 percent less likely to have their dental needs met than those with dental insurance. Themes from the qualitative data indicated a lack of oral health care, quality-of-life issues, and lack of support to access ongoing dental care. Most state Medicaid programs do not provide comprehensive dental care for adults past the age of 20, contributing to oral health disparities among this population. The addition of oral health care coverage under the Patient Protection and Affordable Health Care Act of 2010 for foster care alumni would greatly enhance their quality of life. The article concludes with a discussion of the implications for the role of social workers in promoting oral health care for foster care youths.

Access to Dental Care for Children and Young People in Care and Care Leavers: A Global Scoping Review

“…Four studies from Malta, the UK and Australia included carers [3,49,52,59], two from the US and UK included social workers [3,6] and two from the UK included dental health professionals [3,53]. Fourteen studies used data relating to CYP in care, and two studies from the UK and Sweden included data from care leavers [17,57].…”

“…Children in foster care are often dependent on social workers to protect their health and well-being [6,17]. In the UK, the local authority has responsibility for meeting the needs of the CYP in their care, including dental care, usually via a named social worker.…”

“…Carrellas [17] emphasises that social workers should ensure that the CYP in their care are accessing preventative oral health care and dental treatment and that social workers should promote increased access to and utilisation of these services by CYP in care. Negro et al [6] evaluated the feasibility of social worker-delivered oral health interventions for preschoolers in foster care.…”

“…After entering care, they continue to experience poorer oral health than their peers, including dental decay [11,12], periodontal disease [13,14] and dental trauma [15,16]. Upon leaving care, they have less access to dental care [17].…”

“…Both children in care and care leavers experience greater difficulty in accessing dental services [3,[25][26][27][28][29][30] and are less likely to access dental services compared to other children in the general population [31][32][33][34]. After leaving care, CYP continue to have compromised access to dental care [17,35]. Research from the Global South also suggests that children and young people in care are disadvantaged in accessing oral health care and receiving treatment [15,[36][37][38][39].…”