Problems With Access to Dental Care for Medicaid-Insured Children: What Caregivers Think

Mofidi, Mahyar; Rozier, R. Gary; King, Rebecca

doi:10.2105/ajph.92.1.53

Cited by 177 publications

(163 citation statements)

References 13 publications

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“…Lack of transportation and limited appointment availabilities were reported by caregivers as 2 reasons they felt discouraged from seeking dental care for their children covered by Medicaid. 19 In addition, it has been reported that dental patients feel more comfortable with a provider of their own race. 19 This could have influenced minority utilization in our study, because Ͻ10% of the practicing dentists in NC represent minorities, 20 whereas ϳ38% of NC residents Յ5 years of age are of minority populations.…”

Section: Disparities In Dental Usementioning

confidence: 99%

Early Preventive Dental Visits: Effects on Subsequent Utilization and Costs

Savage¹,

Lee²,

et al. 2004

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ABSTRACT. Objective. To determine the effects of early preventive dental visits on subsequent utilization and costs of dental services among preschool-aged children.Design. This investigation studied North Carolina children who were enrolled continuously in Medicaid from birth for a 5-year period. Our research design was a longitudinal cohort study that relied on 4 large administrative datasets, including North Carolina composite birth records from 1992, Medicaid enrollment and claims files from 1992 to 1997, and the Area Resource File. Our outcome measures included type of use and dentally related costs.Results. Of the 53 591 Medicaid-enrolled children born in 1992, 9204 were continuously enrolled for 5 years and met our inclusion criteria. Twenty-three children had their first preventive dental visit before 1 year of age, 249 between 1 and 2 years, 465 between 2 and 3 years, 915 between 3 and 4 years, and 823 between 4 and 5 years. Children who had their first preventive dental visit by age 1 were more likely to have subsequent preventive visits but were not more likely to have subsequent restorative or emergency visits. Those who had their first preventive visit at age 2 or 3 were more likely to have subsequent preventive, restorative, and emergency visits. The age at the first preventive dental visit had a significant positive effect on dentally related expenditures, with the average dentally related costs being less for children who received earlier preventive care. The average dentally related costs per child according to age at the first preventive visit were as follows: before age 1, $262; age 1 to 2, $339; age 2 to 3, $449; age 3 to 4, $492; age 4 to 5, $546.Conclusions. Our results should be interpreted cautiously, because of the potential for selection bias; however, we concluded that preschool-aged, Medicaid-enrolled children who had an early preventive dental visit were more likely to use subsequent preventive services and experience lower dentally related costs. In addition, children from racial minority groups had significantly more difficulty in finding access to dental care, as did those in counties with fewer dentists per population. Pediatrics 2004;114:e418-e423. URL: www.pediatrics.org/ cgi/doi/10.1542/peds.2003-0469-F; early childhood caries, preventive dental visit, cost, first dental visit, Medicaid dental use.ABBREVIATIONS. ECC, early childhood caries; NC, North Carolina; DPCR, number of dentists per 10 000 population according to county of residence. E arly childhood caries (ECC) is defined as dental decay among children Յ5 years of age. 1 It is estimated that 2% of infants 12 to 23 months of age in the United States have at least 1 tooth with questionable decay, whereas 19% of children 24 to 60 months of age meet the criteria for ECC. 2 ECC is much more prevalent among children from low-income families; for example, among children 3 to 5 years of age in Head Start, the prevalence of ECC has been reported to be as high as 90%. 3,4 Untreated caries is concentrated disproportionately among...

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Section: Disparities In Dental Usementioning

confidence: 99%

Early Preventive Dental Visits: Effects on Subsequent Utilization and Costs

Savage¹,

Lee²,

et al. 2004

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“…However, the one woman who was adamant about how poorly she was treated by a Latina receptionist is a reminder that a health literate health organization is one that makes it easier for people to navigate and use information and services rather than creates barriers [16]. Perception of discrimination by parents whose child is covered by Medicaid is not unique to this study as others have documented similar problems [17,18]. These findings reinforce the importance of cultural competency training, communication skills and the need for health facilities to be 'user friendly. '…”

Section: Discussionmentioning

confidence: 84%

Perceptions and Practices of Dental Caries Prevention by Maryland Latinas: A Qualitative Study

Am¹,

Mt²,

H³

et al. 2016

Journal of Dentistry and Oral Care Medicine

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“…SCI patients are eligible for Medicaid, but it is difficult to find a dentist willing to take this form of payment. Moreover, patients perceive care as sub-standard when Medicaid is the source of payment [3] and only 50% of dentists report adequate financial compensation when Medicaid is the source of payment in treatment of the disabled population [36].…”

Section: Discussionmentioning

confidence: 99%

“…Among the services most difficult to access are dental services [2]. Obstacles that may limit maintenance of proper oral health include a lack of accessibility to the dental office [3], dental environment [3], lack of special needs dental professionals [4], poor quality of life, fear [5], lack of perceived need [6,7], and lack of financial assistance [8]. Dental offices are required to provide accessibility to the physically challenged and must follow the guidelines provided by the Americans with Disabilities Act (ADA) [9,10].…”

Section: Introductionmentioning

confidence: 99%