Published online June 29, 2009
PEDIATRICS Vol. 124 No. 1 July 2009, pp. e120-e127 (doi:10.1542/peds.2008-3089)
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ARTICLE

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

Charlotte Lewis, MD, MPHa,b, Elizabeth Teeple, MSc, Andrea Robertson, MPHa and Alexis Williams, BSa

a Child Health Institute
b Division of General Pediatrics, Department of Pediatrics
c Department of Biostatistics, School of Public Health, University of Washington, Seattle, Washington

BACKGROUND: 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.

OBJECTIVES: 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.

METHODS: We extracted 2003 Washington Medicaid dental claims for continuously enrolled children ≤6 years of age. Multivariable analysis was performed to identify variables independently associated with ≥1 preventive dental visit (PDV) in 2003. For national comparison, we used the 2003 Medical Expenditure Panel Survey (MEPS).

RESULTS: Among Medicaid-insured children ≤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]).

CONCLUSIONS: We confirmed our hypothesis that residing in an ABCD county was associated with a higher likelihood of having ≥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.

Key Words: oral health • access to dental care • Medicaid

Abbreviations: ABCD—Access to Baby and Childhood Dentistry • PDC—preventive dental care • PDV—preventive dental visit • MEPS—Medical Expenditure Panel Survey • GEE—generalized estimating equation • CDT—current dental terminology • MSA—metropolitan statistical area • CI—confidence interval

Accepted Mar 6, 2009.


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