Something to smile about

Something to smile about

New Medicaid policy increases the rate of children receiving vital oral health care 

By Elizabeth Hillaker Downs

Oral Health_MCM_7843One-fourth of children living in poverty experience untreated tooth decay, which can lead to pain, difficulty eating, serious infections, missed school days, emergency room visits, hospitalizations and, in rare instances, death.

Florida ranks 50th in the nation in dental care rates among children enrolled in Medicaid, but a new study shows that a policy change may help change this. 

A Medicaid policy change in Florida that reimburses pediatricians and other medical primary care providers for basic oral health screenings and cavity prevention has increased the likelihood of children receiving these essential services by 20 percent.

Only 31 percent of publicly insured children under age 5 receive dental services. Even though comprehensive dental benefits are required in Medicaid, it is much more likely that preschool-aged children enrolled in Medicaid will receive medical care than dental care. Therefore, 46 state Medicaid programs have enacted policies to reimburse medical primary care providers for administering early childhood tooth decay preventive services since 2000. These services may include topical fluoride application, parental counseling, mouth exams and an overall assessment for risk of tooth decay. The policy in Florida, which covers children ages 6 months to 42 months, was implemented in 2008 and reimburses providers $27 for these services.

“Given the high stakes for untreated tooth decay on children’s overall health and well-being, especially among vulnerable and low-income children, it is important to identify effective policies to tackle this prevalent problem,” said Jill Boylston Herndon, Ph.D., an associate professor in the department of health outcomes and policy in the University of Florida’s College of Medicine and the lead researcher on this project, which was funded by the National Institutes of Health. “Particularly among very young children, medical primary care providers serve as the gateway to the health care system and can play an important role in preventing tooth decay and facilitating the establishment of a dental home.”

This analysis, which was published in the journal Health Services Research in July, has far-reaching public health implications given that Medicaid covers more than one-third of all children in the U.S.