Tooth decay is the most common chronic disease affecting U.S. children. One-third of U.S. children ages 2-5 have tooth decay. Poor children in this age group are four times more likely to experience severe tooth decay. Contributing to this problem are dentist shortages in many states and few dentists who accept Medicaid. But a new study in the December issue of Health Affairs shows how a novel program in North Carolina that incorporated preventive dental care into routine physician visits for Medicaid-enrolled children significantly increased children's access to dental care.
In 2000, with only 16% of dentists accepting Medicaid, North Carolina began to reimburse physicians for up to six preventive oral health care visits to Medicaid-enrolled children under age 3. R. Gary Rozier of the University of North Carolina and colleagues found that by 2006, approximately 30% of well-child visits for children ages 6 months up to 3 years included preventive dental services. They also found:
- By 2006, the rate of oral health visits in medical offices greatly exceeded the rate of dentist visits and was almost four times the rate of dentist visits with fluoride.
- Participation by medical providers was greatest in rural areas where shortages of dentists are most severe.
- Recent reports show that the upward trend in oral health services provided in medical offices continued through 2009.
As other states search for ways to solve dental shortages, these findings show how dental care coordinated with early medical care can improve access to care for at-risk children.
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