THURSDAY, July 8 (HealthDay News) -- Children in California who
have dental insurance through Medicaid and other public insurance
programs are less likely to visit the dentist regularly than
privately insured kids, a new study has found.
The study, by researchers at the University of California, Los
Angeles and the California HealthCare Foundation (CHCF), revealed
that black and Latino children are especially at risk of having
inadequate dental care.
"We know that disparities in health and oral health care exist, but we often do not know the more subtle ways these disparities persist," said Nadereh Pourat, director of research planning at the UCLA Center for Health Policy Research and co-author of the study, published in the July issue of the journal Health Affairs.
Pourat and Len Finocchio, senior program officer at the CHCF,
examined data from the 2005 California Health Interview Survey to
look at the length of time between dental visits and whether or not
it differed by racial or ethnic group and type of insurance. The
survey contains data on more than 11,300 children from birth
through age 11. In the study group of 10,805 children with teeth,
45 percent were covered by private insurance, roughly 37 percent
were covered by Medicaid or the Children's Health Insurance Program
(CHIP), and 18 percent were uninsured.
National health initiatives call for at least one dental visit
yearly for all children, and Medicaid, CHIP and private insurers
cover semi-annual visits for kids. And the survey showed that 53
percent of the kids had seen a dentist within the past six
But the researchers found that 24 percent of the kids had never
seen a dentist. In addition, children with public insurance were
more likely than privately insured kids to have had longer
intervals between visits. And Latino and black children were more
likely than white children to have never gone to a dentist or had
visits longer than six months apart. Even among children covered by
Medicaid, Latino and black children were significantly less likely
than white children to have had a dental visit in the past six
One of the main reasons for the disparity in care between
publicly and privately insured kids may be because not enough
dentists accept Medicaid, said Pourat, who is also associate
professor of health services at the UCLA School of Public Health.
"Unlike the medical field, where many providers such as community
clinics are available to see Medicaid patients, the dental care
field is dominated by privately practicing dentists," she said.
The small number of participating dentists contributes to racial
and ethnic disparities in care, the authors said, as do the
disproportionately few Latino and black dentists in California.
Pourat said another contributing factor may be that parents
don't always recognize the importance of early, regular dental
visits, "or may find it difficult to take time off work to seek
dental care that may not seem urgent."
The authors say more strategic efforts are needed to reduce
disparities in access to dental care among publicly insured
children, including boosting Medicaid reimbursement for dental
care, expanding training for pediatric care among general dentists,
and training dental students in the community.
Dentist Gary Rozier, a professor of health policy and management
at the University of North Carolina's Gillings School of Global
Public Health, and director of the school's Dental Public Health
Program, said the findings also reinforce the benefit of training
pediatricians to screen and treat very young children at risk for
"Currently, about 37 states are reimbursing physicians to provide preventive dental services, including application of fluoride varnish, which has shown to be effective in reducing the incidence of dental caries," said Rozier. "In North Carolina, which was one of the first states to try this approach, we have found that it increases access to preventive dental care in the medical office, where infants and toddlers are much more likely to seek care than in dentist offices, and reduces the need for dental treatment."
The U.S. Office of Disease Prevention and Health Promotion has
taking care of your child's teeth.