Dental Care Use Among Children and Adolescents in Medicaid: Associations With State-Level Medicaid Policy Factors and Provider Availability

Abstract

Objectives

The aim of this study was to assess the relative strength of association of four state-level factors—Medicaid reimbursement, Medicaid adult dental benefit (MADB) generosity, dentist Medicaid participation, and dentist supply—on individual-level dental care use among children and adolescents in Medicaid.

Methods

This national cross-sectional study used 2018–2019 National Survey of Children's Health data to estimate dental care utilization among children aged 1–17 enrolled in Medicaid. Subgroup analyses were conducted by child age group. A hierarchical regression approach was used; a series of logistic regression models assessed relative effect sizes among the four state-level variables.

Results

Among children aged 1–17, and the age 1–3 subgroup, dentist Medicaid participation was positively associated with dental care use. Among children aged 4–11, children in states with Emergency/No dental coverage for adults had greater odds of having a dental visit compared to children in states with Extensive dental coverage. Among adolescents aged 12–17, no state-level factors were associated with dental utilization.

Conclusions

There was considerable variation by age group in the associations of state-level factors on dental care use among children and adolescents in Medicaid. Dentist participation in Medicaid was associated with dental care use among very young children. State-level policy levers have the potential to improve access to dental care for children enrolled in Medicaid, and are critical to achieve improvement toward oral health equity for children.