Dental Care Utilization Among Medicaid-Enrolled Adults With Substance Use Disorder

Abstract

Introduction

Low-income Medicaid-enrolled adults are likely to have poor oral health and experience substance use disorders. Despite emerging evidence that comprehensive dental care can improve substance use disorder outcomes, there is a lack of evidence about the overlap of substance use disorder and dental care utilization. This study aims to fill that gap.

Methods

This cross-sectional study used 2019 data from the Transformed Medicaid Statistical Information System Analytic Files and included over 30 million nondually eligible Medicaid-enrolled adults aged 21–64 years. Clustered-robust SE logistic regression models were used to predict the odds of receiving early-stage dental care. Analyses were performed in 2024.

Results

Nationally, 56.45 per 1,000 Medicaid-enrolled adults were diagnosed with substance use disorders. There was significant variation in substance use disorder prevalence across states, ranging from 27.11 to 103.45 per 1,000 adults. On average, 173.78 adults per 1,000 accessed dental care, although access varied significantly across states, ranging from 1.69 to 347.27 per 1,000. Adults living in states with extensive Medicaid dental coverage had the highest rates of dental care utilization: 270.38 per 1,000 adults with substance use disorders and 215.39 per 1,000 adults without substance use disorders. The odds of receiving early-stage dental care were 42% lower for Medicaid-enrolled adults with substance use disorders than for those without substance use disorders.

Conclusions

This study found considerable variation in the prevalence of substance use disorders and dental care utilization across states. Further research is needed to uncover the factors driving these variations and inform policy and clinical interventions to improve dental care access for Medicaid-enrolled adults, especially those with substance use disorders.