Medicaid Dental Coverage and Preventive Dental Care Use Among Pregnant Adults.

Abstract

Objectives: The aim of this study was to examine the relationship between Medicaid dental coverage for pregnant adults and receipt of a dental cleaning during pregnancy among adults with Medicaid.

Methods: In this cross-sectional study, 2019 Pregnancy Risk Assessment Monitoring System data were used to measure individuals' receipt of a dental cleaning during pregnancy and in the year prior to pregnancy. The independent variable was the state-level degree of Medicaid dental coverage for pregnant adults as of 2019, ranging from none to extensive. Weighted logistic regression models estimated the odds of having a dental cleaning during pregnancy, both for the full sample and stratified by whether or not a cleaning was received pre-pregnancy.

Results: Approximately one-third (31%) of respondents reported receiving a dental cleaning during pregnancy. In multivariable results, pregnant adults living in states with emergency (OR 0.58, 95% CI 0.41-0.83, p = 0.002) or no (OR 0.60, 95% CI 0.41-0.86, p = 0.006) dental coverage had significantly lower odds of having a dental cleaning during pregnancy than those living in states with extensive dental coverage. This association was concentrated among people who did not have a dental cleaning pre-pregnancy; those without a cleaning pre-pregnancy who lived in a state with extensive dental coverage had approximately twice the odds or more of having a dental cleaning during pregnancy than those who lived in states with emergency or no dental coverage.

Conclusions: Having dental insurance is critically important to be able to access needed dental care and avoid substantial out-of-pocket costs. This study found that for pregnant adults in Medicaid who who hadn't had a dental cleaning in the year prior to pregnancy, having extensive dental coverage was significantly associated with much higher odds of having a dental cleaning during pregnancy relative to having emergency or no dental coverage. Our findings, together with the body of evidence on the impact of Medicaid dental coverage on dental care access, underscore the importance of providing comprehensive dental coverage in Medicaid regardless of age and pregnancy status.