Access to orthodontic services for pediatric and Medicaid-enrolled populations: a survey of non-orthodontists.

Abstract

This study examined the demographics, practice characteristics, service mix, and barriers faced by general and pediatric dentists in the provision of orthodontic care to the pediatric population, including children enrolled in Medicaid programs. A 31-item questionnaire was developed and distributed by email to 567 members of the Academy of Gp Orthodontics and the American Orthodontic Society. Analyses included descriptive and inferential statistical methods: chi-square, Kruskal-Wallis, and Student t tests; analysis of variance; and Spearman correlation. A value of (P < 0.05) was considered statistically significant. Thirty-four practitioners (6.0%), the majority male (58.8%), completed the survey. The mean (SD) age of respondents was 53.3 (11.8) years, and on average they had been practicing 23.3 (12.9) years. Respondents primarily practiced in suburban areas (47.1%), and most identified as general dentists (85.3%). Only 23.5% reported providing orthodontic services to children enrolled in Medicaid. The most common reasons for not participating in the program included low reimbursement rates, difficulty with billing, and patient noncompliance. Although time dedicated to orthodontic services varied, the majority (55.9%) allocated 10% to 25% of their practice time to such treatments. Most respondents (79.4%) referred cases to orthodontists, mainly Class III malocclusions (30.6%) and open bites (23.6%). General and pediatric dentists increase access to orthodontic services by evaluating patients, rendering care, and, when appropriate, referring patients to specialists. Respondents to this survey reported multiple barriers to providing orthodontic care, particularly for the Medicaid population. These findings underscore the need for reforms to address financial and administrative barriers to orthodontic care, particularly for underserved populations.