Dental Care Utilization Among Medicaid-Enrolled Adults with Substance Use Disorder.

Introduction: Low-income Medicaid-enrolled adults are likely to have poor oral health and experience substance use disorders (SUDs). Despite emerging evidence that comprehensive dental care can improve SUD outcomes, there is a lack of evidence about the overlap of SUD 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 non-dually eligible Medicaid-enrolled adults ages 21 to 64 years. Clustered-robust standard error 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 SUD. There was significant variation in SUD 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, though 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 SUD and 215.39 per 1,000 adults without SUD. The odds of receiving early-stage dental care were 42% lower for Medicaid-enrolled adults with SUD than those without SUD.

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