On kidsdata.org, measures of dental care include the percentage of children who have dental insurance and the percentage of children who recently visited a dentist.
Dental problems are a serious concern, especially among low-income children who are less likely to have dental insurance and access to dental care. Untreated dental problems in children can lead to poor academic performance and behavior problems because of the pain, as well as problems with chewing or speaking, and reduced self-esteem. If dental disease is not treated early, it can result in the need for more serious and expensive intervention later.
Children with dental insurance are more likely to receive preventive care, such as regular teeth cleanings with a dental hygienist, as well as early identification and treatment of dental problems. Children who see a dentist also are more likely to learn how to care for their teeth and gums. Parents whose children go to the dentist also learn to avoid dental problems, such as early caries (or baby bottle tooth decay"), which is caused by allowing babies to go to sleep with a bottle of milk or juice.
The American Academy of Pediatric Dentistry recommends that children get a dental check-up before their first birthday and regularly thereafter. The national Healthy People 2010 Objective, developed by the federal Department of Health and Human Services, recommends that by 2010 57% of low-income children ages 2-18 receive preventive dental visits at least yearly.
Scroll down on the web page to see links to research and more information about dental care.
All children need access to high quality, affordable dental care. Among low-income families, finding dentists who accept public insurance can be a particular challenge. Even for higher-income families, dental care may be financially out of reach if they do not have dental coverage. Disparities are persistent among African American/Black and Latino children compared to other children, and must be addressed (1). California law requires an oral health assessment before starting school, which can help ensure early dental care. However, budget pressures led California to suspend the Children’s Dental Disease Prevention Program, the only statewide public program to provide school-based, oral health services to children. Fluoridated water has been successful in reducing cavities among children (6), but it is not available everywhere in California.
According to research and subject experts, policy options that could influence children’s dental care include:
- Increasing reimbursement rates for dental providers under public insurance programs, to create incentives for them to treat low-income children (1, 2); this is most effective when combined with improved administration of Medicaid-funded dental coverage and improved Medicaid partnerships with dental societies (3)
- Protecting children’s dental coverage in public health insurance programs, and incentivizing that coverage in the private insurance market (2)
- Increasing outreach to families enrolled in public insurance programs about the availability of dental care (1, 4)
- Ensuring that schools have adequate funding to fully implement all aspects of the kindergarten dental checkup requirement (5) and reinstating state support for children’s dental disease prevention (2)
- Ensuring that all communities have fluoridated drinking water (6)
- Expanding the dental workforce to help improve access to
care for underserved children; for example, the scope of practice of dental hygienists could be expanded to provide basic preventive and restorative care for children in various settings such as schools, public health clinics, and offices of physicians (7)
- Promoting collaboration across medical and dental disciplines to ensure consistent, evidence-based oral health education for child health care providers, including screening, parent education, and topical fluoride application (8)
For more policy ideas and research on this topic, see kidsdata.org’s Research & Links section, or visit the California Dental Association Foundation, Children Now, the American Academy of Pediatric Dentistry and the American Academy of Pediatrics Oral Health Initiative.
Sources for this narrative:
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Pourat, et al. (2010). Racial and Ethnic Disparities In Dental Care For Publicly Insured Children. Health Affairs. http://content.healthaffairs.org/content/29/7/1356.full?ijkey=OR9Zf6tmdgyb2&keytype=ref&siteid=healthaff
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Children Now. (2010). Strong Dental Benefits for Children: Cost-Effective and Critical to Overall Health and Success. http://www.childrennow.org/uploads/documents/oral_health_factsheet_05052010.pdf
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Borchgrevink, et al. (2008). Increasing Access to Dental Care in Medicaid: Does Raising Provider Rates Work? California HealthCare Foundation. http://www.chcf.org/publications/2008/03/increasing-access-to-dental-care-in-medicaid-does-raising-provider-rates-work
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Hughes, Dana. (2007). Access, Use, and Costs of Dental Services in the Healthy Kids Program. Urban Institute. http://www.urban.org/UploadedPDF/411528_dental_service_kids.pdf
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California Dental Association. (2011). Kindergarten Oral Health Requirement. http://www.cda.org/advocacy_&_the_law/legislation/kindergarten_oral_health_requirement
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U.S. Department of Health and Human Services, Centers for Disease Control and Prevention, Morbidity and Mortality Weekly Report. (1999). Achievements in Public Health, 1900-1999: Fluoridation of Drinking Water to Prevent Dental Caries. http://www.cdc.gov/mmwr/preview/mmwrhtml/mm4841a1.htm
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Nash, D. (2009, November) Adding Dental Therapists to the Health Care Team to Improve Access to Oral Health Care for Children. Academic Pediatrics, 9(6), 446-451. http://www.academicpedsjnl.net/article/S1876-2859%2809%2900249-6/fulltext
- Douglass et al. (2009, November). Educating Pediatricians and Family Physicians in Children's Oral Health. Academic Pediatrics, 9(6), 452-456. http://www.academicpedsjnl.net/article/S1876-2859%2809%2900250-2/fulltext
In California, 80.0% of children had dental insurance in 2007, but that percentage ranged widely among counties, from 91.0% in Solano County to 65.0% in Nevada County. In 2007, 62.3% of California children had a dental visit in the past 6 months, up from 55.6% in 2001. However, 12.9% of children ages 2-17 had never visited a dentist in 2007.