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- Definition: Estimated percentage of children ages 2-17, by length of time since their last dental visit and by age group.
- Data Source: UCLA Center for Health Policy Research, California Health Interview Survey (Dec. 2015).
- Footnote: These estimates are based on a survey of the population and are subject to both sampling and nonsampling error. LNE (Low Number Event) refers to data that have been suppressed because the sample size was lower than 50 or the estimated percentage was less than 0.1%. N/A means that data are not available. For more information about the California Health Interview Survey and for detailed margins of error around specific data points, see http://www.chis.ucla.edu.
- Measures of Dental Care on Kidsdata.org
Kidsdata.org presents the estimated percentage of children ages 2-11 and youth ages 12-17 by the length of time since their last dental visit. These data come from the California Health Interview Survey.
- Dental Care
- Access to Services for Children with Special Health Care Needs (State-Level Data)
- Health Care
- Delayed or No Medical Care
- Length of Time Since Last Routine Health Check-Up
- Visited the Emergency Room in Last Year, by Type of Insurance
- Uninsured at Any Point in Last Year
- Health Insurance Coverage (Regions of 65,000 Residents or More), by Type of Insurance and Age
- Health Insurance Coverage (Regions of 10,000 Residents or More), by Type of Insurance and Age
- Medi-Cal Enrollment
- School Health Centers
- Why This Topic Is Important
Tooth decay is the most common chronic disease among children ages 6-18 (1). Untreated dental problems, such as cavities and gum disease, can affect a child’s health and quality of life by leading to pain, nutritional and sleep problems, impaired concentration, and increased school absences, as well as lost work hours for parents (2, 3). If dental disease is not treated early, it can result in the need for more serious and expensive intervention later on (2).
Tooth decay and other oral diseases disproportionately affect low-income children, children of color, and the uninsured (1, 4). Those children, compared to their peers, are less likely to receive routine dental check-ups, which are critical for preventing tooth decay. For this reason, the federal government has set a public health goal focused on improving access to preventive dental services for low-income children (5).For more information about dental health see kidsdata.org’s Research & Links section.
Sources for this narrative:
1. Paradise, J. (2012). Children and oral health: Assessing needs, coverage, and access. Kaiser Commission on Medicaid and the Uninsured. Retrieved from: http://kff.org/disparities-policy/issue-brief/children-and-oral-health-assessing-needs-coverage
2. Children Now. (n.d.). Oral health. Retrieved from: https://www.childrennow.org/issue-areas/health/oral-health/oral-health-cont
3. Centers for Disease Control and Prevention. (2011). Oral health: Preventing cavities, gum disease, tooth loss, and oral cancers. Retrieved from: http://stacks.cdc.gov/view/cdc/11862
4. Dye, B. A., et al. (2012). Oral health disparities as determined by selected Healthy People 2020 oral health objectives for the United States, 2009–2010 (NCHS Data Brief No. 104). National Center for Health Statistics. Retrieved from: http://www.cdc.gov/nchs/data/databriefs/db104.htm
5. U.S. Department of Health and Human Services, Office of Disease Prevention and Health Promotion. (2012). Healthy People 2020: Oral health, OH-8. Retrieved from: https://www.healthypeople.gov/2020/topics-objectives/topic/oral-health/objectives
- How Children Are Faring
In 2013-14, an estimated 74% of California children ages 2-11 and 79% of youth ages 12-17 had a dental visit in the past 6 months. However, about 9% of children ages 2-11 and 2% of adolescents ages 12-17 had never visited a dentist. Among counties or regions within California, the estimated percentage of children ages 2-11 who had never seen a dentist ranged from about 1% to 28% in 2013-14.
- Policy Implications
All children need access to high quality, affordable dental care. Research has shown that more than 7 in 10 California children suffer from tooth decay by the time they reach third grade, and 3 out of 10 third graders have untreated decay (1). Inequities also persist among African American/black and Latino children compared to other children (2).
The federal Affordable Care Act (ACA) includes dental health care for children in the essential health benefits that must be covered by all qualified health insurance plans, a major step forward in ensuring access to oral health care for children (2, 3). California law also allocates funding for an oral health assessment before starting school, which can help ensure early dental care. However, in 2009, California suspended the only statewide public program to provide school-based, oral health services to children (the Children’s Dental Disease Prevention Program). Research has shown that California students miss an estimated 874,000 school days a year due to dental problems (4).
According to research and subject experts, policy options that could influence children’s dental health include:
For more policy ideas and research on this topic, see kidsdata.org’s Research & Links section, or visit the California Dental Association, the American Academy of Pediatric Dentistry, or the American Academy of Pediatrics Section on Oral Health.
- Increasing reimbursement rates for dental providers under public insurance programs, to create incentives for them to treat low-income children; this is most effective when combined with improved administration of Medicaid-funded dental coverage and improved Medi-Cal partnerships with dental societies (2, 3, 5)
- Increasing the number of pediatric dentists where Medi-Cal patients live, and ensuring adequate transportation and appointment coordination when dentists are out of the area (3, 6)
- Setting pediatric dental benefits under ACA at affordable rates to allow low-income families to access the services (6)
- Expanding outreach to families enrolled in public insurance programs about the availability and importance of dental care (3)
- Reinstating state support for children’s dental disease prevention (7)
- Ensuring that all communities have fluoridated drinking water, as it has been successful in reducing cavities among children (2)
- 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)
Sources for this narrative:
1. Hughes, D., & Gutman, A. (2013). School health policy: An avenue to community collaboration. Philip R. Lee Institute for Health Policy Studies. Retrieved from: http://www.centerfororalhealth.org/images/lib_PDF/school_health_policy_an_avenue_to_community_collaboration.pdf
2. Paradise, J. (2012). Children and oral health: Assessing needs, coverage, and access. Kaiser Commission on Medicaid and the Uninsured. Retrieved from: http://kff.org/disparities-policy/issue-brief/children-and-oral-health-assessing-needs-coverage
3. The Children’s Partnership. (2013). Fix Medi-Cal dental coverage: Half of California’s kids depend on it. Retrieved from: http://www.childrenspartnership.org/publications/525
4. Pourat, N., & Nicholson, G. (2009). Unaffordable dental care is linked to frequent school absences. UCLA Center for Health Policy Research. Retrieved from: http://healthpolicy.ucla.edu/publications/search/pages/detail.aspx?PubID=92
5. Borchgrevink, A., et al. (2008). Increasing access to dental care in Medicaid: Does raising provider rates work? California HealthCare Foundation. Retrieved from: http://www.chcf.org/publications/2008/03/increasing-access-to-dental-care-in-medicaid-does-raising-provider-rates-work
6. Short, N. (2013). Health care reform: 8 months and counting. California Dental Association. Retrieved from: http://www.cda.org/news-events/health-care-reform-8-months-and-counting
7. Children Now. (2016). Restore school-based dental disease prevention program. Retrieved from: https://www.childrennow.org/files/4614/5806/6012/CN-2016-17-Dental-Budget.pdf
8. Douglass, A. B., et al. (2009). Educating pediatricians and family physicians in children's oral health. Academic Pediatrics, 9(6), 452-456. Retrieved from: http://www.academicpedsjnl.net/article/S1876-2859(09)00250-2/
- Websites with Related Information
- Key Reports
- 2016 California Children's Report Card, Children Now
- Access to Dental Care for California’s Adult Immigrants and Their Children: Empirical Analyses, Policy Simulations, and Recommendations, 2008, California Program on Access to Care, Brown, T. T., et al.
- Children and Oral Health: Assessing Needs, Coverage, and Access, 2012, Kaiser Commission on Medicaid and the Uninsured, Paradise, J.
- Dental Care Access for Children in California: Institutionalized Inequality, 2014, Lucile Packard Foundation for Children's Health, Schor, E. L.
- Dental Care and Children with Special Health Care Needs: A Population-Based Perspective, 2010, Academic Pediatrics, Lewis, C. W.
- Early Childhood Caries Trends Upward, Children's Dental Health Project
- Expanding California's Dental Team to Care for Underserved Children: New Times, New Solutions, 2011, The Children's Partnership, Kattlove, J.
- Filling an Urgent Need: Improving Children’s Access to Dental Care in Medicaid and SCHIP, 2008, National Academy for State Health Policy & Kaiser Commission on Medicaid and the Uninsured, Gehshan, S., et al.
- Haves and Have-Nots: A Look at Children's Use of Dental Care in California, 2008, California HealthCare Foundation, Pourat, N.
- Increasing Access to Dental Care in Medicaid: Targeted Programs for Four Populations, 2009, California HealthCare Foundation, Snyder, A.
- It Shouldn't Hurt to Be a Child: Preventing Early Childhood Caries (ECC), 2016, National Maternal and Child Oral Health Resource Center, Holt, K., et al.
- Mommy, It Hurts to Chew: The California Smile Survey, An Oral Health Assessment of California's Kindergarten and 3rd Grade Children, 2006, Center for Oral Health
- Oral Health Care in CSHCN: State Medicaid Policy Considerations, 2009, Pediatrics, Kenney, M. K.
- Oral Health for Children with Special Health Care Needs, 2009, National Maternal and Child Oral Health Resource Center
- Oral Health Need and Access to Dental Services: Evidence from the National Survey of Children’s Health, 2007, 2012, Maternal and Child Health Journal, Bell, J. F., et al.
- Racial Disparity Trends in Children’s Dental Visits: U.S. National Health Interview Survey, 1964–2010, 2012, Pediatrics, Isong, I. A., et al.
- Restore School-Based Dental Disease Prevention Program, 2016, Children Now
- Rural Dental Dilemmas Growing, 2006, Rural Monitor, Hanson, H.
- School Health Policy: An Avenue to Community Collaboration, 2013, Philip R. Lee Institute for Health Policy Studies, Hughes, D., & Gutman, A.
- County/Regional Reports
- Children’s Dental Health in Santa Clara and San Mateo Counties: Overview of Current Needs and Activities, 2006, Lucile Packard Foundation for Children’s Health, Foster, C. C.
- Children's Report Card, Sacramento County Children's Coalition
- Community Health Assessment 2015, Los Angeles County Dept. of Public Health
- Dental Care in the Los Angeles Healthy Kids Program: Successes and Challenges, 2009, Urban Institute, Hogan, S., et al.
- Oral Health Education and Dental Services, Health Trust (Silicon Valley)
- San Diego County Report Card on Children and Families, 2015, The Children's Initiative & Live Well San Diego
- Santa Clara County Children's Agenda: 2016 Data Book, Planned Parenthood & Kids in Common
- More Data Sources For Dental Care
- California Health Interview Survey, UCLA Center for Health Policy Research
- Childstats.gov, Federal Interagency Forum on Child and Family Statistics
- County Health Rankings and Roadmaps, Robert Wood Johnson Foundation & University of Wisconsin Population Health Institute
- Data Resource Center for Child & Adolescent Health, Child and Adolescent Health Measurement Initiative
- Health Indicators Warehouse, National Center for Health Statistics