13:23 PM

Most children covered by Medicaid haven’t had recommended oral health assessments, treatments

Evidence of the important link between oral health and overall health continues to grow, pointing to positive results related to integrated oral health and primary care visits for pediatric patients. Yet, a new evaluation of Medicaid claims data from 13 states shows low rates for well-child visits that include oral health care.

Although oral health integration into primary care is increasing, the DentaQuest Partnership for Oral Health Advancement’s latest research brief shows most children covered by Medicaid are still not receiving recommended oral health assessments and treatments.

The American Academy of Pediatrics and the American Academy of Pediatric Dentistry recommend primary care providers perform oral health assessments, administer topical fluoride varnish, and refer patients to a dentist by age 1 or at first tooth eruption. These recommendations are based on research that demonstrates children who receive an oral health assessment are also likely to get needed and preventive oral health care.

Of the roughly 1.5 million children ages 5 and younger who had a well-child visit in 2017, just 7% received an oral health assessment during that visit, compared to only 6% in 2013. Of those children who had their oral health assessment in 2017, 97% also had fluoride applied at that same well-child visit, while 25% learned of a nontraumatic dental condition that was previously undiagnosed.

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Put another way, a little more than 100,000 children ages 5 and younger with Medicaid received oral care at their primary well-child visit, while 1.4 million did not. Nearly all the kids that did get oral care also received fluoride varnish – a key preventive measure – and a quarter of them were newly diagnosed with existing dental conditions.

The DentaQuest Partnership authors concluded: “The limited use of oral health prevention during well-child visits, paired with the demonstrated success of interprofessional programs designed to overcome challenges cited in the evidence, emphasize the opportunity for expanded [medical-dental integration].” These efforts have the potential to yield better outcomes for all, including improved overall health for children and decreased costs for public insurance programs.

Ultimately, our health system needs greater integration of pediatric and dental care to help facilitate early intervention and prevent oral disease.