Tooth decay is the most common childhood disease — in fact, it is five times more common than asthma, and nearly one-quarter of all preschool-age children in the U.S. have experienced tooth decay. Dental health in children is vital, especially given the long-term and pervasive ways tooth decay can affect a child’s life — for example, missed school days and increased risk for costly dental disease as adults, as well as systemic disease and reduced employability.
Even though oral health care is fully covered under Medicaid’s Early and Periodic Screening, Diagnostic, and Treatment benefit, less than half of all Medicaid-enrolled children receive any dental service in a given year. Barriers to oral health care access include:
A lack of oral health care provider participation in Medicaid;
The reluctance of participating oral health care providers to treat young children due to providers’ inexperience or child behavioral issues;
Awareness gaps among Medicaid-enrolled families about available dental benefits and how to utilize them; and
Transportation issues and difficulty scheduling/attending office appointments due to competing work schedules; and other barriers.
At the federal level, the Centers for Medicare & Medicaid Services (CMS) launched the National Oral Health Initiative in 2010 to support states in improving preventive dental service utilization among Medicaid-enrolled children. Since then, many states have undertaken efforts to increase access to preventive dental care for children in Medicaid. The following examples are drawn from participants in the Center for Health Care Strategies’ seven-state Medicaid Oral Health Learning Collaborative, funded by the DentaQuest Foundation.