Dental Coverage for Pregnant Women and Parents in Medicaid: Impact on Children's Access to Dental Care

Children enrolled in Medicaid experience widespread disparities in access to care compared to children from higher income families leading to increased dental treatment needs and poorer oral health. Despite recommendations to see a dentist by age 1 a low proportion of very young children actually receive dental care particularly among those enrolled in Medicaid. This pattern is also seen among pregnant women; despite recommendations to seek regular dental care during pregnancy dental care use among pregnant women is low especially among those who are Medicaid-enrolled. While states are mandated to provide comprehensive dental coverage for children in Medicaid dental coverage for pregnant women and parents are optional resulting in substantial state-level variation in the extent of dental coverage available to these populations. No studies have examined the impact of this state variation on dental utilization among pregnant women young children and adolescents. Consistent with MCHB's Strategic Research Issue II there is a need to study the degree to which modifiable policy-related factors could increase the use of dental care for pregnant women and children enrolled in Medicaid in order to improve access to dental care and reduce disparities. The proposed project is a national cross-sectional study examining the impact of state-level dental Medicaid coverage for pregnant women and parents on individual-level access to dental care among pregnant women and children. We will use data from the National Survey of Children's Health (NSCH) and the Pregnancy Risk Assessment Monitoring System (PRAMS) to measure dental utilization among children and pregnant women respectively as well as publicly available information about state Medicaid dental coverage. Using a multilevel modeling approach we will study the impact of state-level Medicaid dental coverage for pregnant women on individual-level dental utilization among pregnant women and young children age 1-3. Additionally we will study the impact of state-level Medicaid dental coverage for parents on individual-level dental utilization among older children age 4-11 and adolescents age 12-17