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Untreated tooth decay remains a substantial problem for children with public insurance coverage

Kindergartners enrolled in public health insurance programs such as Medicaid and the State Children's Health Insurance Program (SCHIP) are nearly twice as likely to have untreated tooth decay than children not enrolled in these programs, according to a new study. Yet, SCHIP-enrolled children are 26 percent less likely to suffer from untreated tooth decay than their Medicaid-insured counterparts. The researchers estimate that if Medicaid-insured children were moved into SCHIP, there would be a 16 percent improvement in untreated dental caries in North Carolina.

The reimbursement and administrative improvements in SCHIP, a relatively new program for low-income families who earn too much to qualify for Medicaid, may play a distinct role in these differences, note the researchers. They examined dental health outcomes obtained through oral screening of kindergarten children (enrolled in the 2000-2001 school year). They examined claims data for children enrolled in Medicaid and SCHIP, who were eligible for dental services during 1999 to 2000, to compare children's likelihood and extent of untreated dental cavities based on insurance enrollment.

Children enrolled in Medicaid or SCHIP were 1.7 times more likely to have untreated dental cavities (indicated by prevalence and severity of dental caries) than nonenrolled children, with SCHIP-enrolled children 26 percent less likely than their Medicaid-ensured counterparts to have their tooth decay go untreated. These findings are important, because Federal guidelines require Medicaid to provide access to dental care for children enrolled in Medicaid equal to that of other children in their communities. The study was supported in part by the Agency for Healthcare Research and Quality (HS11514).

See "Effects of enrollment in Medicaid versus the state children's health insurance program on kindergarten children's untreated dental caries," by Tegwyn H. Brickhouse, D.D.S., Ph.D., R. Gary Rozier, D.D.S., M.P.H., and Gary D. Slade, D.D.P.H., Ph.D., B.D.Sc., in the May 2008 American Journal of Public Health 98(5), pp. 876-881.

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