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Kids and Health Care: Preventive Dentistry

Before you scoff at cost-cutting measures like Jeb Bush's, keep in mind that preventive dentistry is more dentistry than most children from poorer families get.

A June 2003 report published by the Child Health Insurance Research Initiative (CHIRI) examined children's access to dental care in the Alabama and Georgia CHIP and Medicaid programs -- and found it so lacking that simple tooth decay looms a major problem for children in those states.

The CHIRI researchers found that less than 40 percent of the Medicaid-enrolled children they studied received dental care of any sort (and they concluded that these numbers were typical of other states during the same time period). This was true, even though the state CHIPs studied did offer at least preventive dental care to kids in the programs.

The report reached some disturbing -- and familiar -- conclusions. For dental care, as for general medical care, kids who don't get preventive checkups end up in the emergency room. Of the kids in the CHIRI study who did get some form of dental care, nearly none used intensive dental services (the dental equivalent of the emergency room).

While broader dentist participation in the state CHIPs had some effect on improving dental care access, the CHIRI report concluded that other factors have more influence on dental care use in public insurance programs. Summing up, it noted, "Medicaid-enrolled children are far more likely to receive medical care than dental care. If every child who had a medical visit also had a dental visit, many Medicaid-enrolled children would have received dental care."

Like Jeb Bush, many politicians look at state CHIPs for ways to cut costs. The CHIRI report was designed to help social program managers make the case for keeping enough money in the systems to make dental care available. It emphasized the importance of:

  • early access to dental care and the use of preventive dental services;
  • comprehensive dental benefits in public insurance programs for children; and
  • multi-pronged strategies for improving access to dental care that capitalize on where kids and their families seek care.
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