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A peer-reviewed journal that offers evidence-based clinical information and continuing education for dentists.

Breaking Down Barriers: The Crucial Role of Medicaid in Ensuring Oral Health for Low-Income Americans

Discover how Medicaid is pivotal in providing essential dental care to low-income families, addressing significant health disparities, and enhancing overall well-being across the United States.

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Oral health professionals have long known that the health of the oral cavity is intimately connected to the health of the body. Without access to dental care, many in the United States suffer the ramifications of poor or neglected oral health. KFF, a health policy organization based in San Francisco, recently released a brief on the utilization of dental services by Medicaid enrollees.

The brief notes that more than a quarter of adults and one in 10 children experience untreated dental caries. The lack of dental care impacts quality of life, making everyday activities challenging and contributing to chronic conditions like heart disease and diabetes. The absence of regular dental care often leads to more severe health problems and expensive emergency care, costing the United States economy approximately $45 billion annually in lost productivity.

The unmet oral health needs are disproportionately higher among low-income individuals, including those covered by Medicaid. Nearly one-fourth of children from households below the federal poverty level have one or more oral health issues, and low-income children report more problems than those from higher-income households. Similarly, low-income adults have more unmet dental healthcare needs compared to their higher-income counterparts. These disparities also extend to people of color, who are more likely to experience oral health problems and less likely to receive dental care than white individuals. Additionally, people living in rural areas face greater challenges accessing dental care than those in urban areas. Medicaid plays a crucial role in addressing these disparities, as it covers a majority of nonelderly people living in poverty and over half of Black, Hispanic, and American Indian and Alaska Native children.

Medicaid dental coverage is mandatory for children under the early and periodic screening, diagnostic, and treatment benefit, but dental services for adults are optional and vary by state. This has led to significant differences in dental service utilization between children and adults covered by Medicaid. Nearly half of children with Medicaid or Children’s Health Insurance Program (CHIP) receive at least one dental service annually, compared to only one-fifth of adult Medicaid enrollees.

The analysis of Medicaid claims data reveals that while adult Medicaid enrollees across racial and ethnic groups receive dental services at similar rates, Hispanic and Asian children enrolled in Medicaid or CHIP have higher rates of dental service use compared to other groups. This disparity underscores the critical role of Medicaid in providing dental care and addressing oral health inequities.

Medicaid’s role in improving oral health outcomes is essential for reducing health disparities and ensuring equitable access to dental care. As Medicaid covers a significant portion of low-income and minority populations, it is a vital tool for promoting oral health and enhancing overall well-being across the United States. Click here to read more.

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