146 - Improving Dental Access for Medicaid-Enrolled Children

Purpose: To evaluate proximity to an active Medicaid-participating dentist influence on preventive dental utilization and continuity of care among children enrolled in Medicaid.

Methods: A cross-sectional analysis of pediatric Medicaid dental claims from Partners For Kids (2023–2024) was conducted. Children ages 1–18 years with ≥10 months of continuous enrollment in each year were included. Continuity of care was defined using the Dental Quality Alliance measure, requiring a dental examination in two consecutive years. Children were categorized by continuity status. Outcomes included annual preventive visits, sealants, restorations, silver diamine fluoride, and extractions, identified using procedure codes. Chi-square and regression analyses were performed, including a rural-only sensitivity analysis.

Results: Of the 200,820 children included in analysis, 179,664 (90%) had an annual preventive dental visit and 85,326 (43%) met the continuity of care measure. Continuity of care was significantly associated with all outcomes. Children with continuity of care were more likely to receive sealants (32.0% vs. 21.0%), silver diamine fluoride (9.0% vs. 6.0%), and restorative treatment (47.0% vs. 33.0%) compared with those without continuity of care (all p<0.001). Tooth extraction was also more common among children with continuity of care (17.0% vs. 15.0%), though the magnitude of association was smaller. Increased travel time was associated with lower odds of continuity (16–30 minutes: OR 0.84; 31–60 minutes: OR 0.66). In rural-only analyses, continuity was not explained by distance.

Conclusions: Children with continuity of care are more likely to receive preventive and restorative treatment but geographic proximity alone does not eliminate disparities.