title: Utilization of dental sealants by Alabama Medicaid children: barriers in meeting the year 2010 objectives.
abstract: OBJECTIVE
  As a national objective, 50% of US children are expected to have dental sealants on at least one permanent molar by the age of 14 years. The present study was conducted to estimate the prevalence of dental sealants among Alabama Medicaid children and to evaluate the characteristics of the sealant users and non-users so the potential barriers in meeting the year 2000/2010 sealant objectives can be identified.
  
  
  METHODS
  Alabama Medicaid 1990-1997 claims for children (N = 3,683,842) were analyzed using basic descriptive statistics, likelihood ratio, Chi-Square and t-tests, and ANOVA. Logistic regression analysis was used in identifying the predictors of dental sealant utilization.
  
  
  RESULTS
  Nearly 22 percent of children had at least one sealant claim by 12 to 14 years of age (white = 28.3%; Black = 19.8%; OR = 1.6, 95% CI = 1.4-1.8; female = 23.6%; male = 19.7%; OR = 1.3, 95% CI = 1.1-1.4). 5- to 9-year-olds were more likely to have sealants compared to 11- to 14-year-olds (OR = 4.1, 95% CI = 2.7-6.1). The availability of a Medicaid accepting dentist within the county of residence was a significant predictor (OR = 1.5, 95% CI = 1.1-2.2). Less than 2% of the annual amount claimed for total dental services in Alabama was related to sealants and the providers were reimbursed only for 50% to 70% of the amount claimed for sealant procedures.
  
  
  CONCLUSIONS
  Racial and gender disparities in obtaining care, non-availability of a Medicaid-participating dentist within the county, and lower payment/claim ratio may make the national sealant objective difficult to achieve in Alabama.
authors.affiliation: Department of Pediatric Dentistry, University of Alabama, Birmingham School of Dentistry, UAB School of Public Health, Birmingham, Alabama, USA. ananda@uab.edu
authors.forename: A P
authors.initials: AP
authors.lastname: Dasanayake
authors.forename: Y
authors.initials: Y
authors.lastname: Li
authors.forename: S
authors.initials: S
authors.lastname: Philip
authors.forename: K
authors.initials: K
authors.lastname: Kirk
authors.forename: J
authors.initials: J
authors.lastname: Bronstein
authors.forename: N K
authors.initials: NK
authors.lastname: Childers
mesh_terms: D000293:Adolescent; D001741:Black or African American / Q000706:statistics & numerical data; D000407:Alabama; D000704:Analysis of Variance; D016009:Chi-Square Distribution; D002648:Child; D019140:Dental Care for Children / Q000191:economics / Q000706:statistics & numerical data*; D005260:Female; D017048:Health Care Costs / Q000706:statistics & numerical data; D006297:Health Services Accessibility / Q000706:statistics & numerical data; D006801:Humans; D007342:Insurance Benefits / Q000706:statistics & numerical data; D007347:Insurance, Dental / Q000706:statistics & numerical data*; D016015:Logistic Models; D008297:Male; D008484:Medicaid / Q000706:statistics & numerical data*; D010895:Pit and Fissure Sealants / Q000191:economics* / Q000627:therapeutic use*; D044465:White People / Q000706:statistics & numerical data
chemical_list: D010895:Pit and Fissure Sealants