title: Access and utilization of dental services by Alabama Medicaid-enrolled children: a parent perspective.
abstract: OBJECTIVE
  The purposes of this survey were to assess barriers to utilization of dental services among Medicaid-enrolled Alabama children and identify families who used or did not use Medicaid-covered dental services.
  
  
  METHODS
  A random sample of 4,500 parents of Medicaid-eligible children ages 3 to 19 years was surveyed. Participants came from Medicaid enrollment data stratified by area of residence into 3 groups: (1) large urban; (2) town; and (3) rural. Univariate and multivariate analyses were conducted.
  
  
  RESULTS
  The overall response rate was 40% (N = 1,766). Most respondents (71%) reported that their child had a dental visit in the past year. Compared to parents who had a dental visit, those who reported no visits were more likely to: (1) be non-Hispanic African American; (2) be less educated; (3) live in rural settings of Alabama; (4) have more children younger than 6 or older than 12; (5) have more children with disabling conditions; and (6) report poor perceived oral health. Respondents with no dental visits were grouped into 3 categories-those who: (1) believed they did not need dental care (46%); (2) thought dental care was hard to find (34%); and (3) tried but could not get dental care (20%). The first group had significantly less respondents with a high school or greater education, more reporting perceived good to excellent oral health, and more living in rural areas, compared to the other 2 groups.
  
  
  CONCLUSIONS
  Families who did not use Medicaid-covered dental services include: (1) a group with high perceived need and barriers to care; and (2) a group with little perceived need. Interventions must target both groups.
authors.affiliation: Department of Maternal and Child Health, School of Public Health, Birmingham, AL, USA. dania@uab.edu
authors.forename: Dania E
authors.initials: DE
authors.lastname: Al Agili
authors.forename: Janet M
authors.initials: JM
authors.lastname: Bronstein
authors.forename: Mary
authors.initials: M
authors.lastname: Greene-McIntyre
mesh_terms: D000293:Adolescent; D000328:Adult; D000407:Alabama; D002648:Child; D002675:Child, Preschool; D019140:Dental Care for Children / Q000523:psychology / Q000706:statistics & numerical data*; D004812:Epidemiologic Methods; D005260:Female; D006297:Health Services Accessibility; D006801:Humans; D008297:Male; D008484:Medicaid; D009819:Office Visits / Q000706:statistics & numerical data*; D010290:Parents / Q000523:psychology*; D012424:Rural Population; D014481:United States; D014505:Urban Population