title: North Carolina physician-based preventive oral health services improve access and use among young Medicaid enrollees.
abstract: To combat disparities in oral health and access to dental care among infants and toddlers, most state Medicaid programs now reimburse physician-based preventive oral health services such as fluoride varnish applications. We used geospatial data to examine the distribution of dental and medical Medicaid providers of pediatric oral health services throughout North Carolina to determine if these services have improved access to care for Medicaid enrollees younger than age three. We then used claims data to examine the association between distance from these practices and use of dental services for a cohort of approximately 1,000 young children. Among one hundred counties, four counties had no physician-based preventive oral health services, and nine counties had no dental practice. While children who lived farther from the nearest dental practice were less likely to make dental visits, distance from physician-based preventive oral health services did not predict utilization. For young Medicaid enrollees, oral health services provided in medical offices can improve access and increase utilization.
authors.affiliation: Ashley M. Kranz (akranz@unc.edu) is an adjunct assistant professor of pediatric dentistry at the University of North Carolina-Chapel Hill School of Dentistry, and a Health Systems Integration Program fellow at the Health and Human Services Agency, County of San Diego, in California.
authors.forename: Ashley M
authors.initials: AM
authors.lastname: Kranz
authors.affiliation: Jessica Lee is a distinguished professor and chair in pediatric dentistry at the University of North Carolina-Chapel Hill School of Dentistry.
authors.forename: Jessica
authors.initials: J
authors.lastname: Lee
authors.affiliation: Kimon Divaris is an associate professor in pediatric dentistry at the University of North Carolina-Chapel Hill School of Dentistry.
authors.forename: Kimon
authors.initials: K
authors.lastname: Divaris
authors.affiliation: A. Diane Baker is a research associate at the University of North Carolina-Chapel Hill School of Dentistry.
authors.forename: A Diane
authors.initials: AD
authors.lastname: Baker
authors.affiliation: William Vann Jr. is a research professor in pediatric dentistry at the University of North Carolina-Chapel Hill School of Dentistry.
authors.forename: William
authors.initials: W
authors.lastname: Vann
mesh_terms: D002675:Child, Preschool; D019140:Dental Care for Children / Q000458:organization & administration*; D006297:Health Services Accessibility / Q000458:organization & administration* / Q000706:statistics & numerical data; D006801:Humans; D007223:Infant; D008484:Medicaid / Q000458:organization & administration* / Q000706:statistics & numerical data; D009657:North Carolina; D009909:Oral Health / Q000706:statistics & numerical data; D011313:Preventive Dentistry / Q000458:organization & administration* / Q000706:statistics & numerical data; D014481:United States
keywords: Access To Care; Children’s Health; Disparities; Medicaid; Oral Health Care