Treating latino children with public insurance: The dentist's perspective

Background: Latino children have higher rates of early childhood caries (ECC) than other populations. Many ECC cases go untreated due to multiple barriers Latino parents face in obtaining dental care for their children. This study sought to gain a contextual understanding of the challenges dentists encounter while treating this population.

Methods: In rural and urban settings of California, we conducted open-ended qualitative interviews with a convenience sample of 25 dentists about their practices, treatment methods and patient bases. These dentists represented clinics that predominantly served low-income, Latino children with public insurance (Denti-Cal). Audio taped, in-depth interviews were independently read and thematically analyzed by two researchers using the NVivo software package.

Results: Only seven clinics were capable of treating nearly all of their patients. The majority (18 of 25) often refer children to specialty clinics for three reasons: young age (usually under three years), severe or extensive decay, or uncooperative behavior. Some dentists immediately referred these patients while others did so only after multiple attempts to treat a child (using rewards, parental assistance or games). The frequent referrals resulted from the limited number of clinics that used a papoose board or sedation, forcing parents to make multiple dental visits to complete their child's treatment.

Conclusions: Caregivers of Latino children that are young, uncooperative or have rampant decay must make multiple dental visits to finally obtain care for their child. Treatment is therefore delayed due to a shortage of accessible, willing and qualified dentists in the community.

Funding: NIDCR U54 DE14251