Dental services accessed by California's vulnerable children: Utilization and Policy implications

Locally funded Healthy Kids programs provided medical, dental and vision coverage to over 83,000 children who were not eligible for other state programs due to income or immigration status. This study evaluates the use of dental services by Healthy Kids members, analyzes types of services accessed, and discusses policy implications.

Researchers obtained dental plan electronic reports of all services provided to Healthy Kids enrollees in 2006, in sixteen (n=16) counties. Enrollment data for Healthy Kids programs in each county were used to calculate utilization rates for any dental service, including preventive and restorative.

For Healthy Kids enrollees age 3 and under, 2% received dental care, 13% of enrollees 4 to 6 years and 79% of enrollees 7 to 18 years old received care. Nearly two thirds of children in Healthy Kids received diagnostic (64%) or preventive (63%) dental services; one third (35%) received some type of restorative dental care (fillings). On average, 14% of children had oral surgery. Of children age 6 and older who received dental care, 27% received dental sealants, 52% received a fluoride treatment.

Healthy Kids programs demonstrate great value to its members who need oral health care. The large numbers of children who had oral surgery indicates dental disease so severe that teeth had to be extracted rather than restored. Given that Healthy Kids enrollees represent a high risk population, and the efficacy of dental sealants and fluoride treatments in protecting against disease, efforts should be made to increase preventive visits at a very young age.