Comparison of dental service utilization among rural Medicaid eligible children participating and not participating in Head Start

Children enrolled in Head Start programs are more likely to have dental insurance, tooth decay and pain, and unmet oral health needs, but less likely to have dental visits. The purpose of the study was to determine if children who participate in rural Head Start Programs were more likely to visit the dentists for preventive, diagnostic, and restorative care; but less likely to visit emergency rooms and primary care providers for conditions related to dental problems, than a comparison group of children who are demographically similar, but not enrolled in Head Start programs. Enrollment data from two Head Start programs that cover 7 rural counties in South Carolina and Medicaid claims data were used in the study. The case group comprised of 985 children enrolled in Head Start during the study period. The comparison group comprised of 1,969 children enrolled in Medicaid for at least 9 of 12 months for each year of the study. The comparison group was matched to the case group on race, gender, age, and rural county of residence. Dental claims from Medicaid were coded as preventive, diagnostic, and restorative visits to any type of dentist. Medical claims from Medicaid were coded as either emergency room visits to a hospital or visits to a primary care provider, which included the following: family medicine physicians, pediatricians, general medicine physicians, nurse practitioners, and physician assistants.

ICD-9 codes 520-529 were examined, as they have been previously validated for these settings.