Access to preventive dental care by pregnant Medicaid recipients, Iowa 2005-2008

Pregnant women are at increased risk for periodontal disease due to hormonal changes during pregnancy. All pregnant women should receive preventive dental care (PDC) to reduce this risk. The Iowa Medicaid and Public Health programs have promoted PDC among recipients, including pregnant women. We examined characteristics of women receiving PDC and improvements in care provision over time.

We analyzed data from matched Medicaid claims and birth certificate (BC) files for 2005 through 2008 (n=54,841). The match rate was > 95% for each year. We used the chi-square test for trend to examine PDC receipt over time. Because the greatest difference in PDC receipt was between 2005 and 2008 we limited the logistic regression analysis to 2005 and 2008 (n=24,940). We defined ever use of PDC using Medicaid paid claims, and examined associations with maternal characteristics (age, race/ethnicity, education, marital status, and urbanicity), and year of service per the BC.

The proportion of Medicaid recipients who received PDC during pregnancy increased from 9.4% (2005) to 21.2% (2008) (p<.0001). After adjustment for maternal characteristics and year, non-Hispanic Black (aOR: 1.64; CL: 1.42-1.89) and Hispanic women (aOR: 2.21; CL: 1.94-2.52) were more likely to receive no PDC than non-Hispanic white women. Women ages 20-29 (aOR: 1.28; CL: 1.16-1.41) and 30 or older (aOR: 1.31; CL: 1.15-1.49) were more likely to receive no PDC than women < 20.

Receipt of PDC by pregnant Medicaid recipients is improving among all groups, but remains low. Program outreach efforts are needed for all pregnant Medicaid recipients.