Provision of Dental Procedures Among Children Enrolled in Delta Dental Insurance in Milwaukee, Wisconsin

Introduction: Most studies on the provision of dental procedures have focused on Medicaid enrollees known to have inadequate access to dental care. Little information on private insurance enrollees exists. This study documents characteristics and patterns of preventive, restorative, endodontic, and surgical dental procedures provided to children enrolled in Delta Dental insurance in Milwaukee, Wisconsin.

Methods: We analyzed Delta Dental insurance claims for Milwaukee children aged 0-18 years between 2002 and 2006. We used zip-codes of enrollees linked to US Census information on population characteristics as proxy for race/ethnicity. A cut-off of 70% or more of a particular race/ethnicity was used in the designation. Descriptive and multivariable analysis using Poisson GEE modeling on number of visits and procedures per year was done.

Results: A total of 24,608 children had 151,060 visits. Of these 18,952 children had at least one visit with a preventive procedure, 11,381 with a restorative, 3,048 with a surgical, and 1,962 with an endodontic procedure. Compared to children living in predominantly white zip-codes, children living in predominantly African American and Hispanic zip-codes had significantly lower rates of preventive visits and procedures in the 4-14 age group and significantly higher rates of restorative procedures for all age groups. No such effects were seen for surgical and endodontic procedures.

Conclusions: Enrollees with Delta Dental insurance from predominantly minority zip-codes had lower rates of preventive and higher rates of restorative dental procedures. Future studies should examine the impact of more confounding factors to identify whether racial/ethnic disparity does exist.