Rural-urban differences in early childhood dental service utilization patterns among Medicaid-enrolled children in South Carolina

Purpose: This study examined rural-urban differences in dental care utilization during early childhood among Medicaid enrolled children aged younger than 4 years in South Carolina (SC). Methods: We conducted a secondary data analysis using Medicaid data stored by the Office of Research and Statistics of the SC State Budget and Control Board. Dependent variables included regular preventive dental visits, use of emergency room (ER) and primary care (PC) services for dental reasons, receipt of fluoride varnish, and dental home status. The primary independent variable was child's area of residence, rural or urban. The control variables included child's age, gender, race, special healthcare need status, and dental health professional shortage area designation. Results: In adjusted analyses, rural children were found to have significantly higher odds of lacking regular preventive dental visits, fluoride varnishes, and dental homes as well as using ER and PC services for dental reasons compared to urban children. However, for regular preventive dental visits, use of PC services for dental reasons, and receipt of fluoride varnish, the rural-urban difference was not a simple function of rural residence. Race and gender interacted with rurality in explaining the differences in these outcomes. Conclusion: Rural Medicaid-enrolled pre-school children continue to have significant disparities in dental care utilization during early childhood compared to urban children living in SC. Focused efforts and targeted interventions are needed to address these disparities and to ensure availability of and access to dental care services for young children in rural areas.