Pediatric dental care use and parent- or caregiver-rated oral health among Alabama children enrolled in Medicaid

Justin Blackburn, Aleena Bennett, Matthew Fifolt, Andrew C. Rucks, Heather Taylor, Paul Wolff, Bisakha Sen

Research output: Contribution to journalArticlepeer-review


Background: Reducing caries and improving access to dental care is a public health challenge. Understanding low use of dental care is of critical importance. This study estimated parent- or caregiver-reported prevalence and identified factors associated with children's dental care use, including the association with children's oral health. Methods: A cross-sectional analysis of children enrolled in Medicaid in Alabama, using data from the 2017 statewide Consumer Assessment of Healthcare Providers and Systems Health Plan Survey, was conducted. Associations were measured using adjusted prevalence ratios (aPRs) and 95% confidence intervals (CIs) from logit regression and generalized linear model postestimation of least-squares means. Results: The 6-month prevalence of children receiving dental care was 70.4%. Children aged 0 through 3 years (aPR, 0.72; 95% CI, 0.53 to 0.91) had lower prevalence of care than other age groups. The prevalence of low-rated oral health was 9.2%. Low-rated oral health was associated with not receiving dental care (aPR, 1.50; 95% CI, 1.12 to 1.87) and parental education of 8th grade or less (aPR, 2.59; 95% CI, 1.20 to 3.98). Falsification tests determined that dental care use was not associated with ratings for overall health (aPR, 1.18; 95% CI, 0.83 to 1.52) or emotional health (aPR, 1.06; 95% CI, 0.79 to 1.33). Conclusions: It was observed that children not receiving dental care had low-rated oral health; however, as a cross-sectional study, it was not possible to assess the temporality of this relationship. Practical Implications: Oral health care providers should continue to recognize their role in educating parents and providing anticipatory guidance on children's oral health.

Original languageEnglish (US)
Pages (from-to)416-426
Number of pages11
JournalJournal of the American Dental Association
Issue number6
StatePublished - Jun 2020


  • Children's dental care
  • Consumer Assessment of Healthcare Providers and Systems
  • Medicaid
  • dental health services
  • oral health

ASJC Scopus subject areas

  • Dentistry(all)

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