One in four California children have never seen a dentist

Lack of dental care continues to be a significant problem for American children, who miss about 1.6 million school days each year due to dental disease. A new study published in the July issue of Health Affairs reveals that in California, nearly 25 percent of children have never seen a dentist and that disparities exist across race, ethnicity, and type of insurance when it comes to the duration between dental care visits.

The study, Racial and Ethnic Disparities in Dental Care for Publicly Insured Children, examines barriers to dental care in California children age 11 and under, using data from the 2005 California Health Interview Survey. The study contains data on nearly 11,000 children.

Researchers Nadereh Pourat, of the UCLA Center for Health Policy Research, and Len Finocchio, of the California HealthCare Foundation, found that Latino and African-American children with all types of insurance were less likely than Asian-American and white children to have visited the dentist in the prior six months or even in their entire lifetime. 

Similarly, researchers found Latino and African-American children in public insurance programs, including Medicaid and the Children’s Health Insurance Program (CHIP), went to the dentist less often than white and Asian-American children with the same insurance coverage. Overall, children with private insurance saw a dentist more often than those in Medicaid or CHIP.

“The findings suggest that having insurance isn’t always enough,” said Pourat, Ph.D., and director of research planning at the Center.  “We need to address the other barriers that keep children from getting the help they need.”

The authors note the findings raise concerns about Medicaid’s ability to address disparities in dental care access. Ultimately, they observe, more strategic efforts are necessary to overcome systemic barriers to care, including raising reimbursement rates paid to dentists who serve the Medicaid population and increasing the number of participating Medicaid providers.

“These findings indicate that many poor children in California do not make routine dental visits or simply never receive any dental care,” said Finocchio, Dr.P.H., CHCF senior program officer and study co-author. “Even with Medicaid coverage, there are tremendous barriers to getting services.”

And despite the disparities, having any form of dental insurance significantly increases the odds of seeing a dentist on a regular basis – 54 percent of privately-insured children and 27 percent of publically-insured children had seen the dentist in the last six months, compared to 12 percent of children without dental coverage.

“The data tell us that Medicaid and CHIP have improved children’s ability to get dental care,” said Pourat.  “However, both programs need to do more to reduce disparities.”

The research was supported by the California HealthCare Foundation.

Read the journal article: Racial and Ethnic Disparities in Dental Care for Publicly Insured Children

The UCLA Center for Health Policy Research is one of the nation's leading health policy research centers and the premier source of health-related information on Californians. 

The California HealthCare Foundation is an independent philanthropy committed to improving the way health care is delivered and financed in California.

The California Health Interview Survey (CHIS) is the nation's largest state health survey and one of the largest health surveys in the United States.