Study: 1 in 5 kids don't see dentist each year

February 23, 2010

Alison Young

At least one in five U.S. children go without annual dental care and most states lack key policies to ensure access to cost-saving preventive treatments, according to a study released Tuesday by the Pew Center on the States.

Six states received an "A" grade from the non-profit policy analysis group for their dental health policies. But even children in those states have problems accessing care, the report said.

"Americans will be spending $106 billion on dental care this year," said Shelly Gehshan, director of the Pew Children's Dental Campaign. Much of that care pays for costly treatments such as fillings and root canals, which have their origins in poor childhood dental care, she said.

GRADING THE STATES: How does your state fare in dental care?

Among eight policy solutions it graded states on:

School-based dental sealant programs. Just 17 states have programs to apply cavity-preventing sealants to children's molars in at least 25% of schools with low-income children.

Fluoridated water. Only 26 states have at least 75% of their citizens on community water supplies with adequate fluoride to prevent tooth decay.

Medicaid payments. Many dentists aren't willing to accept Medicaid reimbursement rates set below the actual cost of treatment. Only 25 states pay dentists at least 60.5% of retail fees. Medicaid is a joint state-federal program serving low-income patients, and state policies vary.

"That is a huge issue," American Dental Association President Ron Tankersley said. In states covering actual costs, "dentists will step up to the plate and take care of these kids."

In Rhode Island, which received an "A," the number of dentists treating Medicaid children increased from 27 to 217 — nearly half of dentists statewide — after the state increased payments and made other program changes in 2006.

South Carolina, which ranked best in the study, has in place seven of the eight dental policies.

"The policies have definitely impacted children's dental health," said Christine Veschusio, South Carolina's oral health director. "But we still have more children than we would like that are in school with untreated tooth decay."

New Jersey ranked last with only one of eight benchmark policies. Suzanne Esterman, a state Medicaid spokeswoman, said the agency questions some measures in the report. "New Jersey has made great strides ... to improve the number of children who receive care," she said.

Grading the States

The Pew Center on the States scored states on eight policy benchmarks it considers critical to children having access to and receiving dental care. These benchmarks include cost-effective ways to prevent costly dental problems, Medicaid improvements and gathering data to improve performance. The full report is available at www.pewcenteronthestates.org/costofdelay.

"A" states: Met at least six of the eight policy benchmarks and had policies needed to improve dental care

Connecticut

Iowa

Maryland

New Mexico

Rhode Island

South Carolina

"D" states: Met three of the policy benchmarks

Alabama

District of Columbia

Indiana

Mississippi

Montana

Nevada

Utah

"B" states: Met five of the policy benchmarks

Alaska

Colorado

Idaho

Illinois

Maine

New Hampshire

Ohio

Texas

Washington

"F" states: Met only one or two policy benchmarks

Arkansas

Delaware

Florida

Hawaii

Louisiana

New Jersey

Pennsylvania

West Virginia

Wyoming

"C" states: Met four of the policy benchmarks

Arizona

California

Georgia

Kansas

Kentucky

Massachusetts

Michigan

Minnesota

Missouri

Nebraska

New York

North Carolina

North Dakota

Oklahoma

Oregon

South Dakota

Tennessee

Vermont

Virginia

Wisconsin