California Children Lack Vital Dental Care

The American Academy of Pediatric Dentistry says that children should have a dental visit no later than their first birthday. But 37% of two- and three-year-olds in California have never been to the dentist, according to a report by Children Now. The rates are even lower for California’s poorest young children, as only one in three, ages birth-to-three, enrolled in Denti-Cal have seen a dentist.

By kindergarten, over 50% of children in California have experienced dental decay and 28% have untreated decay. California students miss 874,000 days of school each year due to dental problems, costing schools over $29 million each year. Children who reported recent tooth pain were four times more likely to have a low grade point average. Approximately 3.6 million children are enrolled in Denti-Cal with nearly half of all California children expected to be enrolled by 2014.

Most dentists see a low volume of children on Denti-Cal. Dentists often cite low reimbursement rates as the reason for not accepting Denti-Cal patients. In addition, 22 California counties have no pediatric dentists who accept Denti-Cal.

The 2013 to 2014 state budget includes a 10% reimbursement rate reduction to most Medi-Cal providers. The only pediatric service affected by the cut is dentistry, despite the fact that California already ranks among the lowest nationally in reimbursing dental providers in Medicaid.

The Dept. of Health Care Services worked to recruit more dental providers in 2013, during the state-mandated transition of children from Healthy Families to Medi-Cal. However, the Medi-Cal payment rate cuts are likely to reduce the number of providers.

The California Dept. of Health Care Services is creating a statewide pediatric oral health action plan to increase the number of children (ages one to 20) who get preventive dental services and children (ages six to nine) who get a dental sealant. These strategies will help increase dental utilization for children enrolled in Medi-Cal.

The report offers the following recommendations for the state:
• Increase Medi-Cal dentist reimbursement rates.
• Provide incentives for pediatricians to explain the importance of routine dental care to parents.
• Expand the use of tele-dentistry (the delivery of dental-related services and information via telecommunications technologies) to reach under served child populations.
• Expand the oral health care workforce so more children can access needed services.
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Last Updated 01/19/2022

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