The Role of Physicians in Children’s Oral Health

Dental disease is the most common chronic disease among children in the United States. Although Medicaid entitles children to medically necessary dental care under the Early and Periodic Screening, Diagnostic and Treatment (EPSDT) benefit, many children do not see a dentist until age 3 or later – even though cavity risk factors can be well established before a child’s first birthday and before the first tooth erupts. Untreated dental disease can lead to dietary problems, infection, missed school days, and a lower quality of life. This state health policy monitor highlights two recent surveys, which detail the extent and characteristics of twenty-five state Medicaid programs that reimburse physicians for providing basic preventive oral health care to young children during an office visit. The early and frequent contact that most young children typically have with physicians presents a unique opportunity to evaluate their oral condition and perform basic preventive services. States most often reimburse physicians for application of fluoride varnish, which helps prevent cavities; some states also reimburse separately for additional services such as risk assessments, oral exams, and face to face parent/caregiver education about proper oral health practices. Some states, such as North Carolina, are seeing fewer dental caries (cavities) in their young populations and an increase in the utilization of oral health care services. Through these state programs, policy makers seek to improve the condition of children’s oral health.  

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