Dental caries and treatment need in schoolchildren related to Medicaid enrollment.

Objectives: This study compared dental caries status and treatment need in four groups of children: those not enrolled in Medicaid, those enrolled in Medicaid who used dental services prior to a dental survey, those enrolled in Medicaid who used services after the survey, and those enrolled in Medicaid who did not use dental services. Methods: This study used data on 6,620 children 5 to 18 years of age, who were representative of North Carolina schoolchildren and who participated in a statewide oral health survey in 1986–87. Clinical results from the survey were linked with a separate data base of Medicaid claims and enrollment files from 1984 to 1992. With this link, the surveyed children were classified into the four study groups and dental status compared. Results: Medicaid-enrolled children who used services prior to the survey had the highest caries prevalence of all groups (DMFS=1.74 at ages 6 to 11 years), and had fewer treatment needs (D/DMFS=19%) than children outside of Medicaid (DMFS=0.95, D/DMFS=33%). Enrolled children who never used dental services had a caries prevalence (DMFS=0.83) similar to children outside of Medicaid, yet had greater unmet treatment need (D/DMFS=62%). Conclusion: Caries prevalence did not differ substantially among groups; however, the level of unmet treatment did vary. Some Medicaid-enrolled children had a significant portion of their restorative treatment needs met.