Dental service use among Medicaid-eligible children

Dental service use among Medicaid eligible children by:

Children enrolled in Medicaid and other Minnesota Health Care Programs can receive dental services  

Child and Teen Checkups (C&TC) is Minnesota’s Early and Periodic Screening, Diagnosis, and Treatment (EPSDT) Program—a federal program required in every state to provide children enrolled in a Medicaid or public health insurance programs with yearly well-child care health and dental visits.

The American Academy of Pediatric Dentistry and the American Academy of Pediatrics recommend at least one dental visit each year, starting by the child’s first birthday, when the first tooth appears, or whichever occurs first. Dental visits are important to maintain healthy gums and teeth, prevent dental disease, and identify any treatment needs.

Children eligible for Minnesota’s C&TC services include all children under the age of 21 enrolled in a Medicaid or Children Health Insurance (CHIP) expansion program (Medical Assistance) or MinnesotaCare (collectively called Minnesota Health Care Programs).

The following is based on data from the CMS-416 Report, which reports on children oral health measures such as dental service use among children:

  • Ages 1 to 20 years
  • Enrolled in a Minnesota Health Care Program (MHCP) for at least 90 consecutive days
  • By federal fiscal year (October 1 through September 30).

A dental service is any diagnostic, preventive, or treatment service provided by or under the supervision of a dentist. Data come from paid, unpaid and denied fee-for-service claims and encounter data reported to the Minnesota Department of Human Services. MHCP pays for any medically necessary dental services for children (Minnesota Statutes 2018, chapter 256B.0625, subd. 9). For more information: About the Child and Teen Checkups Program (CMS-416) Report.

 

Less than half of Medicaid eligible children receive at least one yearly dental service

4 out of every 10
C&TC eligible children (1 to 20 years)

 

(42.0%, 95% CI = 41.9 to 42.2; n =247,077 of 587,857)

Have at least one dental service
FFY 2018

During federal fiscal year 2018, 4 out of 10 Minnesota C&TC eligible children aged 1 to 20 years (42 percent) had at least one dental service.

Although not directly comparable, 81 percent of children in Minnesota aged 1 to 17 years had at least one dental visit in 2016. This prevalence data comes from a web/mail-based survey of parents and guardians (see View Charts: Dental visits).  


 

Dental service use among C&TC eligible children by age, federal fiscal year 2018

 
Source: Minnesota Department of Human Services. Child and Teen Checkups (CMS-416) Report.
Age group (years) Number of C&TC eligible children Number of C&TC eligible children with at least one dental service Percent C&TC eligible children dental service use within age groups (row percent) 95% Confidence Interval
Less than 1 26,080 157 0.6% 0.5 to 0.7
1 to 2 74,172 10,327 13.9% 13.7 to 14.2
3 to 5 100,214 42,676 42.6% 42.3 to 42.9
6 to 9 124,896 65,784 52.7% 52.4 to 52.9
10 to 14 147,338 74,017 50.2% 50.0 to 50.5
15 to 18 99,437 42,314 42.6% 42.2 to 42.9
19 to 20 41,800 11,959 28.6% 28.2 to 29.0

Data include Child and Teen Checkups (C&TC) eligible children enrolled in a Minnesota Health Care Program for at least 90-continuous days during the federal fiscal year (FFY) (October 1 through September 30). Total eligible children (1 to 20 years) enrolled during FFY 2018 = 587,857

A dental service is any diagnostic, preventive, or treatment service provided by or under the supervision of a dentist. Data is based on all unduplicated counts of paid, unpaid, and denied claims submitted for reimbursement from fee-for-service providers, managed care plans, Indian Health Services, and Federally Qualified Health Centers that contract with the Minnesota Department of Human Services. This chart represents percent dental service use within age groups (row percentages). See About the Child and Teen Checkups Program (CMS-416) Report data for more information.

 

Among C&TC eligible children who received a dental service during federal fiscal year 2018, the majority were between the ages of 3 to 18 years. However, half to less than half of each age group received the recommended yearly dental visit. Most notable, are the very low proportion of 0 to 2 year olds and 19 to 20 year olds who received at least one dental service.   


 

Dental service use among C&TC eligible children by race and ethnicity, federal fiscal year 2018

 
Source: Minnesota Department of Human Services. Child and Teen Checkups (CMS-416) Report.
Race and ethnicity Number of C&TC eligible children
(1 to 20 years)
Number of C&TC eligible children
(1 to 20 years) with
at least one dental service
Percent C&TC
eligible children
(1 to 20 years)
with at least one
dental service within race and ethnicity groups
(row percent)
95% Confidence Interval
American Indian/Alaska Native 15,637 6,998 44.8% 44.0 to 45.0
Asian or Pacific Islander 29,693 12,951 43.6% 43.1 to 44.2
African American or Black 80,630 34,282 42.5% 42.2 to 42.9
Hispanic/Latino 34,777 14,737 42.4% 41.9 to 42.9
White 193,059 81,215 42.1% 41.8 to 42.3
Two or more races 27,024 11,014 40.8% 40.2 to 41.3

Data include Child and Teen Checkups eligible children enrolled in a Minnesota Health Care Program for at least 90-continuous days during the federal fiscal year (FFY) (October 1 through September 30). Total eligible children (1 to 20 years) enrolled during FFY 2018 with a known single race and ethnicity or mixed race = 380,820 Unknown or missing race and ethnicity (not shown in this chart) = 85,880 with at least one dental service out of 207,037 eligible. Two or more races = any combination of two or more single race and ethnicity.      

A dental service is any diagnostic, preventive, or treatment service provided by or under the supervision of a dentist. Data is based on all unduplicated counts of paid, unpaid, and denied claims submitted for reimbursement from fee-for-service providers, managed care plans, Indian Health Services, and Federally Qualified Health Centers that contract with the Minnesota Department of Human Services. This chart represents percent dental service use across race and ethnicity groups (row percentages). See About the Child and Teen Checkups Program (CMS-416) Report data for more information.

 

 

During federal fiscal year 2018 there were no major differences in dental service use by race and ethnicity.


 

C&TC eligible children (1 to 20 years) dental service use, federal fiscal year 2018

   

Child and Teen Checkups eligible children include all children enrolled in a Minnesota Health Care Program (Medical Assistance or Medicaid, MNCare) for at least 90-continuous days during the federal fiscal year (FFY) (Oct. 1 through Sept. 30). Total eligible children (1 to 20 years) enrolled during FFY 2018 = 587,857. A dental service is any diagnostic, preventive, or treatment service provided by or under the supervision of a dentist. Data is based on all unduplicated counts of paid, unpaid, and denied claims submitted for reimbursement from fee-for-service providers, managed care plans, Indian Health Services, and Federally Qualified Health Centers that contract with the Minnesota Department of Human Services. See About the Child and Teen Checkups Program (CMS-416) Report data for more information.

Lake County C&TC eligible children (66%) had the highest dental service use and Rock County C&TC eligible children (24%) had the lowest dental service use of all counties. Some counties were significantly different from the statewide rate.