Dental sealant use among Medicaid eligible children

Dental sealant service use among Medicaid eligible children by:

Dental sealants can prevent tooth decay and cavities

Children enrolled in Medicaid and other Minnesota Health Care Programs can receive dental sealants. A dental sealant is a thin plastic coating most commonly applied to the biting surfaces of premolars and molars (8 back teeth) to prevent tooth decay and cavities. Other teeth with pits and grooves can be sealed. Dental sealants may also stop the tooth decay process in teeth that show signs of decay (change in color, glossiness, or surface structure), but do not have a cavity.

Evidence-based clinical guidance from the American Dental Association and the American Academy of Pediatric Dentistry strongly recommend dental sealants for all children, especially when their first permanent molars appear (see Report: Evidence-based clinical practice guidelines for the use of pit and fissure sealants: a report of the American Dental Association and the American Academy of Pediatric Dentistry [pdf]). First permanent molars (also known as “6-year molars”) appear at ages 5 through 7 years. Second permanent molars (also known as “12-year molars”) appear at ages 11 through 14 years.

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

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 program with yearly well-child care health and dental visits.

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 records dental sealant service use:

  • Among children ages 6 to 14 years,
  • Enrolled in Medicaid and other state health insurance programs at least 90 continuous days,
  • During federal fiscal year (October 1 through September 30).

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 dental sealants only on children’s permanent molar teeth with replacement every five years (Minnesota Statutes 2018, chapter 256B.0625, subd. 9). Dental sealants are provided by any oral health professional for whom placing a sealant is within their legislative scope of practice (i.e. dentist or dental hygienist with a collaborative agreement). For more information: About the Child and Teen Checkups Program (CMS-416) Report.      

Dental sealants are provided by any oral health professional for whom placing a sealant is within their scope of practice (e.g., dentist, dental hygienist with a collaborative agreement). For more information visit:About the CTC program CMS-416 report data.

Many children are not receiving recommended dental sealants

During federal fiscal year 2018, about 1 out of 10 Minnesota C&TC eligible children (14%) ages 6 to 14 years had at least one dental sealant placed on a permanent molar tooth. This includes the 6 to 9 year old first permanent molar group (15%) and the 10 to 14 year old second permanent molar group (13%).

Although not directly comparable, the prevalence of dental sealants in Minnesota third grade public school students in 2015 was 60% or 6 in 10 third graders (see View charts: Dental sealants).  

1 out of every 10
C&TC eligible children (6 to 14 years)

 

(13.9%, 95% CI = 13.7 to 14.0; n = 37,717 of 272,234)

Have at least one dental sealant on a permanent molar tooth
FFY 2018


Permanent molar dental sealant placement among Child and Teen Checkup (C&TC) eligible children by race and ethnicity, federal fiscal year 2018

 
Source: Minnesota Department of Human Services. Early and Periodic Screening, Diagnosis, and Treatment (CMS-416) Report.
Race and ethnicity Number of C&TC eligible children
(6 to 14 years)
Number of C&TC eligible children
(6 to 14 years) with
at least one dental sealant placed on a permanent molar tooth
Percent C&TC eligible children
(6 to 14 years) with at least one dental sealant placed on a permanent molar tooth within race and ethnicity groups (row percent)
95% Confidence Interval

American Indian/
Alaska Native

7,410 1,256 17.0% 16.1 to 17.8
Hispanic/Latino 17,033 2,628 15.4% 14.9 to 16.0
African American or Black 38,808 5,797 14.9% 14.6 to 15.3
Asian or Pacific Islander 13,845 2,001 14.5% 13.9 to 15.0
Two or more races 13,591 1,721 12.7% 12.1 to 13.2
White 92,906 11,402 12.3% 12.1 to 12.5

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 aged 6 to 14 years enrolled during FFY 2018 with a known single race and ethnicity or mixed race = 183,593. Unknown or missing race and ethnicity (not shown in this chart) = 12,912 with at least one dental sealant of 88,641 eligible. Two or more races = any combination of two or more single race and ethnicity.   

A dental sealant is a thin plastic coating applied to the biting surfaces of molars (8 flat teeth in the back of the mouth) to prevent tooth decay and cavities. 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 sealant placement within race and ethnicity groups (row percentages). See About the Child and Teen Checkups Program (CMS-416) Report for more information.

Regardless of race and ethnicity, dental sealant rates for C&TC eligible children aged 6 to 14 years remained low in federal fiscal year 2018.

 

Child & Teen Checkup eligible children dental sealant placement

 

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 aged 6 to 14 years enrolled during FFY 2018 = 272,234.

A dental sealant is a thin plastic coating applied to the biting surfaces of molars (8 flat teeth in the back of the mouth) to prevent tooth decay and cavities. 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 sealant placement within race and ethnicity groups (row percentages). See About the Child and Teen Checkups Program (CMS-416) Report for more information.

During federal fiscal year 2018, C&TC eligible children in Rice County (24 percent) had the highest dental sealant rate and C&TC eligible children in Pennington County (5 percent) had the lowest dental sealant rate. Some counties had dental sealant rates that were statistically different from the statewide rate.