ERIC Number: ED502957
Record Type: Non-Journal
Publication Date: 2008-Sep
Medicaid: Extent of Dental Disease in Children Has Not Decreased, and Millions Are Estimated to Have Untreated Tooth Decay. Report to Congressional Requesters. GAO-08-1121
Cosgrove, James C.
US Government Accountability Office
In recent years, concerns have been raised about the adequacy of dental care for low-income children. Attention to this subject became more acute due to the widely publicized case of Deamonte Driver, a 12-year-old boy who died as a result of an untreated infected tooth that led to a fatal brain infection. Deamonte had health coverage through Medicaid, a joint federal and state program that provides health care coverage, including dental care, for millions of low-income children. Deamonte had extensive dental disease and his family was unable to find a dentist to treat him. GAO was asked to examine the extent to which children in Medicaid experience dental disease, the extent to which they receive dental care, and how these conditions have changed over time. To examine these indicators of oral health, GAO analyzed data for children ages 2 through 18, by insurance status, from two nationally representative surveys conducted by the Department of Health and Human Services (HHS): the National Health and Nutrition Examination Survey (NHANES) and the Medical Expenditure Panel Survey (MEPS). GAO also interviewed officials from the Centers for Disease Control and Prevention, and dental associations and researchers. In commenting on a draft of the report, HHS acknowledged the challenge of providing dental services to children in Medicaid, and cited a number of studies and actions taken to address the issue. Survey data on Medicaid children's receipt of dental care showed some improvement; for example, use of sealants went up significantly between the 1988 through 1994 and 1999 through 2004 time periods. Rates of dental disease, however, did not decrease, although the data suggest the trends vary somewhat among different age groups. Younger children in Medicaid--those aged 2 through 5--had statistically significant higher rates of dental disease in the more recent time period as compared to earlier surveys. By contrast, data for Medicaid adolescents aged 16 through 18 show declining rates of tooth decay, although the change was not statistically significant. Appended are: (1) NHANES Analysis; (2) MEPS Background and Analysis; (3) Comments from the Department of Health and Human Services; and (4) GAO Contact and Staff Acknowledgments. (Contains 9 tables and 7 figures.)
Descriptors: State Programs, Income, Dental Health, Diseases, Child Health, Dentistry, Federal Programs, Health Services, Health Insurance, Access to Health Care, Comparative Analysis, Low Income Groups, Children, Adolescents, National Surveys, Interviews, Dental Evaluation
US Government Accountability Office. 441 G Street NW, Washington, DC 20548. Tel: 202-512-6000; Web site: http://www.gao.gov
Publication Type: Reports - Evaluative
Education Level: N/A
Authoring Institution: General Accounting Office, Washington, DC.