According to an award-winning study on children with and without Medicaid, a Case Western Reserve University third-year dental student found that Medicaid children have three times the unmet dental problems and treatment needs than other non-Medicaid children.
In a related study, Anita Bhavnani, of Scottsdale, Ariz., also surveyed nearly 400 dental providers to find out what prevents dentists from taking on Medicaid patients.
"Medicaid children have an urgent need for improved access to dental care—including preventative services," said Bhavnani, lead researcher on the studies, "The Oral Health Status of Medicaid and non-Medicaid Children," and "Dentists' Perception about the Medicaid Dental Program in Cuyahoga County, Ohio."
The research project evolved from her dental education at the university. As a student dentist in the Healthy Smiles Sealant Program that gave preventative dental exams, sealants, toothbrushes and oral health education to more than 26,000 Cleveland school children from 2001-2007, Bhavnani said the "first-hand experience made me aware that children in the area have blown out teeth and caries everywhere."
"Children told me they do not have toothbrushes," she added.
With research support from the dental school, Bhavnani reviewed the records of nearly 200 children that had services provided through the Tapper Pediatric Dental Clinic at Rainbow Babies & Childrens Hospital to determine the status and oral health treatment needs of the county's children. She recorded the prevalence and severity of dental caries and what treatment was provided. She then made a comparison between the Medicaid and non-Medicaid groups. The average age of the children was five years old, with 71.4 percent of Medicaid children and 44.1 percent of non-Medicaid children showing untreated dental cavaties.
Noting that unmet dental needs are just half of the problem, Bhavnani surveyed local dentists to find out reasons why they do not offer services to Medicaid patients. The major roadblocks were financial reasons, lack of patient compliance in keeping appointments and the cumbersome paper work needed for reimbursement of services provided.
She explained that when Medicaid patients do not make appointments, the dentist is not compensated for missed appointments but is for the non-Medicaid patient.
Bhavnani conducted the study between her first and second year.
The research has received numerous honors, including the International Association for Dental Research's Colgate Research in Prevention Travel Award, following a presentation during the IADR's 85th General Session and Exhibition; the American Dental Association's Dentsply Student Clinician Research Award; and the American Dental Education Association's Listerine Preventative Dentistry Scholarship. Bhavnani won honorable mention during the 2007 Research ShowCASE at the university and recently presented this project at the 2007 Hinman Student Research Symposium.
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