Density of pediatric dentists and preventive dental care utilization for Medicaid-enrolled children in Washington State

Thesis (Master's)--University of Washington, 2014Purpose: This study evaluates the relationship between pediatric dentist density and dental care use for Medicaid-enrolled children in Washington. Methods: This is a cross-sectional analysis of 604,885 children ages 0-17 enrolled in Washington State Medicaid for 11 months or more in 2012. The relationship of pediatric dentist density, defined as the number of pediatric dentists per 10,000 Medicaid-enrolled children, and preventive dental care utilization by county was evaluated using linear regression models. Results: In 2012, 179 pediatric dentists practiced in 16 of the 39 counties in Washington. County-level pediatric dentist density varied from zero to 5.98 pediatric dentists per 10,000 Medicaid-enrolled children. County-level preventive dental care utilization ranged from 32% to 81%, with 62% of Medicaid-enrolled children in Washington receiving preventive dental services. After adjusting for confounders, county-level density was significantly associated with county-level dental care use (â =1.67, 95% CI = (0.02, 3.32), p=0.047). Conclusions: There is a significant relationship between pediatric dentist density in a Washington State county and the proportion of Medicaid-enrolled children who receive preventive dental care services. Policies aimed at improving pediatric oral health disparities should include strategies to increase the number of pediatric dentists who practice in counties with large numbers of Medicaid-enrolled children