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Children's Access to Dental Care in Rhode Island

Written by: Rhode Island KIDS COUNT

This has been excerpted from the 2019 Rhode Island KIDS COUNT Factbook. To see the full publication, please click here

Dental caries (tooth decay) is the most common chronic disease among children. Poor oral health has immediate and significant negative impacts on children’s overall health, growth and development, school attendance, and academic achievement.

Insurance is a strong predictor of access to health and dental care. Twenty-one percent of uninsured children in the U.S. have unmet dental needs, compared with 5% of those with Medicaid and 3% of those with private health insurance. In Rhode Island, pediatric dental coverage is embedded in most private health insurance coverage, and RIte Smiles is Rhode Island’s dental insurance for Medicaid-eligible children born after May 1, 2000.

Children living in poverty are more likely to have untreated tooth decay than higher-income children. For children in low-income families, the efficacy and continuity of public dental insurance is a critical factor in access to dental care. In the U.S. and in Rhode Island, children who have public health insurance coverage have greater access to dental and medical care than children who have no insurance.

Children of color have the highest rates of tooth decay and untreated dental problems. In Rhode Island and the U.S., non-Hispanic White children are more likely to have had a recent dental visit than non-Hispanic Black or Hispanic children.

Some evidence suggests that poor oral health during pregnancy is a potential risk factor for some pregnancy complications and poor birth outcomes, including preterm birth and low birthweight infants. Although oral health care can be safely provided during pregnancy, less than two-thirds (59%) of Rhode Island women report having a dental visit during their pregnancy. Rhode Island women without insurance and low incomes are less likely to see a dentist. Of the women who received preventive dental care during their pregnancy, 50% participated in WIC and 21% were uninsured.

Children with special health care needs may have problems finding and accessing providers who are trained and equipped to address their special dental, medical, behavioral, and mobility needs. A dental home can provide comprehensive, continuously accessible, coordinated, and family-centered dental care for all children, including those with special needs.

  • Fifty-three percent (67,981 of the children who were enrolled in RIte Care, RIte Share, or Medicaid fee-for-service on June 30, 2018 received a dental service during State Fiscal Year (SFY) 2018. The number of children receiving dental services has increased by 57% since 2006, when RIte Smiles launched.
  • The federal Early and Periodic Screening, Diagnostic and Treatment (EPSDT) standard requires that states provide comprehensive dental benefits to children with Medicaid coverage, including preventive dental services.18 In Rhode Island, 45% of children with Medicaid in Rhode Island received a preventive dental visit in FFY 2017.
  • RIte Smiles, Rhode Island’s managed care oral health program for children has been credited with improving access to dental care for children. RIte Smiles is for low-income children born on or after May 1, 2000, and the cohort expands through an eligibility age-in process. As of December 31, 2018, there were 113,462 children enrolled in RIte Smiles.

This has been excerpted from the 2019 Rhode Island KIDS COUNT Factbook. To see the full publication, please click here

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