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Dental insurance and its impact on preventive dental care visits for U.S. children.

BACKGROUND
The authors sought to describe the proportion and characteristics of U.S. children with dental insurance and to assess the relationship between dental insurance and preventive dental care (PDC).


METHODS
The authors used the National Survey of Children's Health, designed to represent all U.S. children. Outcomes of interest were dental insurance status and at least one PDC visit in the previous year.


RESULTS
Seventy-seven percent of U.S. children had dental insurance; of these, 29 percent had public dental insurance. Overall, 16.3 million children lacked dental insurance, 2.6 times the number of children who did not have medical insurance. Children uninsured for dental care were less than half as likely to have received PDC. Among children without dental insurance, 3 million were potentially eligible for public dental insurance and 8 million had private medical insurance but no dental insurance. While the majority of children younger than 3 years had dental insurance, few received PDC (for example, 76 percent of 2-year-olds had dental insurance but less than one-quarter had received PDC). Race/ethnicity was an important modifier in the relationship between insurance coverage and PDC. African-American children, regardless of dental insurance type, were significantly less likely than white children to have received PDC.


CONCLUSIONS
Dental insurance, whether public or private, is associated with the receipt of PDC. However, disparities in PDC disproportionately affect young children and black and multiracial children, even those with dental insurance. Despite recent increases in the number of children with dental insurance, 2.6 times as many children did not have dental insurance compared with those who had medical insurance.


CLINICAL IMPLICATIONS
The authors offer recommendations to increase the availability of dental insurance to U.S. children.