Projected Oral Health Outcomes and Costs Associated With Pediatric Medicaid Disenrollment
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By
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Sung Eun Choi
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Lisa Simon
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Catherine Hayes
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William V. Giannobile
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May 12, 2026
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Clinical Scorecard: Anticipated Dental Health Impacts and Financial Implications of Pediatric Medicaid Disenrollment
At a Glance
| Category | Detail |
|---|
| Condition | Pediatric dental health and access to care |
| Key Mechanisms | Impact of Medicaid coverage on dental care access and outcomes |
| Target Population | Children aged 0 to 18 years, particularly from low-income families |
| Care Setting | Community and emergency dental care settings |
Key Highlights
- Nearly 1 in 5 US children aged 5 to 19 years have untreated dental caries.
- Medicaid provides dental coverage to approximately 37.3 million children.
- Projected loss of Medicaid coverage could affect 480,000 children annually from 2025 to 2034.
- Insurance coverage in childhood is dynamic, with 42% experiencing uninsurance by age 18.
- Loss of Medicaid may widen gaps in access to dental care and oral health outcomes.
Guideline-Based Recommendations
Diagnosis
- Utilize NHANES data for baseline demographic and clinical data on pediatric dental health.
Management
- Implement policies to maintain Medicaid coverage for low-income children to ensure access to dental care.
Monitoring & Follow-up
- Track dental caries prevalence and treatment outcomes among children with varying insurance statuses.
Risks
- Increased risk of untreated dental caries and complications such as tooth abscess and loss.
Patient & Prescribing Data
Children aged 0 to 18 years, particularly those from low-income families
Insurance type influences the probability of receiving treatment for dental caries.
Clinical Best Practices
- Encourage continuous Medicaid enrollment to prevent gaps in dental care access.
- Utilize simulation models to predict impacts of policy changes on pediatric dental health.
- Incorporate sociodemographic factors in assessing dental care needs and outcomes.
Related Resources & Content
