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No Toddlers in the Dentist's Chair at Some Offices
April 10, 2013

By Nancy Volkers
InteliHealth News Service

INTELIHEALTH - Dental experts say children should start visiting the dentist by age 1. But a survey of New York City dentists finds that many general dentists,and even some children's dentists, will not see very young Medicaid managed care patients.

New York City researchers did the study. They mailed surveys to 2,311 general dentists and 140 pediatric dentists in the city's 5 boroughs. All of the dentists took part in Medicaid managed care plans. Just under half of the surveys were filled out and returned.

Nearly half (45%) of the general dentists said they did not see children under the age of 3. About 9% did not see children under age 6. Even 2% of the pediatric dentists did not see children younger than 3.

General dentists who saw young patients tended to provide examinations and set up treatment plans. They also educated parents and caregivers. They were less likely to provide preventive services, such as fluoride treatments. They also were less likely to restore teeth, for example by placing fillings.

The main reasons that general dentists did not see young children were:

  • Discomfort dealing with small children (56%)
  • Concern about disruption due to crying (31%)
  • Low payments by insurance (26%)

The survey also found a relative shortage of dentists seeing young children in low-income areas of the city. For every 100,000 Medicaid patients under age 6, there were 4 times as many dentists accepting patients of all ages in low-poverty areas, compared with high-poverty areas.

Tooth decay is the most common chronic disease in young children. It is five times more common than asthma. Poor children have a higher risk of tooth decay. They are also more likely than other children to have untreated dental problems.

Nationwide, only about 13% of 1- and 2-year-old children on Medicaid receive preventive dental care. A study of children who were continuously enrolled in Medicaid showed that early care saves money. The study found that the older a child was when first visiting the dentist, the higher dental costs were.

Other state-based surveys have shown that as many as 66% of general dentists do not treat young children. In the New York City study, some general dentists said they were willing to start seeing young children. However, they wanted more training or access to a consulting pediatric dentist.

About 80% of U.S. dentists are general dentists. Fewer than 2% of all U.S. dentists specialize in treating children. (Because of this, the researchers recommend training programs for general dentists, as well as chances increasing the opportunities for them to consult with pediatric dentists. The researchers also recommend more educational programs to give general dentists more experience with young children.

The study appears in the April issue of the Journal of the American Dental Association.

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