In addition to regular preventive medical visits, it is recommended that children have regular preventive dental visits. Although the AAP does not have a periodicity schedule for dental visits, the American Academy of Pediatric Dentistry guidelines indicate that beginning at age one, children should have preventive dental procedures "every 6 months or as indicated by individual patient's risk status/susceptibility to disease." Figure 5 indicates the rate of preventive dental visits for children and youths for the three plans across four different age categories: 2-6, 7-11, 12-15, and 16-18. In this figure, rates are calculated for all children regardless of length of enrollment. Figure 6 provides the same rates, but includes only children who were eligible for at least 11 months during FY 2001. These rates were calculated according to the protocol established for the HEDIS dental outcome measures. Across all age groups in both figures, children in Iowa Health Solutions had the lowest rates of preventive dental care. Preventive dental utilization rates for children in Wellmark and John Deere were more comparable.

Figure 5. Percent of children with a preventive dental visit in
fiscal year 2001 by age and plan

Figure 6. Percent of children enrolled in a plan for at least 11 months
with a preventive dental visit in fiscal year 2001 by age and plan

The rates for children who had any dental visit, not just a preventive dental visit, and who were enrolled for at least 11 months are presented in Figure 7. Once again, children in Iowa Health Solutions had the lowest visit rates regardless of age group.

Figure 7. Percent of children enrolled in a plan for at least 11 months
with any type of dental visit in fiscal year 2001 by age and plan

 

Across the three figures, for children ages 2-6 and 16-18, John Deere had the highest utilization rates, while for children 5-15, Wellmark had the highest utilization rates.

The consistently low rates for Iowa Health Solutions should be of concern. For some age groups the rates for this plan were less than half those of the other plans. This may be due to poor access to providers, geographic differences in practice and care seeking, or ineffective communication regarding the services and providers available to enrollees. Further investigation is needed to monitor these rates over time and to determine the factors that underlie the rate differentials.

Figure 8 compares dental rates for children enrolled in Medicaid to those of children enrolled in the hawk-i program for at least 11 months. Children in hawk-i had consistently higher rates of utilization than children in the Medicaid program for this measure. This may be due to increased need in the population entering hawk-i , or it could be that the managed care plan dental panels offer enhanced access to dentists.

Figure 8. Comparison of dental utilization rates for children
enrolled for at least 11 months in Medicaid or hawk-i

American Academy of Pediatric Dentistry. 2003-2004 Policy guidelines: Periodicity of Examination, Preventive Dental Services, Anticipatory Guidance and Oral Treatment for Children. Available at http://www.aapd.org/media/policies.asp . Most recently accessed October 3, 2003.