Dental Utilization for Medicaid-­‐Enrolled Children with Cystic Fibrosis

Abstract

Background: Despite a highly cariogenic diet and frequent use of inhaled xerostomia-inducing medications, children with CF are believed to be at a lower risk for dental caries (tooth decay) compared to other children. A potential protective factor is increased use of preventive dental care, but not studies to date have examined dental use for children with CF. This goal of this study was to compare dental care use for Medicaid-enrolled children with and without CF. Methodology: Iowa Medicaid data from 2012 were analyzed for children age 3 –17 years who were enrolled in Medicaid for at least 11 months (N = 156,268). Poisson regression models were used to compare utilization rates for any dental care and also for specific categories of dental care (diagnostic, preventive, routine restorative, and complex restorative). Results: The study included 85 children with CF (0.05%). Overall, 66.8% of study children utilized dental care. Children with CF were significantly less likely to use any dental care than children without CF after adjusting for confounders (incident rate ratio: 0.819, 95% CI: 0.80–0.84, p < 0.001). Among children who utilized any dental care, children with CF were more likely to have used diagnostic and preventive care and less likely to have used restorative care than children without CF, but these differences were not statistically significant. Conclusions: Medicaid-enrolled children with CF are less likely to use dental care than children without CF. These findings suggest that greater use of dental care is an unlikely explanation for lower caries rates among children with CF.