The Role of Medicaid Dental Benefits in Access to Preventive Dental Care and Unmet Dental Needs During Pregnancy

TL;DR

Medicaid dental benefits in some U.S. states help pregnant women access preventive dental care and reduce unmet dental needs, especially among Black and Hispanic populations.

Contribution

This study shows that Medicaid dental benefits are linked to better dental care access and reduced unmet needs during pregnancy, particularly for racial and ethnic minorities.

Findings

States with Medicaid dental benefits had a 6.7 percentage point higher likelihood of dental cleanings during pregnancy.

Medicaid dental benefits were associated with a 4.0 percentage point lower likelihood of unmet dental needs.

Non-Hispanic Black women saw the strongest benefit increase in dental cleaning rates.

Abstract

Maintaining oral health during pregnancy is important for maternal and child health, yet many lowincome individuals face barriers to dental care. Medicaid dental benefits vary by state and may influence access to preventive services and unmet dental needs during pregnancy. This study examined whether state Medicaid dental benefits for pregnant women were associated with preventive dental care use and unmet dental needs, overall and by race and ethnicity.

We analyzed data from the Pregnancy Risk Assessment Monitoring System for 45 states from 2012 to 2021 using a pooled cross-sectional design. The sample included Medicaid-enrolled pregnant women. Outcomes were receipt of a dental cleaning and reporting unmet dental needs during pregnancy. State Medicaid dental benefit status was the primary exposure. Descriptive and bivariate analyses summarized sample characteristics and outcome prevalence. Multivariable regression models estimated adjusted differences in outcomes by benefit status. Subgroup analyses were conducted for Hispanic, non-Hispanic White, non-Hispanic Black, and non-Hispanic Other groups.

Among Medicaid-enrolled pregnant women, 34.1% reported a dental cleaning and 10.8% reported unmet dental needs. Living in a state with Medicaid dental benefits was associated with a 6.7 percentage point higher likelihood of receiving a dental cleaning (95% CI: 4.0, 9.5) and a 4.0 percentage point lower likelihood of reporting unmet dental needs (95% CI: −6.4, − 1.7). The association with dental cleaning was strongest among non-Hispanic Black women (9.1 percentage points; 95% CI: 2.6, 15.6), followed by Hispanic women (8.3; 95% CI: 1.6, 15.1) and non-Hispanic White women (5.7; 95% CI: 2.0, 9.4). A significant association with reduced unmet needs was observed only among non-Hispanic White women.

State Medicaid dental benefits were associated with greater use of preventive dental care and fewer unmet dental needs during pregnancy. Expanding dental coverage for pregnant Medicaid beneficiaries may improve access to oral health care and help reduce disparities.