Children’s Dental Health
..................................................................................................................................................................................................................

Issues / Needs: Service & Information Gaps

• There are too few dentists willing and able to sedate children
• Not enough providers accept Denti-Cal
• Prevention messages to children and parents are insufficient
• Regular oral exams and preventive measures need to begin earlier
• Spanish- and Vietnamese-speaking providers are in short supply
• Disabled and special needs children face unmet dental care needs
• Strengthened coordination is needed
• Accessibility to dentists should be improved

Not Enough Providers Accept Denti-Cal

Insufficient numbers of private providers are willing to accept Denti-Cal and, to a slightly lesser extent, Healthy Families and Healthy Kids. Denti-Cal reimbursement rates for pediatric services are dramatically lower than general dentistry fees, and are among the lowest in the country.

This has a direct effect on access to care. Statewide, only 40 percent of dentists in private practice will treat any Denti-Cal patients. Anecdotal evidence elicited through county-sponsored focus groups in San Mateo County, which were part of that county's evaluation of its Children's Health Initiative, and in interviews with experts in Santa Clara County, suggest that the primary reasons dentists are reluctant to serve children with public health insurance are:

• very low reimbursement rates
• burdensome paperwork
• a concern about being inundated with such patients
• and the sense that low-income children are hard to deal with ( e.g., have major dental and other problems, miss appointments, etc.).

Some dentists assume that low-income children are already being taken care of through private storefronts, such as Western Dental. Some providers also are unaware of Healthy Kids. In San Mateo County, 11.4 percent of Healthy Kids enrollees answering a recent survey had dental needs but were unable to receive services. Some 9 percent of enrolled Santa Clara children faced the same problem. While many dentists do serve low-income children on a regular basis, and additional providers offer valued volunteer care periodically, too many local children in need are not receiving dental care. Moreover, low-income parents seeking care for their children cannot turn to any current and accurate information source listing which dentists -- outside of county clinics -- will actually serve their children.