The Journal of the American Dental Association
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J Am Dent Assoc, Vol 137, No 1, 86-94.
© 2006 American Dental Association

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TRENDS

JADA Continuing Education

Early orthodontic treatment as a means to increase access for children enrolled in Medicaid in Washington state



Gregory J. King, DMD, DMSc, Charles V. Hall, DDS, MSD, Peter Milgrom, DDS and David E. Grembowski, PhD

Background. The authors assessed the likelihood that interceptive orthodontic Medicaid programs would increase access to care for Washington children.

Methods. The authors surveyed 210 Washington state orthodontists, including questions on demographics, attitudes toward early treatment, use of innovations and perceptions of Medicaid. Respondents were either Medicaid participants or nonparticipants.

Results. Fifty of 159 respondents were Medicaid participants. Most respondents perceived early orthodontic treatment as beneficial. Medicaid participants were more willing to participate in Medicaid early-treatment programs, had slightly fewer patients in the "other insurance" category, provided more discounted fees, received more Medicaid inquiries, practiced in rural areas with lower household incomes, reported feeling overworked and experienced fewer Medicaid problems. The principal problem reported with the Medicaid system was low fee reimbursement.

Conclusions. Programs offering early orthodontic treatment could increase access. Important barriers would be low fees and unfamiliarity with Medicaid.

Practice Implications. Medicaid should design programs aimed at early treatment with reasonable reimbursement and an educational component.

Key Words: Access; health care disparities; interceptive orthodontics; early orthodontic treatment; Medicaid







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