Special Health Care Needs
Selin Soyupak, DMD
Pediatric Dentistry Resident
University of North Carolina, Chapel Hill, NC
UNC Chapel Hill
Chapel Hill, North Carolina, United States
Jessica Y. Lee, DDS, MPH, PhD
Distinguished Professor and Chair
University of North Carolina at Chapel Hill, Adams School of Dentistry
Chapel Hill, North Carolina, United States
Sue Tolleson-Rinehart, PhD
University of North Carolina - Chapel Hill
Kimon Divaris, DDS, PhD
Professor
Adams School of Dentistry, UNC-Chapel Hill
University of North Carolina-Chapel Hill
Chapel Hill, North Carolina, United States
Scott W. Cashion, DDS MS
Associate Professor and Program Director
UNC Chapel Hill, Adams School of Dentistry
chapel Hill, North Carolina, United States
Jessica Y. Lee, DDS, MPH, PhD
Distinguished Professor and Chair
University of North Carolina at Chapel Hill, Adams School of Dentistry
Chapel Hill, North Carolina, United States
Purpose: Children with complex medical needs face difficulties in accessing dental care. The aim of this study was to investigate access and utilization of dental services among publicly insured children with a cancer diagnosis in North Carolina.
Methods: Cancer patients ages 0 to 21 were identified using ICD-10 diagnosis codes and CPT procedure codes in NC Medicaid claims data between 2016 and 2019. Dental claims were used to estimate two metrics: the percentage of patients who received any dental service (i.e., “access rate”) and among those, the percentage of patients who received preventive dental services (i.e., “prevention ratio”). These estimates among cancer patients were compared to those among the entire NC Medicaid population, as well as between age groups, regions of NC, and federal fiscal years.
Results: There were 5,635 NC Medicaid enrollees ages 0-21 who were identified as cancer patients between 2016-2019. Access rates and prevention ratios remained relatively stable during the study period, ranging between 52-54% and 89-90%, respectively. Cancer patients’ access rates were similar to the overall population (i.e., 51-52%) whereas their prevention were slightly lower than the overall population (i.e., 94%). Considerable variation in both dental access and prevention was found between age groups (e.g., utilization peaked among 6-9-year-olds) and state regions.