This policy briefing examined the extent to which uninsured and insured Californians use emergency departments (EDs) for preventable dental conditions such as untreated cavities, dental abscesses, and periodontal disease. It also looked at the efforts of six states using targeted increases in Medicaid reimbursement and other strategies designed to help young children, pregnant women, and people with developmental disabilities obtain access to dental care.

The speakers were:

• Lisa Maiuro, PhD, senior consultant, Health Management Associates, and
• Andrew Snyder, MPA, senior associate, the Dental Health Initiative of the Pew Center on the States.

Highlights of the presentation were:

• Maiuro presented findings on ED visits and hospitalizations for ambulatory care sensitive (ACS) dental conditions. She presented data showing that residents in dental health professional shortage areas (typically, rural areas of California) have access issues.
• Rural counties in northern California reported the highest ED visits for ACS dental conditions per 100,000 people, and metropolitan areas reported the lowest rates.
• In 2007, there were more ED visits (without a hospital admission) for ACS dental conditions than ACS diabetes conditions, and in some counties more ED visits for ACS dental conditions than ACS asthma conditions.
• Adults under 65 comprised 80% of all ED dental visits. Rates were highest for adults ages 18 to 34.
• Much of the discussion focused on the methodology and limitations of the data sources.
• Snyder presented findings from a CHCF-funded National Academy for State Health Policy (NASHP) study, "Increasing Access to Dental Care in Medicaid: Targeted Programs for Four Populations." Snyder focused on six state programs focused on improving access to dental care for young children, pregnant women, people with developmental disabilities, and people in rural areas. The states included New Mexico, North Carolina, Oregon, Pennsylvania, Rhode Island, and Wisconsin.
• Snyder noted that targeted programs can be an effective way to pursue modest, achievable steps in a difficult fiscal environment, particularly when such programs are aimed toward groups of specific interest to policymakers.

The presentation slides are available under Document Downloads, and the presenters' reports are under Related CHCF Pages.