Children's Access to Dental Care in Southeastern Pennsylvania (summary)

Tooth decay is the most common chronic illness among children, affecting more than three quarters of adolescents and increasing in prevalence among younger children (1, 2, 3). Oral health problems can have far-reaching consequences. In addition to the damage done by tooth decay, poor oral health can lead to time spent away from school and recreation. This article highlights some of the new data on dental care from PHMC’s Community Health Data Base 2008 Southeastern Pennsylvania (SEPA) Household Health Survey, and summarizes key findings of CHDB’s recent data brief, Children’s Access to Dental Care in Southeastern Pennsylvania. Data presented here refer to children between ages 4 and 17 in Bucks, Chester, Delaware, Montgomery and Philadelphia counties.

In the past year, more than one in ten children ages 4 -1 7 across the five-county area (11.5%) went without a dental exam. Dental health disparities are seen across the region by geography, income, race and ethnicity and health insurance status.

Geographic Differences

Compared to their suburban counterparts, children residing in Philadelphia are almost twice as likely to have not received a dental exam in the past year: 16.4% of children living in Philadelphia have not visited a dentist in the past year compared to 8.8% of children living in the surrounding suburban counties. Within the five-county Southeastern Pennsylvania region, Philadelphia and Delaware Counties have the highest percentages of children who did not visit a dentist in the past year (16.4% and 13.1%, respectively), followed by Montgomery (8.9%), Chester (7.7%), and Bucks (5.8%) counties.

Household Income

Children living in poorer households (below 100% of the Federal Poverty Line) were more than three times less likely to have seen a dentist in the past year than children in non-poor households. More than a quarter of SEPA children ages 4-17 (27.6%) living below the Federal Poverty Line did not see a dentist in the past year, compared to 8.5% of non-poor children.

Race and Ethnicity

Racial and ethnic disparities are evident in children’s dental care in Southeastern Pennsylvania. White children are more likely to see a dentist than are Latino or Black/African American children. While 7.8% of White children did not see a dentist in the prior year, 12.5% of Latino children and 20.4% of Black or African American children did not have a dental exam during the same period.

Health Insurance

While 8% of children with private health insurance did not see a dentist in the past year, 40.0% of children without private or public health insurance went without dental care in the same time period. Nearly one in five children with Medicaid coverage (19.5%) and more than one in eight children (12.0%) insured by Children’s Health Insurance Program (CHIP) did not have a dental visit.

The 2008 Community Health Data Base Household Health Survey data show that approximately 84,300 children in SEPA went without dental care for the past year or longer. Children without medical insurance, as well as those living below the poverty line face additional risks for oral health problems. Poor dental health may reach beyond youth and lead to lifelong complications. For more information on children’s dental care in Southeastern Pennsylvania or the Community Health Data Base, please contact Rose Malinowski Weingartner at rosemw@phmc.org. For a copy of our recent Data Brief on Children’s Access to Dental Care in Southeastern Pennsylvania, please contact Johanna Trowbridge at johannat@phmc.org.

1 Centers for Disease Control. (2004). Children’s Oral Health. http://www.cdc.gov/OralHealth/publications/factsheets/sgr2000_fs3.htm. Accessed 4/10/09.

2 Dye, B.A., Tan, S., Smith, V., Lewis, B.G., Barker, L.K., Thornton-Events, G. et al. (2007). Trends in Oral Health Status: United States, 199-1994 and 1999-2004. National Center for Health Statistics. Vital Health Stat, 11: 248.

3 U.S. Department of Health and Human Services (HHS). Oral Health in America: A Report of the Surgeon General. Rockville, MD: HHS, National Institutes of Health (NIH), National Institute of Dental and Craniofacial Research (NIDCR), 2000.