Pediatric dental clinic location and utilization in a high-resource setting

Examine dental utilization by Medicaid-insured children living in a high-resource area. Characterize distance and travel-related variables to accessing care.

Cross-sectional data were collected on dental clinics in Pittsburgh, Pennsylvania, caring for Medicaid-insured children ≥1 year. Shortest distances, drive times, and bus travel between dental clinics and high-poverty census tracts were determined through geographical information systems analysis. Primary care clinic (PCC) survey data were analyzed for children's dental use. Demographic characteristics and travel-related variables were compared between children who had and had not been to a dentist.

Ten dental clinics accepted Medicaid-insured children ≥1 year. Mean distance between high-poverty census tracts and their nearest clinic was 1.2 miles [standard deviation (SD) 0.2 miles], with mean bus travel time 15.6 minutes (SD 12.3 minutes). Overall, 46 percent of PCC children reported a dental visit, and this was not significantly different between those who lived in a high-poverty census tract versus those who did not (41 percent and 35 percent, respectively, P = 0.58). Children traveled a mean distance of 4.75 miles (SD 2.37 miles) to their dental clinic. Mean distance to their nearest dental clinic was 2.81 miles (SD 2.12 miles).

Dental clinics in a high-resource area are in close proximity to where young Medicaid-insured children live; and distances between children's homes and dental clinics are not significantly different between children who had and had not reported a dental visit, suggesting that barriers persist despite close proximity. Regardless, closer proximity may contribute to the higher utilization of services observed compared with national rates.