Dental Service Variability Provided by General Versus Pediatric Dentists in Ohio Medicaid: A Cross-Sectional Study

Purpose: To compare dental services delivered to Medicaid-covered children by age (0 to 21 years old), health status, and rural and nonrural settings based on the treating provider (general [GP] and pediatric dentists [PD]) in Ohio, USA. Methods: A retrospective Medicaid claims review was completed for Ohio children covered by an accountable care organization (ACO), with a dental claim from 2021 to 2022. Descriptive statistics, bivariate analysis, and logistic regression were used to answer the study questions. Results: A total of 1,004 dentists treated 157,049 children. GPs outnumbered PDs 5 to 1 in the claims data. Median (M) number of children treated per dentist was 39 (M by GPs equals 34, M by PDs equals 107; P<0.001). Dentists who treated more than 100 children (n equals 376) treated 95% of the population. The age of the children treated did not differ based on rurality (P=0.49). More children treated were urban residents (3 to 1), but overwhelmingly more children in rural areas were seen by GPs than PDs (74.2% vs 51.0%; P<0.001). PDs had 16% increased odds of treating children with a complex medical condition, but this decreased in rural areas. Children from rural areas were 69% less likely to see a PD only (P<0.001). Conclusions: Age, health status, dentist type, and rurality all influenced access and types of treatment provided in this Medicaid population. Rural general practitioners were more likely to see younger children and those with medical conditions, suggesting less access to specialist care.