State Action for Oral Health Access

An RWJF National Program

Field of Work: Increasing access to oral health services for low income and minority populations and children and adults with disabilities.

Problem Synopsis: In May 2000, the landmark report Oral Health in America: A Report of the Surgeon General, stated that "a silent epidemic of dental and oral disease" is affecting Americans. The report emphasized that oral health is an integral part of overall health and noted that there were significant disparities in oral health in the United States. Disproportionately, low-income children and adults, racial and ethnic minority groups and individuals with disabilities have limited access to dental services, according to the U.S. Department of Health and Human Services.

Synopsis of the Work: State Action for Oral Health Access (October 2001 to August 2009) supported six state-based demonstration projects that tested innovative and comprehensive ways to increase access to oral health services for low income and minority populations and children and adults with disabilities served through Medicaid, CHIP (Children's Health Insurance Program) and the health care safety net. The six participating states were Arizona, Oregon, Pennsylvania, Rhode Island, South Carolina and Vermont.

Key Results

  • According to the program's final report, the program achieved the following results (names of states were not included in the report):

    • Five of the states significantly increased the percentage of children under the age of 6 enrolled in Medicaid and CHIP who were receiving dental care.
    • Four of the states significantly reduced the percentage of children receiving dental care who had one or more teeth extracted during the study period.
    • Four of the states significantly improved preventive oral health services for the Medicaid population in all age categories (under 6, 6 to 14, 15 to 20, over 20 years).
    • One state significantly improved its diagnostic, prevention and treatment services for children under the age of 6 enrolled in Medicaid, while two other states improved two of the three types of services for children under the age of 6.
    • Two states significantly improved diagnostic, prevention and treatment services for children 6 to 14 years of age.
    • One state significantly improved the use of all oral health services for all age groups.