Medicaid policy change ups fluoride varnish treatments

Aug 19, 2009

A 2004 state-level Medicaid policy change in Wisconsin significantly increased the provision of fluoride varnish treatments (FVT) to children in the state, according to a study by Christopher Okunseri, B.D.S., M.Sc., an associate professor and director of the dental public health program at the Marquette University School of Dentistry.

In the two years following the policy change, which allowed primary medical care providers to be reimbursed for FVT provided to Medicaid-enrolled children, FVT claims increased from 3,361 to 28,303, according to the study (Health Services Research, August 2009, Vol. 44:4). Overall, 48.6% of the increase in FVT was attributable to medical care providers.

"The results are particularly encouraging," Dr. Okunseri said in a press release. "Dental caries is preventable with the proper use of a preventive oral health regimen, including FVT. Yet caries remains the single most prevalent childhood disease. And it disproportionately affects vulnerable populations with limited access to dental care."

According to the ADA, children from 6 months of age at high risk of caries should receive FVT at six-month intervals. In the Wisconsin study, the largest increase in FVT claims was seen in children 1 to 2 years of age. Medical care providers were responsible for 83.5% of the increase in that age group.

"Most infants and children see their pediatricians and family physicians for early preventive procedures such as immunizations and for other healthcare checks," Okunseri added. "What's more, medical provider clinics are often open for longer hours than regular dental offices."

The study's findings have the potential to serve as an important baseline for future Medicaid policies regarding the delivery of preventive oral health services, according to Dr. Okunseri