Facts, Oral Health

Facts & Figures

Nationally, an estimated one in three children enrolled in Medicaid has untreated tooth decay, and one in nine has untreated tooth decay in three or more teeth. Children enrolled in Medicaid are almost twice as likely to have untreated tooth decay as children with private insurance.

California ranks near last in the nation on children’s oral health status. Approximately two-thirds (6.3 million) of all California children suffer needlessly from poor oral health by the time they reach third grade.

54% of kindergartners and 71% of third-graders in California have a history of dental decay.

Since 2006, California law, under AB 1433 (Emmerson/Laird), has required that children have a dental check-up before entering kindergarten or 1st grade, with the goal of establishing a regular source of dental care for every California child. Unfortunately, due to state budget cuts, school districts have not been required to implement the new law.

One in five (1.8 million) California children does not have dental coverage, a slight increase from 2003, when approximately 1.6 million children (18%) lacked coverage.

Among racial/ethnic groups in California, Pacific Islander children are most likely to lack dental insurance (30%), followed by Latino children (22%), white children (20%), Asian children (18%), African American children (12%) and Native American children (10%).

Children in California without dental insurance (59%) are more likely to miss two or more school days per year due to a dental problem than children with private dental insurance (33%).

20% of California’s children under age 12, excluding children who have not yet developed teeth, have never been to the dentist.

Only 78% of California’s children received a preventive dental visit in 2007, which parallels the national rate.

Having dental insurance does not guarantee children will access dental services. Only 59% of children covered by Healthy Families receive a dental visit each year. In fiscal year 2008, only 30% of children with Medi-Cal coverage received dental care, and only 25% received preventive dental services. Compared to other states, California ranks 44th and 45th, respectively, in these categories. Furthermore, the dental care utilization rate among children in Medi-Cal varies by age in California, from 21% to 37%. California’s youngest children, ages 0-5, are least likely to access oral health care (21%).

Medi-Cal’s low reimbursement rates for dentists are a barrier to increasing children’s access to and use of oral health care services, and the number of providers who accept Medi-Cal is decreasing. Between 2003 and 2010, the percentage of providers accepting Medi-Cal patients has decreased from 40% to 25%.

While children across the state generally lack sufficient access to dental care, the problem is particularly acute in rural areas: no dentists are listed on Medi-Cal’s referral list in 13 rural California counties.

The Centers for Disease Control and Prevention considers community water fluoridation as one of ten great public health achievements of the 20th century.

Although the percentage of California’s population with access to fluoridated water has increased dramatically, from 27% in 2006 to 59% presently, that rate is still well below the national average (72%).

Prior to its funding suspension in 2009-10 and 2010-11, California’s Children’s Dental Disease Prevention Program provided fluoride varnish and weekly fluoride rinses to over 300,000 preschool and elementary school children annually.

Every $1 spent on community water fluoridation saves $8 to $49 in dental treatment costs, depending on the size of the community, with the largest communities experiencing the greatest savings.