Though Virginia enacted comprehensive dental care coverage for pregnant women enrolled in Medicaid in March 2015, a significant portion of this population remained unaware of the benefit even years later, according to a study by researchers at theVirginia Commonwealth University School of Dentistry.

Recently published in the Journal of Women’s Health, a survey of reproductive-age women visiting VCU Health between October 2017 and March 2018 found that Medicaid-enrolled women were half as likely to visit the dentist in the past year as women with private insurance. Despite the availability of Medicaid Pregnancy Dental coverage, one in three reproductive-aged women enrolled in Medicaid were unaware of the benefit.

The study concluded prior to the expansion of comprehensive dental coverage for all Medicaid-enrolled adults in Virginia in July 2021.

“Our findings showed significant gaps existed in oral health knowledge among reproductive-age women by health insurance status. In addition, a significant portion of Medicaid-enrolled women were unaware of dental care benefits during pregnancy even after three years of policy implementation,” said Shillpa Naavaal, B.D.S., M.S., M.P.H., an assistant professor in the Department of Dental Public Health and Policy at VCU School of Dentistry and lead author on the study. “This is the first time awareness of Medicaid policy has been assessed in this population.”

Medicaid-enrolled and uninsured women experienced barriers to oral health care during pregnancy at much higher rates compared to women with private insurance. Approximately 15-20% of Medicaid-enrolled women reported difficulty finding a dentist or dental office that would take their insurance or treat pregnant women, compared to less than 1% of women with private insurance.

In addition, almost 40% of Medicaid-enrolled women did not know that pregnancy is a period of higher risk for oral health problems. One-fifth were unaware of the links between oral health and general health, and one-fourth had safety concerns about receiving dental care during pregnancy.

Dental coverage awareness was found to be positively associated with respondents’ oral health knowledge score and health information source. The researchers found that awareness of Medicaid dental benefits for women enrolled in Medicaid did not differ by pregnancy status.

Prior research by Naavaal estimated that Medicaid Pregnancy Dental benefits would impact about 45,000 women. However, between 2015-2017, only 10,395 women utilized the benefits.

“Now that Medicaid has been expanded in Virginia to include comprehensive dental coverage, work is needed to educate recipients in order to improve oral health knowledge and increase dental benefit utilization,” Naavaal said. “The information from this study can help program administrators, clinicians and oral health stakeholders identify groups for focused outreach and inform programs designed to educate recipients and connect community resources.”

Naavaal collaborated on this study with Caroline K. Carrico, Ph.D., biostatistician and associate professor in the Department of Dental Public Health and Policy at the VCU School of Dentistry; Tiffany L. Williams, D.D.S., director of student recruitment and interim director of the Pediatric Dental Residency Program at the VCU School of Dentistry; Tegwyn H. Brickhouse, D.D.S., Ph.D., chair of the Department of Dental Public Health and Policy and professor at the VCU School of Dentistry; and Sarah E. Raskin, Ph.D., assistant professor at the VCU L. Douglas Wilder School of Government and Public Affairs. All researchers except Carrico are affiliated with the Oral Health in Childhood and Adolescence Core at the Institute for Inclusion, Inquiry and Innovation (iCubed) at VCU.

This study was funded in part by a Virginia Department of Health contract under the Virginia Department of Health’s Perinatal and Infant Oral Health Quality Improvement grant by the Health Resources and Services Administration.