Impact of Medicaid Dental Expansion on Prenatal Dental Cleaning and Birth Outcomes

• In Event: Impacts of Medicaid Dental Benefits Among Pregnant People, Reproductive-Age Women, and Other Adults

Abstract

Medicaid pregnancy dental benefits offer a critical opportunity to address maternal and child health disparities. Poor oral health during pregnancy is linked to adverse maternal outcomes, such as gestational diabetes and preeclampsia, as well as negative birth outcomes, including preterm birth and low birth weight. Despite this, pregnant individuals are less likely to access dental care compared to their non-pregnant counterparts, with significant disparities: non-Hispanic Black and Hispanic pregnant individuals report lower utilization rates and higher untreated dental decay.

This study examines the impact of state-level Medicaid pregnancy dental benefits on dental care utilization and birth outcomes using a multi-state quasi-experimental design. We combine data from the Pregnancy Risk Assessment Monitoring System (PRAMS) with state-level Medicaid policy information from 2012 to 2022, employing a stacked difference-in-differences framework. Our analysis focuses on dental cleaning rates during pregnancy and birth outcomes, including low birth weight, preterm birth, and small for gestational age (SGA). We also explore heterogeneous effects by race, ethnicity, rural/urban residence, and socioeconomic factors.

Findings reveal that Medicaid dental benefit expansions significantly increase dental cleaning rates among pregnant Medicaid recipients, with these effects persisting over time. We further some evidence suggesting that Medicaid dental benefit expansions reduce the rates of very low birthweight, preterm birth, and small for gestational. These findings underscore the importance of addressing not only dental coverage gaps but also broader social determinants of health that influence the effectiveness of such policies.

Subgroup analyses reveal notable heterogeneity. Medicaid dental benefits have stronger effects on dental care utilization among non-Hispanic Black individuals compared to non-Hispanic Whites, partially narrowing the utilization gap. However, improvements in birth outcomes for disadvantaged groups remain limited, suggesting that dental benefits alone may be insufficient to fully address health disparities. Additionally, rural residents experience lower gains in utilization, highlighting the need for tailored outreach and service delivery strategies.

This study contributes to the growing evidence on Medicaid dental benefits and their role in promoting equitable health outcomes. It is among the first to link state dental policy changes to birth outcomes on a large scale, offering critical insights for policy design and implementation. Findings suggest that expanding Medicaid dental coverage for pregnant individuals can increase access to recommended dental care and partially reduce income-based disparities.

Overall, this research underscores the complex interplay between Medicaid policies, healthcare utilization, and health equity. It provides actionable insights for policymakers aiming to improve maternal and child health outcomes across diverse populations.

Author

• Anwar Assamidanov, University of California, Irvine
  Presenting Author