P2.K208: Understanding oral health care utilization in an under-resourced community in Washington, DC

Background: Tooth decay, the most common chronic disease in U.S. children, disproportionally affects under-resourced communities leading to poor long-term health outcomes. Since the most recent DC data showed that only 38.5% of Medicaid patients aged 1-20 received preventative dental care, a Community Dental Health Coordinator (CDHC) role was implemented to understand the care gap. When CDHC model proved to be ineffective, further study was warranted. Objective is to describe the individual and environmental factors that impact preventative oral health access in an under-resourced area of Washington, DC and analyze rates of preventative dental care of an academic outpatient medical home.

Methods: Through facilitator-led focus groups and CDHC individual patient screenings, factors that impact oral health care utilization were identified. Parents who did and did not participate in dental care coordination participated. In partnership with the Medicaid agency for Washington DC, Medicaid claims for preventative dental health utilization were trended over a 5-year period among patients of the academic medical home.

Results: CDHC’s screenings and qualitative focus groups endorsed high rates of dental awareness and utilization despite parents identifying barriers to access. Barriers included low capacity of existing dental practices (appointments too far in the future) and low flexibility for appointments outside of traditional work hours (Table 1). Further analysis of Medicaid billing data from 2018 – 2022 showed preventative care utilization was higher than previously reported (Figure 2)

Conclusion: Oral health care access continues to be multifactorial with individual and environmental factors impacting access. This study shows that rates of preventative care are higher than previously published reports and many families are accessing preventative care. Future interventions should focus on those who are still unable to access preventative care by addressing the factors that are unique to this patient population.