Provision of Fluoride Varnish in Dental Health Professional Shortage Areas

Objective: To describe the association of rates of FVT for Wisconsin Medicaid children enrollees with DPHSAs, Urban Influence Code (UIC) based on county of residence, and race/ethnicity following the policy change.

Methods: Poisson regression modeling of the rate of Medicaid claims for FVT in Wisconsin from 2002-2006.

Results: In response to the policy change, a significant (p <0.05) 2-fold increase in the rate of FVT was seen for Native-Americans, Hispanics, and Asians, as well as greater than 9-fold increases for children residing in micropolitan and rural counties, as well as counties designated as total DHPSAs. In the two years post-policy change, the rate of FVT per 1000 person-years of enrollment was highest for rural counties (35.2), partial DHPSAs (28.2), and for Native Americans (68.4), but lowest for metropolitan counties (23.5), none DHPSAs (22.0), and for African-Americans (17.5).

Conclusions: Children living in counties designated as micropolitan, rural, or total DHPSAs, as well as racial/ ethnic minorities with the exception of African-Americans benefitted the most from the policy change allowing medical care providers to apply FVT. Despite the observed improvements, future policies and programs will need to target groups such as African-Americans in order to increase access and utilization of primary preventive dental services.