The Impact of Insurance on Dental Utilization during Pregnancy

Objectives: The purpose of this study was to compare utilization rates of dental services during pregnancy among women with no insurance, Medicaid insurance, or private insurance, who were receiving care at a public, university-affiliated prenatal care center.

Methods: Pregnant women (N=243) completed an anonymous survey about oral health while waiting for their regularly scheduled prenatal care appointment. Women who agreed to participate received oral hygiene supplies. This study was approved by our Institutional Review Board.

Results: Regardless of insurance status, women who were referred for oral health care during pregnancy (n=38) were more likely to be in pain. Of the 81 participants who reported a dental visit during pregnancy, 51% had private insurance. Compared to women who had no dental insurance, women with Medicaid insurance reported lower income and education, yet reported fewer barriers to care. However, Medicaid insurance was not associated with receipt of referral, greater utilization of dental services during pregnancy, or less time since last dental visit.

Conclusions: These results suggest that Medicaid insurance is associated with fewer barriers to oral health care but does not improve utilization among pregnant women. With the exception of socioeconomic factors, there appear to be few differences in utilization of dental services for women with no insurance compared to women with Medicaid insurance, despite having fewer barriers to care. These findings suggest that Medicaid insurance may be insufficient in encouraging pregnant women to seek oral health care. Interventions are needed to increase utilization among this population, who have increased susceptibility to oral health problems during pregnancy.