Factors associated with increased dental care utilization in five urban, low-income areas.

Survey data were used to measure change in dental utilization in five urban low-income areas as a result of increased financial (Medicaid) and facility (community health centers) access to dental care. The average annual dental visit between the baseline and follow-up surveys showed a dramatic increase in four of the five survey areas. With the exception of Roxbury, Massachusetts, where the rate was already high in the earlier survey, the dental visit rate in the remaining areas increased 33 to 80 per cent compared to an increase of only 7 per cent nationally between 1969 and 1975. Both CHC and Medicaid programs made important contributions to increased dental care. Among persons who saw a dentist in the year in these areas, 25 per cent reported CHC as their usual source of dental care and 46 per cent reported that their dental care costs in the year were borne by Medicaid. In spite of recent increases, however, the average annual dental visit rate was only 1.0 in the five areas compared to 1.6 nationally, which is 60 per cent higher. The generally low dental utilization levels among persons covered by Medicaid or served by CHCs may indicate that much of the increased dental utilization which occurred in these areas was limited to taking care of existing dental problems while neglecting preventive dental care.