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August JADA finds youth with foster care experience report more oral health problems than their peers

July 26, 2021

By Mary Beth Versaci

 August JADA cover

Youth with a history of foster care report more oral health problems and less access to oral health care than their peers with no experience of foster care, according to a study published in the August issue of The Journal of the American Dental Association.

The cover story, "Oral Health Needs Among Youth With a History of Foster Care: A Population-Based Study," used the 2019 Minnesota Student Survey, a statewide survey of public school students in fifth, eighth, ninth and 11th grades, to compare the responses of youth who have experienced foster care with youth who have not. Looking at oral health indicators from the survey, the study found the odds of an oral health problem for youth with a history of foster care were 1.54 higher than for their peers.

"When I think about the children with special health care needs that I treat, my mind doesn’t always jump to include individuals with a history of foster care among them. Given the trauma they have experienced and their sporadic access to health care, these children and adolescents unquestionably fall into that category," said Elise W. Sarvas, D.D.S., corresponding author of the study and a clinical associate professor in the Division of Pediatric Dentistry of the University of Minnesota Department of Developmental and Surgical Sciences. "Dental professionals have a duty to prioritize these individuals."

The American Academy of Pediatrics recommends children in foster care undergo a dental exam within 30 days of placement.

"Despite having medical and dental insurance through Medicaid, these individuals often face significant barriers to dental care, leading to pain and infection," Dr. Sarvas said. "Our study is the first to confirm firsthand from these children and adolescents that their dental needs are not being met. We hope that this report is a catalyst to increasing their access to care."

The ADA sent a letter in May and joined a coalition letter in June supporting HR 1794, the Foster Youth Dental Act, which would expand Medicaid oral health coverage by increasing the eligibility age from 21 to 25 for former youth who are eligible for the foster youth Medicaid pathway. The act would also help improve access by providing enhanced reimbursement for dentists, and states would be required to establish outreach programs for dentists, as well as programs to increase foster youth enrollment. The act would also ensure that foster youth who move between states do not lose their coverage.

Other articles in the August issue of JADA discuss the efficacy of personal protective equipment against coronavirus transmission by dental handpieces, COVID-19 vaccine acceptance and hesitancy among dental and medical students, and trends in national opioid prescribing for dental procedures among Medicaid patients.

Every month, JADA articles are published online at JADA.ADA.org in advance of the print publication.