Children who don’t go to the dentist are less likely to participate in school-based tooth decay prevention programs, according to research published in . JAMA network open.
Our research suggests that the children who may need these services the most are the least likely to receive them. ”
Shulamite Huang, health economist and study author, assistant professor of epidemiology and health promotion at New York University School of Dentistry
Additionally, the study found that improving participation in a statewide school dental program targeting people at high risk for tooth decay could result in significant savings to the state’s Medicaid program and health care system, potentially avoiding up to $2.4 million in annual costs in New York state’s emergency departments.
Children miss more than 34 million hours of school each year to receive emergency dental care. In recent years, hospitals have seen a sharp increase in the number of patients presenting to the emergency department for pediatric dental problems.
In order to prevent children from getting emergency dental cavities and the associated pain and infections, some schools offer cavity prevention programs. New York State recently announced a $10 million initiative to expand access to school-based dental programs and improve children’s oral health.
Research shows that school dental programs that use non-invasive treatments such as sealants are effective in preventing cavities. But parents must choose for their children to receive care at school, and it’s unclear whether these programs will reach those most in need.
Huang and colleagues evaluated data on more than 63,000 Medicaid-eligible children living in the Bronx. This includes more than 1,000 children who participated in school-based tooth decay prevention programs at local elementary schools. They looked at Medicaid claims data to see if children visited the dentist outside of school or received emergency dental care.
Researchers found that children who already had a history of dental treatment were more likely to participate in a school-based cavity prevention program. In contrast, children with no prior dental visits were 18% less likely to participate in these programs. Children with a history of dental emergencies (and perhaps at higher risk for tooth decay) were also less likely to participate in school-based programs.
The researchers then calculated the potential cost savings of expanding school-based dental care across New York State and improving the participation of children most at risk for tooth decay. They estimate that optimizing recruitment to enroll high-needs children in school programs could save the state up to $2.4 million annually in dental-related emergency department costs (not including accident- and injury-related dental treatment).
“This has a surprising impact on Medicaid costs,” Huang said. “As New York State expands access to school-based dental care, improving recruitment strategies and redirecting support to high-risk children could save the state millions of dollars and offset some of the costs of expanding care.”
Other study authors include Ryan Richard Ruff of the University of Pennsylvania School of Dentistry, Heather Gold of New York University’s Grossman School of Medicine, and Scarlett Wang of New York University’s Wagner School of Public Service. This research was supported by the National Institutes of Health (K25 DE028584-01A1 and K25 DE028584-02S1).
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Reference magazines:
Yellow, SS; Others. (2026). School-based dental caries prevention programs and recruitment of high-risk pediatric Medicaid populations. JAMA network open. DOI: 10.1001/jamanetworkopen.2026.5996. https://jamanetwork.com/journals/jamanetworkopen/fullarticle/2847556
