# Impact of Dental Care Access on Children's Oral Health and Academic Outcomes

> **NIH NIH R03** · SAN DIEGO STATE UNIVERSITY · 2020 · $150,500

## Abstract

PROJECT SUMMARY/ABSTRACT
Poor oral health in childhood is correlated with more school absences and lower academic achievement. There
is evidence to suggest that state-level Medicaid policies, including payment rates to dentists, adult dental
coverage, and coverage of fluoride varnish (FV) application by non-dentist primary care providers, have
meaningful effects on the likelihood that low-income children receive recommended dental services. However,
little research has linked specific Medicaid policies that increase dental care access to measures of child oral
health, and further, no rigorous, large-scale studies with plausibly causal research designs have examined the
connection between these policies and academic performance. There is a critical need for rigorous evidence
on the potential for state-level policies to achieve improvements in these outcomes. This proposal will provide
novel evidence on the link between dental care access and measures of oral health and academic
performance using a natural experiment design that leverages state-level variation in Medicaid payment rates
to dentists, adult dental coverage, and FV policies during 1999-2016 and large-scale national datasets that
include exam-based and administrative outcome measures. Our study period captures a substantial number of
state-level changes while also representing a relatively recent time frame. Our analysis will also assess
important subgroup differences by child sex, age group, and race and ethnicity. In Aim 1, we will examine the
link between each policy and oral health measures including the parent-reported condition of teeth from the
National Survey of Children’s Health (NSCH), exam-based objective measures of untreated caries and the
presence of dental sealants from the National Health and Nutrition Examination Survey (NHANES), and
administrative records of emergency department visits for oral conditions from the State Emergency
Department Databases (SEDD). In Aim 2, we will assess the connection between each policy and academic
outcomes including school absences, school contacts with parents, parental concern about learning pre-school
skills, and grade retention from the NSCH, Peabody Individual Achievement Test scores and grade retention
from the National Longitudinal Survey of Youth – Child and Young Adult Cohort (CNLSY), and school
absences from the Early Childhood Longitudinal Study – Kindergarten Cohort (ECLS-K). This will be the first
national study to estimate the plausibly causal link between increased access to dental care and academic
performance among low-income children. This research will provide critical, timely, and policy-relevant new
evidence on the effects of increased access to dental care and the role for public health insurance policy.

## Key facts

- **NIH application ID:** 10041658
- **Project number:** 1R03DE029799-01
- **Recipient organization:** SAN DIEGO STATE UNIVERSITY
- **Principal Investigator:** Brandy Lipton
- **Activity code:** R03 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2020
- **Award amount:** $150,500
- **Award type:** 1
- **Project period:** 2020-08-05 → 2022-07-31

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10041658

## Citation

> US National Institutes of Health, RePORTER application 10041658, Impact of Dental Care Access on Children's Oral Health and Academic Outcomes (1R03DE029799-01). Retrieved via AI Analytics 2026-05-23 from https://api.ai-analytics.org/grant/nih/10041658. Licensed CC0.

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