Despite the inclusion of oral health care in Medicaid’s benefit for children, in a given year, less than half of children enrolled in Medicaid receive any dental service. The consequences of inadequate oral health care for children are numerous, and include progressive dental disease; costly emergency room and hospital use; missed school days; and low self-esteem from unhealthy looking teeth. States may be able to use their purchasing power to encourage better access, quality, and accountability in oral health care for children in Medicaid – particularly through contracting with dental plans.

This brief explores contract-based options for improving access to oral health care for children enrolled in Medicaid. It describes how states with managed care delivery systems can use contracting mechanisms and incentives to engage plans and providers in improving access and outcomes in children’s oral health care.