Geographic Variation in Medicaid Claims for Dental Procedures in New York State: Role of Fluoridation under Contemporary Conditions

Abstract

Objective. We conducted an evaluation to determine if the number of claims reimbursed for caries-related procedures for children in the New York State Medicaid program varied by county fluoridation coverage. Methods. We calculated the mean number of claims per recipient for children in each county separately for the treatment of caries and all other procedures not related to caries using the 2006 Medicaid claims data. Results. Compared with the predominantly fluoridated counties, the mean number of restorative, endodontic, and extraction procedures per recipient was 33.4% higher in less fluoridated counties. The mean number of claims per child for caries-related services was inversely correlated with the extent of fluoridtion in a county (Spearman's correlation coefficient = −0.54, p<0.0001), but claims for non-caries related services were not. Conclusions. These findings, when added to the already existing weight of evidence, have implications for promoting policies at the federal and state levels to strengthen the fluoridation program.