Michelle Kobayashi, Donald Chi, Susan E Coldwell, Peter Domoto, Peter Milgrom

The authors estimated the effectiveness of the Access to Baby and Child Dentistry (ABCD) program as a tool to improve the oral health of children, and they measured its costs. ABCD is an effort to increase the utilization of dental care by Medicaid-enrolled children younger than 6 years. The authors compared the oral health of third-grade children in Spokane County Wash. (ABCD) with that of children in Pierce County (non-ABCD). They then compared the expenditures of ABCD with those associated with alternative dental care interventions. Children in Spokane County had better oral health than did the children in Pierce County. The authors also found that the ABCD program increased mean dental care costs by $8.17 per user over costs in Pierce County, and the program cost a mean of $5.33 per user in outreach and dentist and staff training costs. This study found that ABCD improved the oral health of all third graders, including those not eligible or enrolled in the program. Increased expenditures were attributable mainly to outreach and training costs. Programs such as ABCD, carried out collaboratively by component societies, health districts, dental schools and Medicaid, have the potential to increase access to care and improve health.