Brandy J Lipton, Laura R Wherry, Sarah Miller, Genevieve M Kenney, Sandra Decker

Healthy tooth development starts early in life, beginning even before birth. We present new evidence suggesting that a historic public health insurance expansion for pregnant women and children in the United States in the 1980s and 1990s may have had long-lasting effects on the oral health of the children gaining eligibility. We estimated the relationship between adult oral health and the extent of state public health insurance eligibility for pregnant women, infants, and children throughout childhood separately for non-Hispanic whites, non-Hispanic blacks, and Hispanics. We found that expanded Medicaid coverage geared toward pregnant women and children during their first year of life was linked to better oral health in adulthood among non-Hispanic blacks. Our results also suggested that there might be a benefit to expanded public health insurance eligibility for children at ages 1-6 among non-Hispanic blacks and Hispanics. Medicaid expansions appear to have had long-lasting effects for certain low-income children and helped narrow racial/ethnic disparities in adult oral health.