The fragmentation of childrens’ oral health: Access to care in pediatric dentistry and orthodontics

Improving access to care in order to reduce the burden of oral disease has gained increased attention with the passage of the Patient Protection and Affordable Care Act (ACA) in 2010. With regard to oral health, it is primarily children, and not adults, that have been the beneficiaries of the new mandates and policies of the ACA. There are three stakeholders involved: patients, caregivers, and payers. Each have unique needs and constraints that ultimately affect the ability of children to receive necessary dental care including both preventive/restorative and orthodontic treatment. The definition of “medically necessary care” for pediatric dentistry and orthodontics is crucial in determining access to care for children.