Date of Award

Fall 2019

Document Type

Open Access Dissertation


Health Services and Policy Management

First Advisor

Janice C. Probst


Since the implementation of the South Carolina Medicaid adult dental benefit, there has been limited public knowledge on how effective the policy has been in increasing access to dental services for Medicaid adults.The South Carolina Medicaid eligibility dataset, all payer emergency department dataset and, Medicaid dental claims dataset were examined from the period of December 2011- December 2017. Approximately 16% of enrollees had a dental visit since policy initiation. In the adjusted analysis, ED visits made by Medicaid enrollees during the second and first period before policy initiation were more likely to have a non-traumatic dental diagnosis, with respective adjusted odds ratios (AOR’s) of 1.070 (95% confidence interval [CI] = 1.022, 1.119) and 1.067 (CI=1.022,1.114) compared to enrollees during the third period before policy initiation. Conversely, non-traumatic dental ED visits were less likely to be made during the first, second, and third period after policy initiation by Medicaid enrollees with respective AOR’s of 0.891 (CI=0.853,0.923), 0.770 (CI=0.736,0.807), and 0.343 (CI= 0.324,0.363) compared to non-traumatic dental ED visits made by enrollees during the third period before policy initiation. The findings of this research support that the adult dental benefit decreased dental ED visits among Medicaid adult enrollees in South Carolina with a greater effect in counties with a FQHC.