Medical College of Wisconsin
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Rural-urban differences in dental service use among children enrolled in a private dental insurance plan in Wisconsin: analysis of administrative data. BMC Oral Health 2012 Dec 21;12:58 PMID: 23259637 PMCID: PMC3548684

Pubmed ID



BACKGROUND: Studies on rural-urban differences in dental care have primarily focused on differences in utilization rates and preventive dental services. Little is known about rural-urban differences in the use of wider range of dental procedures. This study examined patterns of preventive, restorative, endodontic, and extraction procedures provided to children enrolled in Delta Dental of Wisconsin (DDWI).

METHODS: We analyzed DDWI enrollment and claims data for children aged 0-18 years from 2002 to 2008. We modified and used a rural and urban classification based on ZIP codes developed by the Wisconsin Area Health Education Center (AHEC). We categorized the ZIP codes into 6 AHEC categories (3 rural and 3 urban). Descriptive and multivariable analysis using generalized linear mixed models (GLMM) were used to examine the patterns of dental procedures provided to children. Tukey-Kramer adjustment was used to control for multiple comparisons.

RESULTS: Approximately, 50%, 67% and 68% of enrollees in inner-city Milwaukee, Rural 1 (less than 2500 people), and suburban-Milwaukee had at least one annual dental visit, respectively. Children in inner city-Milwaukee had the lowest utilization rates for all procedures examined, except for endodontic procedures. Compared to children from inner-city Milwaukee, children in other locations had significantly more preventive procedures. Children in Rural 1-ZIP codes had more restorative, endodontic and extraction procedures, compared to children from all other regions.

CONCLUSIONS: We found significant geographic variation in dental procedures received by children enrolled in DDWI.

Author List

Bhagavatula P, Xiang Q, Szabo A, Eichmiller F, Kuthy RA, Okunseri CE


Pradeep Bhagavatula BDS, MPH, MS Assistant Professor in the Department of Dental Clinical Services department at Marquette University
Christopher Okunseri DDS,MS Associate Professor and Director in the Clinical Services department at Marquette University
Aniko Szabo PhD Associate Professor in the Institute for Health and Equity department at Medical College of Wisconsin


2-s2.0-84871370418   4 Citations

MESH terms used to index this publication - Major topics in bold

Child, Preschool
Dental Care for Children
Dental Health Services
Dental Restoration, Permanent
Health Services Accessibility
Insurance, Dental
Linear Models
Multivariate Analysis
Poverty Areas
Rural Population
Suburban Population
Urban Population
jenkins-FCD Prod-299 9ef562391eceb2b8f95265c767fbba1ce5a52fd6