Key factors associated with oral health services at Federally Qualified Health Centers

Abstract

Objective

This study aimed to investigate changes in oral health services from 2012 to 2021 and identify factors influencing the number of different types of services directly provided by all Federally Qualified Health Centers (FQHCs).

Methods

Data from the 2012–2021 Uniform Data System were analyzed using multilevel mixed-effect negative binomial regression models. These models explored associations between oral health staffing, federal grant revenue, and state Medicaid dental policies for adults, and the number of different types of oral health services provided at FQHCs. Regressions were adjusted for FQHC and state characteristics, and survey year.

Results

FQHC visits for any oral health service increased significantly with each additional full-time equivalent (FTE) in all types of oral health staffing, ranging between 0.8% and 13.7% (e.g., IRR = 1.137, 95% CI = 1.126–1.148 for preventive services by dental hygienists/therapists). Preventive dental visits increased significantly by 32% (IRR = 1.320, 95% CI = 1.028–1.694) for every 1% increase in the proportion of capital development grants to the total revenue. Although not statistically significant, FQHCs in states with extensive Medicaid dental coverage had a 2%–7% increase in all types of oral health services except emergency services compared to those in states with emergency-only coverage.

Conclusions

This study found that increasing dental staffing, particularly of dental hygienists/therapists, enhances FQHCs' ability to provide preventive services. Capital development grants also positively influence preventive dental care delivery. Expanding Medicaid dental coverage may also increase service utilization, particularly among underserved groups, reducing oral health disparities.