In the face of major budget shortfalls, 22 states were able to raise their 2010 grades, proving that dental health policies can be improved at a relatively low cost.

Pew graded the states based on eight benchmarks (PDF) that are a roadmap for policymakers looking to improve and expand access to children's dental health. The grades reflect changes that have occurred since Pew's initial assessment in 2010. Read the state facts sheets.

While many states have made significant strides in improving oral health policies, too may children go without proper dental care, mainly because of a shortage of dentists willing to serve Medicaid-enrolled patients.

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Pew graded all 50 states and the District of Columbia on their dental health policies.

Key findings  

 The report card, produced with support from the W.K. Kellogg and the DentaQuest Foundations found that: 

• 27 states earned grades of an A or B, while 23 states and the District of Columbia received a C or lower grade.
  
  
• 22 states raised their grades and six of them have improved by at least two letter grades: Arkansas, Delaware, Massachusetts, Minnesota, Utah and West Virginia.
  
  
• Seven states received an A grade, and five earned an F.  Three of those five states—Florida, Hawaii and New Jersey—got an F for the second consecutive year.
  
  
• States that raised their grades made progress primarily by reimbursing physicians for preventative dental services, expanding water fluoridation and increasing the percentage of Medicaid-enrolled children who receive care.
  
  
• Six states received lower grades mainly because Medicaid reimbursement rates have not kept pace with the growth in dentists’ fees.
  

Tooth decay is the most common disease of childhood— five times more common than asthma. For every child without medical insurance, there are nearly three children without dental insurance.

Dental health has a major affect on children's health, education and well being. Research shows that kids who do not receive dental care miss a significant number of school days, use expensive emergency room services more often and face worsened job prospects as adults, compared with their peers who do receive care.

The State of Children’s Dental Health: Making Coverage Matter graded states' ability to serve insured and soon-to-be insured children. In the face of major budget shortfalls, 22 states were able to raise their 2010 grades, proving that dental health policies can be improved at a relatively low cost.

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