Washington's ABCD Program

Improving Dental Care for Medicaid-Insured Children

Washington's ABCD Program
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Quick Summary

This 2010 Pew Center on the States report looked at how dental care remains the greatest unmet need for health services among children.

This 2010 Pew Center on the States report looked at how dental care remains the greatest unmet need for health services among children. Washington’s ABCD Program: Improving Dental Care for Medicaid-Insured Children, surveyed the remarkable impact that one program in Washington state made in confronting dental disease among Medicaid-insured children under age six.

Since its inception in 1994, the Access to Baby and Child Dentistry (ABCD) program has been established in 30 of Washington’s 39 counties and demonstrated impressive results:

  • Between 1997 and 2004, the number of Medicaid-enrolled children who received annual dental care more than doubled, from 40,000 to 107,000. 
  • The number of enrolled children visiting the dentist before their second birthday has more than quadrupled. 
  • Children in ABCD averaged 2.4 dental visits per year, while children on Medicaid but not enrolled in the program averaged less than one visit per year. 

ABCD fosters strong collaboration between dentists, public health leaders and parents to achieve its goals, including:

  • enrolling Medicaid-eligible children by age one; 
  • educating their families and caregivers about dental hygiene and eating habits; and 
  • training dentists in the best care practices for young children. 

The program’s resilience, even amid state budget shortfalls, is a tribute to its solid results and efficient public-private financing model.  Other states would be smart to consider the approach taken by Washington’s policy makers and dental health community.

Report Assets

June 29, 2010
Mary McNamara | 202.540.6580
Children's Dental Policy
Dental Health, Health Care Costs, Children's Health Insurance Program


  • December 10, 2010

    It Takes A Team

    This 2010 report was the first to examine the impact that hiring new types of dental providers—dental therapists and hygienists-therapists—could have on both the productivity and profits of a private dental practice, where more than 90 percent of the nation’s dentists work. 


  • June 23, 2013

    In Search of Dental Care

    In Search of Dental Care examines the lack of access to dental care, especially for low-income children and families, in the United States. It also explores the strategies states are employing—particularly the expansion of the dental team by licensing additional types of providers—to address workforce shortages and serve low-income children.


  • February 23, 2010

    The Cost of Delay

    An estimated one in five children go without dental care each year. States play a key role in ensuring that low-income children have access to basic, preventive dental care. This 2010 report, The Cost of Delay: State Dental Policies Fail One in Five Children, found that two-thirds of states are doing a poor job. The report was produced by the Pew Center on the States with support from the W.K. Kellogg Foundation and the DentaQuest Foundation.



  • May 28, 2009

    Help Wanted

    This 2009 report looked at how access to dental care has become an increasingly serious problem for many people in the United States, particularly for children.  There is a shortage of private dentists and a limited availability of affordable, or government-supported dental care. This is further compounded by the small number of private dentists willing to participate in public health insurance programs, or treat young children and other underserved populations, especially in rural areas.


  • January 12, 2012
    A Costly Dental Destination

    A Costly Dental Destination

    Already stressed state budgets are shouldering an extra burden to cover expensive emergency room (ER) treatment for toothaches and other avoidable dental ailments, according to a new report by the Pew Center on the States. more