Children from low-income families have 3x the rate of untreated cavities as higher-income children, with only 1 in 5 Medicaid-eligible children receiving preventive dental care

Untreated dental caries in children aged 2 to 5 from low-income families occurs at 18% -- three times the rate of higher-income children (7%). Among low-income children aged 2-11 with cavities, 60% have untreated disease compared to 46% in higher-income families. Despite Medicaid's EPSDT mandate requiring states to cover comprehensive dental care for all enrolled children, only 1 in 5 children covered by Medicaid receive preventive oral care they are eligible for. Seven in 10 Mexican American children (70%) aged 6-9 have had cavities compared to 4 in 10 non-Hispanic white children (43%). Why it matters: Low-income children enrolled in Medicaid cannot access the dental care they are legally entitled to because too few dentists participate, so cavities in primary teeth go unfilled and progress to infections, so children experience pain that disrupts sleep, concentration, and school attendance -- dental disease is the leading cause of school absence due to chronic conditions, so untreated decay in primary teeth damages developing permanent teeth underneath, so these children enter adulthood with compromised oral health that compounds into lifelong dental costs and poorer overall health outcomes, so the cycle of dental poverty perpetuates across generations. The structural root cause is that while federal law (EPSDT) mandates comprehensive pediatric dental coverage under Medicaid, enforcement is delegated to states, and states face no meaningful penalty for failing to ensure adequate provider networks -- so even though children have coverage on paper, the practical reality is that Medicaid's low reimbursement rates (often 30-50% of private insurance rates for pediatric dental) mean most pediatric dentists limit Medicaid patients or refuse them entirely.