Type of insurance coverage and dental sealants among US children: findings from the National Survey of Children's Health

Access to preventive dental services, such as dental sealants, varies based on several factors, including insurance coverage. The aim of this study was to examine the association between different types of insurance and dental sealant placement among US children. Data from the National Survey of Children Health (NSCH) cycle 2018 was analyzed. The sample size comprised 18,012 children aged 4-14 years. The main outcome was dental sealant placement in the past year (yes/no). The primary predictor was the type of insurance (public, private, both public and private, and uninsured). Bivariate and adjusted multivariate analysis was carried out to estimate weighted prevalence and adjusted odds ratios using SAS 9.4. The adjusted multivariate results showed that dental sealant use was the lowest among uninsured children compared to publicly insured children, followed by privately insured children, and finally mixed insured (public and private) children (adjusted odds ratio (AOR): 0.70; 95% confidence interval (CI): 0.57-0.86, AOR: 0.79; 95% CI: 0.54-1.14, AOR: 0.57; 95% CI: 0.40-0.82, respectively). In conclusion, privately insured, mixed insured, and uninsured children had lower odds of dental sealant use compared to publicly insured children. There was a significant variation in the accessibility of dental sealants among US children based on their insurance coverage. Despite these disparities, every child should have access to dental sealants, regardless of insurance status.