Association Between Type of Health Insurance and Children's Oral Health, NHANES 2011–2014

Published in: Journal of Public Health Dentistry, Volume 78, Issue 4 (Fall 2018), Pages 337-345. doi:10.1111/jphd.12278

Posted on on December 20, 2018

by Erin Lindsey Duffy, Ashley M. Kranz, Andrew W. Dick, Mark J. Sorbero, Bradley D. Stein


To examine the association between type of health insurance (public, uninsured, private, or other) and oral health outcomes for children in the United States using nationally representative surveillance data.


Using the National Health and Nutrition Examination Survey (2011/12–2013/14), logistic regression models were used to estimate the odds of any dental caries and any untreated caries by type of health insurance (public, uninsured, private, and other) for children aged 2–19 years, with adjustment for relevant individual and socioeconomic characteristics.


Among 6,057 children, the odds of having any dental caries or untreated caries was not significantly different for publicly insured and uninsured children compared to privately insured children, when adjusting for family income and education. Children in families with income to poverty ratios <200 percent had greater odds of caries and untreated caries relative to children in families with income to poverty ratios ≥ 400 percent. Children with less educated parents also experienced greater odds of caries and untreated caries.


Oral health outcomes, after adjusting for covariates, were similar for children with public and private health insurance. However, children in low-income families and with less educated parents had greater odds of untreated caries and dental caries, suggesting that initiatives focused on publicly insured populations may miss other vulnerable children of low socioeconomic status.

Research conducted by

This report is part of the RAND Corporation External publication series. Many RAND studies are published in peer-reviewed scholarly journals, as chapters in commercial books, or as documents published by other organizations.

The RAND Corporation is a nonprofit institution that helps improve policy and decisionmaking through research and analysis. RAND's publications do not necessarily reflect the opinions of its research clients and sponsors.