Children with sickle cell disease face low dental care utilization despite elevated risks

Children with sickle cell disease face low dental care utilization despite elevated risks | Image Credit: © Wat.Pt - stock.adobe.com.

Children with sickle cell disease (SCD) are more likely to experience dental complications, yet fewer than half of those enrolled in Michigan Medicaid received dental care in 2022, according to a new study published in JAMA Network Open.^1,2

The study, led by researchers at Michigan Medicine and the RAND Corporation, examined Medicaid dental claims for 1,096 children with SCD and compared them with claims from more than 1.18 million Medicaid-enrolled children in Michigan. Despite increased risk for oral health problems, children with SCD had dental care utilization rates comparable to the general Medicaid pediatric population.

“Sickle cell disease is known to increase the risk of dental complications in children, which underscores the importance of preventive dental care for this population,” said senior author Sarah Reeves, PhD, MPH, an associate professor of pediatrics and epidemiology at the University of Michigan Medical School and the Susan B. Meister Child Health Evaluation and Research (CHEAR) Center.

Study design and findings

Using validated case definitions from the Michigan Sickle Cell Data Collection program, investigators analyzed dental claims for preventive services, treatment, and overall utilization. The analysis followed STROBE reporting guidelines and used Centers for Medicare & Medicaid Services data for comparison.

Results showed that 42% of children with SCD received any dental services in 2022, compared with 44% of the general Medicaid population. Preventive dental care was received by 38% of children with SCD compared with 40% of peers without SCD. Treatment services were accessed by 15% of children with SCD versus 18% of other Medicaid-enrolled children.

When analyzed by age group, some disparities emerged. For example, children aged 6 to 14 years with SCD were significantly less likely to receive any dental services (50% vs 54%) and preventive dental services (46% vs 51%) compared with their peers. In contrast, children aged 1 to 5 years with SCD had slightly higher utilization rates, although these differences were not statistically significant.

Clinical significance

The authors emphasized the importance of preventive dental care for children with SCD due to the disease’s reciprocal relationship with oral health. Dental infections can trigger or worsen SCD complications by causing inflammation and red blood cell sickling.

“Oral infections are especially dangerous for people with sickle cell disease because they can trigger or worsen symptoms and serious complications,” Reeves said. “Preventative dental care helps reduce the risk of pain crises and hospitalizations.”

Despite these risks, access barriers persist. Medicaid covers pediatric dental services, and guidelines recommend annual visits for children. However, both children with and without SCD in the study showed low utilization rates.

Barriers and recommendations

The study noted several barriers limiting dental care access for children with SCD, including limited participation of dentists in Medicaid programs and a lack of clear clinical guidance for treating these patients.

“Our findings show that we need to take steps to make sure kids with this condition get the dental care they need—by helping dentists feel more prepared to treat them and making sure doctors know how important dental health is for these children,” Reeves said.

Targeted interventions may include improved training for dental providers, stronger coordination between medical and dental professionals, and expanded research on structural barriers.

“Given increased risk of oral health problems among patients with sickle cell disease we need focused efforts to expand access to dental services for them,” Reeves said. “There are many reasons why dental care rates are low in this group. Future research should look at what those barriers are and how we can overcome them to improve care for this vulnerable population.”

The study highlights the need for improved strategies to ensure preventive dental care reaches children with SCD, underscoring its role in preventing serious health complications.

References

1. Michigan Medicine - University of Michigan. Children with sickle cell disease face higher risk of dental issues, yet many don’t receive needed care. Eurekalert. September 3, 2025. Accessed September 5, 2025. https://www.eurekalert.org/news-releases/1096502
2. Kranz A, Peng HK, King AA, Clark SJ, Plegue MA, Reeves SL. Sickle Cell Disease and Dental Care Access Among Medicaid-Enrolled Youths. JAMA Network Open. 2025;8(9):e2529849-e2529849. doi:https://doi.org/10.1001/jamanetworkopen.2025.29849