Effects of Preventive Dental Services and Requiring Dental Screening Certificates for School on Academic Achievement

/ABSTRACT Oral health disparities by income emerge early in life in the United States, with disproportionately higher rates of untreated dental decay dental decay and unmet dental care needs more among low-income children and those in Medicaid. Poor oral health is associated with reduced school performance and lower psychosocial wellbeing. However, the extant evidence is mostly based on contemporaneous and self-reported measures of oral health, dental services use, and academic outcomes. Despite the conceptual relevance of preventive dental services and the clinical evidence on their effects on oral health, there is no causal evidence on effects of preventive dental care on academic achievement including the magnitude of effects and their timing (at what ages effects develop and oral health interventions are most effective over the child’s life). Policymakers recognize the links between oral health and school health and achievement. Some states have enacted dental screening requirements before kindergarten. However, there is no causal evidence on the effects of such policies on dental services use and academic achievement. Adding this evidence is critically important to guide policymaking by accounting for the full benefits of preventive oral health services and screening programs including those accruing to school achievement. This study leverages unique population-based dataset linking birth certificates, Medicaid enrollment/claims files, and school test scores for children enrolled in Medicaid in Iowa. The study will identify the causal effects of preventive dental services including comprehensive oral exams, prophylaxis, fluoride application, and dental sealants on children’s academic achievement including the ages of the children when these effects are most pronounced (based on age when dental services are received and on school age when academic achievement is measured). Examining the timing of effects is critical to identifying developmentally sensitive ages when these services become more effective. The study will also identify the causal effects of requiring a dental screening certificate before kindergarten on subsequent dental services utilization and academic achievement. The study will address key gaps in the literature and provide evidence of direct implications for policymaking aiming at addressing the adverse impacts of poor oral health on the children’s academic performance and overall wellbeing. Project Number: 5R03DE033994-02 | Fiscal Year: 2026 | NIH Institute/Center: National Institute of Dental and Craniofacial Research (NIDCR) | Principal Investigator: George Wehby | Institution: UNIVERSITY OF IOWA, IOWA CITY, IA | Award Amount: $155,500 | Activity Code: R03 | Study Section: ZDE1-TO(04) View on NIH RePORTER: https://reporter.nih.gov/project-details/11324643