Thesis Title

Dentists' Attitudes As Barriers To Dental Care For Pediatric Medicaid Recipients


Terri Schmitt

Date of Graduation

Summer 2001


Master of Science in Nursing



Committee Chair

Kathryn Hope

Subject Categories



Oral health of American children recently has become a national priority. Yet, dental care access for pediatric Medicaid recipients is an ongoing problem, despite the expansion of fee schedules and eligibility for Medicaid dental care. Previous research in this are focused only on bureaucratic complications as barriers to Medicaid dental care. Research examining dentists' attitudes as barriers is sparse. Specifically, the study answers: what is the effect of dentists' attitudes on the acceptance or rejection of pediatric Medicaid patients for dental care; and what attitudes are significant predictors of dentists accepting or rejecting pediatric Medicaid patients for dental care. This secondary analysis used data from a previous survey of Missouri dentists (McCunniff, Damiano, Daneman, Willard, & Momany, 1999) to validate a model of dentists' attitudes as significant barriers to dental care for Pediatric Medicaid enrollees. The study utilized a sub-sample of the original study, with 312 dentists in the Missouri fee-for-service areas that returned mailed questionnaires, for a 65% response rate. Model testing was performed through logistical regression. Study findings included: significant model fit with inclusion of all four concepts, which were dentists' attitudes about the Medicaid program, Medicaid as compared to private insurance, Medicaid patients and care, and moral and social obligation. The two concepts that brought the model to significant fit were attitudes about Medicaid patients and care and moral and social obligation. As well, four questionnaire items, in the model, were found to be significant through logistical regression: low fees, spending less time with other patients, other patients in dental practices feeling uncomfortable, and ethical obligation. Although several questionnaire items were insignificant in the model of dentists' attitudes, they still produced a statistically significant variance. Implications of this research include focusing reform on improving access through changing dentists' attitudes about children with Medicaid and ethical obligations in treating all patients.


© Terri Schmitt