VCU news

By Joan Tupponce

Shillpa Naavaal’s concern for Virginians who need the most dental care but receive the least has been at the root of her research for the past 10 years.

“Oral health is one of the most unmet health needs. Financial barriers are major, and the burden of disease is higher among vulnerable groups,” said Naavaal, an associate professor in the Department of Dental Public Health and Policy at Virginia Commonwealth University’s School of Dentistry.

Oral health is important to a person’s overall health and is associated with social, emotional and financial well-being, she said. “In order to support everyone in achieving the best health possible, it’s important to have strong and effective policies in place.”

Naavaal hopes to promote them through her five-year grant from the National Institutes of Health, with funding of nearly $1 million. 

The grant is supporting her study titled the “Role of Comprehensive Adult Medicaid Dental Benefits in Improving Oral Health and Reducing Disparities among Adults and Children.” It expands her health policy research by examining the impact of the dental coverage policy on access to and use of dental care services among Medicaid-eligible Virginians.

Since 2021, all Medicaid-enrolled adults in Virginia have been eligible for comprehensive dental coverage – benefits that were previously available only to children and pregnant women in the program. However, there has been little research on how these policies have impacted oral health in the state.

Naavaal’s multiyear project will provide data to improve strategies for existing and new policies, including system-level changes to minimize disparities and maximize oral health gains among Medicaid enrollees.

“This will be the first-ever comprehensive analysis using rich administrative claims data and rigorous analytic and econometric models to examine the demand for dental services among adults following the implementation of the Medicaid adult dental policy, its effect on the use of dental services in emergency rooms and its indirect effect on the use of dental services among children enrolled in Medicaid,” Naavaal said.

The findings should illuminate individual and family oral health gains attributable to the Medicaid dental benefit. They also will generate actionable evidence to strengthen the policy, identify strategies to minimize disparities in access and use of dental care, and provide valuable information to Medicaid programs across the nation.

Naavaal’s research and advisory team includes experts from VCU’s School of Dentistry (Tegwyn H. Brickhouse, D.D.S., Ph.D.), School of Population Health (Peter Cunningham, Ph.D., and Bassam Dahman, Ph.D.), School of Business (David W. Harless, Ph.D.) and College of Health Professions (Paula Song, Ph.D.), along with experts from the Virginia Department of Health, Virginia Department of Medical Assistance Services, the Virginia Health Information nonprofit and Virginia Health Catalyst, a statewide coalition that promotes oral care.

“The combination of ideas and inputs from different perspectives is important to understand and solve the sticky problems of health care access and utilization,” Naavaal said.

The primary aim of her work is to examine racial and ethnic disparities within the Medicaid group and how groups compare with each other.

“The findings will provide a clear understanding of how dental benefit uptake has been following the policy,” Naavaal said. “The work following this research will help develop specific programs and evaluate various health care delivery models to improve oral health among Medicaid members.”