194 - Medicaid Reimbursement and Parental Psychosocial Concerns for Esthetic Anterior Crowns

Purpose: This study evaluated zirconia crown use in primary incisors, perceived psychosocial effects and barriers to care for children insured by Medicaid.

Methods: A dual questionnaire survey was utilized. The first survey was electronically sent to AAPD members inquiring whether zirconia crowns were a treatment option for Medicaid insured patients and what offices are doing to cover increased costs of zirconia crowns utilization. The second survey evaluated parental perceptions of anterior stainless-steel crowns (SSCs) for Medicaid insured patients.

Results: The provider survey revealed that 54.1% provide anterior zirconia crowns as a treatment option; 35.9% stated that Medicaid reimbursement influences their decision to place a zirconia crown on primary incisors; 64.2% are absorbing additional costs of the zirconia crowns and 35.8% are charging an additional fee. The parent survey revealed that 66.7% of parents would be moderately to extremely concerned if their child had SSCs on primary incisors; 51.7% of parents believe that SSCs would cause their child moderate or extreme concern; 71.2% report that they would be moderately or extremely concerned about bullying; 73.6% of parents stated that SSCs on their child’s incisors would cause moderate or extreme responsibility or guilt; 92% of parents stated a willingness to pay at least twenty dollars or more per tooth for zirconia crowns on primary incisors.

Conclusions: Reimbursement influences providers’ willingness to utilize zirconia crowns as a treatment option and creates a potential barrier to care. However, parental concerns exist for psychosocial effects and most parents are willing to pay additional fees for zirconia crowns.