Access to oral health care under the Early and Periodic Screening, Diagnosis, and Treatment (EPSDT) program is a nationwide problem, particularly for very young minority children. Few studies have examined racial disparities in use of dental care in Medicaid-eligible children by type of service, especially in the pre-school aged group. Objective: This study examines racial disparities in type of dental services use in the North Carolina Medicaid Program for children younger than five years of age. Methods: An analysis file was constructed of 49,512 children ages 1-5 years using four data sources (birth records, Medicaid eligibility and claims files and the Area Resource File). They were chosen from a cohort born in 1992 and were followed up to their fifth birthday. We defined three service categories: preventive, restorative, emergency. A child was defined into a service category if they had one or more claims in that category during the first five years of life. Multiple logit regression models with controls were used in the analyses. Results: Of the 81,518 NC births in 1992, 49,795 were Medicaid eligible and met the inclusion criteria for this study: 49% White, 42% African American, 3% Hispanic, 2% American Indian, 1% Asian and 3% other. When compared to White children, African American children were significantly less likely to use dental services of any type (p<.01), American Indian children were significantly more likely to use preventive (p<.01) and restorative services (p<.01) and less likely to use emergency services (p<.05). Also significant in our models were mother's age, mother's education, Medicaid enrollment duration, dentist-population ratio and geographic location. Conclusion: These analyses suggest racial disparities exist in type of dental services utilization by preschool aged children. Access is particularly problematic in African American children. Supported by NIDCR Grant # 1K22DE14743.

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