U.S. Government Accountability Office Reports on Children's Oral Health and Dental Care: A 31-Year Retrospective Analysis.

Purpose: The purpose of this study was to identify and analyze reports and testimonies from the U.S. Government Accountability Office (GAO) relevant to children's oral health and dental care during the calendar years 1990 through 2021. Methods: The GAO database was searched for reports and testimonies that directly or tangentially addressed children's oral health and dental care. Titles, abstracts, and texts were reviewed to determine what Congress asked of GAO and how GAO responded. Results: Among nearly 30,000 health- and health care-related GAO releases over 31 years, 35 were focused on children's oral health and/or dental care. In response to requests by key congressional committees and legislators, reports addressed coverage, access, utilization, cost, network adequacy, workforce, and safety net. Multiple reports addressed the persistence of health and health care inequities. GAO's findings have supported dental mandates for the Children's Health Insurance Program (CHIP) and Affordable Care Act, the federal pediatric Oral Health Initiative, and congressional oversight of federal agencies that administer Medicaid/CHIP and train dentists. Conclusions: Over more than a quarter century, the U. S. Government Accountability Office has contributed meaningfully to congressional understanding of pediatric oral health and dental care. Continued reliance by Congress on GAO investigations can further enhance policy-making and oversight on issues important to pediatric dentistry.