Dental disease is one of the most prevalent illnesses facing children in the United States today. Eighty percent of untreated dental disease in permanent teeth is found in roughly 25 percent of 5- to 17-year old children, most of whom come from low-income and other vulnerable populations. The State Children's Health Insurance Program (SCHIP) offers states an opportunity to expand health insurance and, by extension, financial access to dental care. This paper analyzes whether and how the coverage and delivery of dental services is changing under SCHIP, examining key differences between new separate SCHIP initiatives and traditional and expanded Medicaid programs. Data from telephone interviews and site visits with 18 states indicated that states did not focus particular attention on dental issues during SCHIP program development, though dental health coverage constituted a fundamentally important component of child health programs. All but one state elected to cover dental benefits. The extent of dental coverage under SCHIP was quite broad, although not as comprehensive as Medicaid dental coverage. Copayments on dental services were nominal in most separate SCHIP programs. Under separate SCHIP programs, some states raised dental payment levels above Medicaid's in an effort to raise dental provider participation, while other states paid about the same for dental services. In two states, early SCHIP dental program successes hastened reform efforts under Medicaid dental programs. Results suggest that improvements in access may be occurring under separate SCHIP programs that are paying dental providers at market rates when compared with Medicaid. (Contains 15 references.) (SM)