An estimated 6.5 million US Medicaid children had untreated tooth decay, according to a report released on Wednesday by the Government Accountability Office.

“Children in Medicaid remain at higher risk of dental disease compared to children with private health insurance; children in Medicaid were almost twice as likely to have untreated tooth decay,” the report reads.

GAO was asked to look at the situation after Deamonte Driver, a Maryland Medicaid covered 12 year old child died last year because of an infected tooth. The untreated infected tooth led to a brain infection. The boy had “extensive dental disease and his family was unable to find a dentist to treat him,” according to the report. The case urged Government Accountability Office (GAO) to investigate how Medicaid covers children, especially their dental health.

Nationwide, only one in three children covered by Medicaid had received any dental care in the year before the survey was carried out, the report found. 14.8 percent of Medicaid recipients said their children had not gotten necessary dental care because their dentist refused to accept Medicaid, the report said. About one in eight children reportedly never sees a dentist, while more than half of children with private health insurance had received dental care in the prior year, it adds. More than 5% (1.1 million children) of Medicaid children reported to have dental conditions like tooth fractures, oral lesions, chronic pain. The percentage is 4 times higher than the number of children with private coverage that had urgent dental conditions.

Medicaid is the joint federal and state program that provides health care coverage for low-income, blind and disabled people.

“We estimate that 724,000 children aged 2 through 18 in Medicaid could not obtain needed care,” the report added.