Preventive Dental Visit

Introduction

This toolkit summarizes content from the Preventive Dental Visit: Pregnancy and Child/Adolescent Evidence Accelerator, and the MCHbest database. The peer-reviewed literature supporting this work can be found in the Established Evidence database. Use the resources below as you develop effective evidence-based/informed programs and measures.

From the MCH Block Grant Guidance. Oral health is a vital component of overall health and oral health care remains the greatest unmet health need for children. Insufficient access to oral health care and effective preventive services affects children’s health, education, and ability to prosper. To prevent tooth decay and oral infection, the American Academy of Pediatric Dentistry (AAPD) recommends preventive dental care for all children after the eruption of the first tooth or by 12 months of age, usually at intervals of every 6 months.1 Oral Evaluation Dental Services is part of the Core Set of Children’s Health Care Quality Measures for Medicaid and CHIP.

Goal. To increase the percentage of pregnant women and children who receive preventive dental visits.

Note. Access other related measures in this Population Domain through the Toolkits page.

Detail Sheet: Start with the MCH Block Grant Guidance

GOAL: To increase the percentage of pregnant women and children who receive preventive dental visits.

DEFINITION:
Numerators: Number of women who reported having their teeth cleaned by a dentist or dental hygienist during pregnancy ; Number of children, ages 1 through 17, who are reported by a parent to have seen a dentist or other oral health care provider for preventive dental care in the past year

Denominators: Number of women with a recent live birth (PRAMS); Number of children, ages 1 through 17

Units: 100
Text: Percent

HEALTHY PEOPLE 2030 OBJECTIVE: Related to Oral Health (OH) Objective 08: Increase the proportion of children, adolescents, and adults who use the oral health care system. (Baseline: 43.3% in 2016 (age adjusted to the year 2000 standard population), Target: 45.0%); Related to Oral Health (OH) Objective 09. Increase the proportion of low income youth who have a preventive dental visit. (Baseline: 78.8% in 2016-17, Target: 82.7%)

DATA SOURCES: Pregnancy Risk Assessment Monitoring System (PRAMS); National Survey of Children's Health (NSCH)

MCH POPULATION DOMAIN: Women/Maternal Health, Child Health, and/or Adolescent Heath

MEASURE DOMAIN: Clinical Health Systems

1. Accelerate with Evidence—Start with the Science

The first step to accelerate effective, evidence-based/informed programs is ensuring that the strategies we implement are meaningful and have high potential to affect desired change. Read more about using evidence-based/informed programs and then use this section to find strategies that you can adopt or adapt for your needs.

Evidence-based/Informed Strategies: MCHbest Database

The following strategies have emerged from studies in the scientific literature as being effective in advancing the measure. Use the links below to read more about each strategy or access the MCHbest database to find additional strategies.

Oral Health During Pregnancy

Chart of Evidence-Linked Strategies and Tools
Evidence-Informed			Evidence-Based
Mixed Evidence	Emerging Evidence	Expert Opinion	Moderate Evidence	Scientifically Rigorous
	Patient Education/Counseling (2016) Quality Improvement Collaboratives (2018)	Information About Teledentistry (2019) Provider Education (National Associations) (2019)	Provider Education (Early Head Start, Home Visiting, WIC) (2018) Medicaid Reforms (2022)	Teledentistry (2019)

Oral Health During Childhood

Chart of Evidence-Linked Strategies and Tools
Evidence-Informed			Evidence-Based
Mixed Evidence	Emerging Evidence	Expert Opinion	Moderate Evidence	Scientifically Rigorous
School-Based Screenings and Follow-Up (2022)	Caregiver/Patient Education and/or Counseling (2015) Mobile Oral Care Programs (2019) Preventive Oral Care Outreach (2010)	Information About Teledentistry (2019)	Community School Partnerships (2017) Early Head Start Integration (2018) Medicaid Reforms (2022) Public Insurance Coverage (2022)	School-Based Dental Programs (2023) Teledentistry (2022)

Field-Based Strategies: Find promising programs from AMCHP’s Innovation Hub

Emerging:

Home By One Program (CT; 2011)
Dental Health Safety Net (MN; 2020)
Healthy Teeth Happy Babies (CO; 2011)
Improve Access to Oral Health Information (VA; 2019)

Promising:

Virtual Dental Home (Teledentistry) Project (HI; 2018)

2. Think Upstream with Planning Tools—Lead with the Need

The second step in developing effective, evidence-based/informed programs challenges us to plan upstream to ensure that our work addresses issues early and is measurable in “turning the curve” on big issues that face MCH populations. Read more about moving from root causes to responsive programs and then use this section to align your work with the data and needs of your populations.

Move from Need to Strategy

Use Root-Cause Analysis (RCA) and Results-Based Accountability (RBA) tools to build upon the science to determine how to address needs.

Planning Tools: Use these tools to move from data to action

3. Work Together with Implementation Tools—Move from Planning to Practice

The third step in developing effective, evidence-based/informed programs calls us to work together to ensure that programs are implementable and moveable within the realities of Title V programs and lead to improved health outcomes for all people. Read more about implementation tools designed for MCH population change and then use this section to develop responsive strategies to bring about change that is responsive to the needs of your populations.

Additional MCH Evidence Center Resources: Access supplemental materials from the literature

Find field-based resources focused on increasing preventive dental visits relevant to Title V programs for pregnancy and for child/adolescent in the MCH Digital Library.
Search the Established Evidence database for peer-reviewed research articles related to strategies for increasing preventive dental visits.
Request Technical Assistance from the MCH Evidence Cente.
MCH Evidence Center Frameworks and Toolkits:

Implementation Resources: Use these field-generated resources to affect change

Practice. The following tools can be used to translate evidence to action to advance this NPM:

Basic Screening Surveys (Association of State & Territorial Dental Directors). These tools were updated in 2022 and available for states to use.
Oral Health Educational Materials (Health Resources & Services Administration). These educational materials are focused on improving oral health literacy.

Partnership. The following organizations focus efforts on supporting improved oral health:

Association‌ of‌ State‌ &‌ Territorial‌ Dental‌ Directors. Provides leadership to support state and territorial oral health programs.
Center for Oral Health. Improves oral health through innovation, research, and education.

Additional Resources:

National Maternal and Child Oral Health Resource Center: An MCHB-funded technical assistance resource center, this project supports NPM 13 topic areas.
- Making a Pitch for Introducing Oral Health Issues to MCH Director or Title V Coordinator describes how to craft a pitch for introducing oral health issues to the MCH director or Title V coordinator in your state.
- Rationale for Including Oral Health in the Title V 5-Year Needs Assessment lists reasons why including oral health in the needs assessment is important. This information can be used as talking points or included in written communication to the MCH director or Title V coordinator.
- Including Oral Health in the Title V Maternal and Child Health 5-Year Needs Assessment and State Action Plan provides information about the needs assessment and state action plan and about how oral health program directors and staff and community partners can contribute to the needs-assessment process.
- Title V National Performance Measure 13 (Oral Health): Strategies for Success, second edition. This resource provides information to help state maternal and child health programs in their implementation of the Title V NPM 13 and oral-health-related state performance measures. It offers sample strategies for providing preventive dental visits for pregnant women and children and adolescents ages 1–17. The second edition includes new strategies for using teledentistry to provide preventive oral health care. For all strategies, the report presents sample evidence-based or evidence-informed strategy measures (ESMs), possible data sources for ESMs, and a comprehensive list of resources.
- Infographics: These infographics provide information for oral health professionals about benefits of and barriers to preventive dental visits for pregnant women and children and adolescents ages 1–17. The resources can be shared with program administrators and other stakeholders to raise their awareness about the Title V NPM 13 and the importance of preventive dental visits to reduce oral health problems and unnecessary treatment expenses.
  - Preventive Dental Visits for Pregnant Women Are Important!
  - Preventive Dental Visits for Children and Adolescents Are Important!
Rural Oral Health Toolkit (Rural Health Information Hub). The evidence-based toolkit is designed to help identify and implement an oral health program in communities. It also provides you with resources and best practices.

References

Introductory References: From the MCH Block Grant Guidance

¹ Periodicity of Examination, Preventive Dental Services, Anticipatory Guidance/Counseling, and Oral Treatment for Infants, Children, and Adolescents. Pediatr Dent. 2017;39(6):188-196.

² Committee Opinion No. 569: oral health care during pregnancy and through the lifespan. Obstet Gynecol. 2013;122(2 Pt 1):417-422. doi:10.1097/01.AOG.0000433007.16843.10

Evidence Tools Preventive Dental Visit