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Strengthen the Evidence for Maternal and Child Health Programs

New: MCHbest strategies database for sample ESMs

Evidence Tools
NPM 13

young girl and dentist smiling into a mirrorPreventive Dental Visit (Oral Health)


The Title V Maternal and Child Health Services Block Grant to States Program guidance defines the significance of this goal as follows:

Oral health is a vital component of overall health. Access to oral health care, good oral hygiene, and adequate nutrition are essential component of oral health to help ensure that children, adolescents, and adults achieve and maintain oral health. People with limited access to preventive oral health services are at greater risk for oral diseases.

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. Early dental visits teach children that oral health is important. Children who receive oral health care early in life are more likely to have a good attitude about oral health professionals and dental visits. Pregnant women who receive oral health care are more likely to take their children to get oral health care.

State Title V Maternal Child Health programs have long recognized the importance of improving the availability and quality of services to improve oral health for children and pregnant women. States monitor and guide service delivery to assure that all children have access to preventive oral health services. Strategies for promoting oral health include providing preventive interventions, such as dental sealants and use of fluoride, increasing the capacity of State oral health programs to provide preventive services, evaluating and improving methods of monitoring oral diseases and conditions, and increasing the number of community health centers with an oral health component.

NPM 13 Tools

New Resources

MCHbest LogoThe MCH Evidence Center is pleased to share Phase 1 of the MCHbest database: the Bank of Evidence-linked Strategies and Tools.

The database aggregates sample evidence-based/informed strategies that can be used as-is or adapted to develop Evidence-based or informed Strategy Measures (ESMs) for each of the MCH National Performance Measures (NPMs). Use the database along with the ESM Development Guide to work through the entire ESM process.

NEW! Watch a short video (below) discussing state-of-the-art, evidence-based/informed strategies that can be used or adapted as ESMs. Experts in the field discuss approaches, the science, and specific ways that Title V agencies can implement and measure these approaches.

NEW! The National Maternal and Child Oral Health Resource Center (OHRC) is pleased to announce three new resources focusing on the NPM 13:

Strategy Video

Presented by Katrina Holt, National Maternal and Child Oral Health Resource Center


Introductory Resources

Summary of the Evidence

The following trends emerged from analysis of peer- reviewed evidence. While findings might not completely align with your ESM, they can serve as ideas for future expansion.

Key Findings for NPM 13.1: Oral Health During Pregnancy:

  • There is limited evidence about interventions to increase dental visits during pregnancy.

Key Findings for NPM 13.2: Oral Health During Childhood:

  • School/preschool interventions appear to be effective.
  • Public insurance coverage appears to be effective.
  • Medicaid reforms appear to be effective.

Access the published evidence.

Evidence Analysis Reports

Promising Practices

You can access strategies from AMCHP’s Innovation Station that have shown promise in advancing your NPM below. While these strategies may not completely align with your current activities, they can be used to help guide further development and measurement of your ESM.

Practice Name Primary Interest  State  Level of Evidence
Children's Dental Services Oral Health MN Emerging
Improving Oral Health Outcomes for Pregnant Women and Infants by
Educating Home Visitors
Oral Health VA Emerging
Home by One Program Child Health CT Emerging
Virtual Dental Home Oral Health HI Promising

Sample ESMs

The following ESMs fall under measurement categories 2 – 4 and can be used as models.

State  Sample ESM Numerator Denominator Unit Category
VT % of pregnant women enrolled in WIC receiving preventive oral health care and education from a public health dental hygienist working in local health offices # of pregnant women enrolled in WIC receiving preventive oral health care and education from a public health dental hygienist working in local health offices The number of pregnant women enrolled in WIC Percent 2
** Number of primary care practices implementing State Oral Health Program after training # of practices reporting using screening, and referring children during at least 85% of well child visits 6 mo. after training N/A Number 3
MA % of community health centers that adopt or implement the MA Oral Health Practice Guidelines     Percent 4

Additional Learning

  • NPM 13 Transformation Tools (MCH Navigator and National MCH Workforce Development Center). Learning resources, implementation strategies, and links to the evidence base for the competencies needed to carry out NPM 13 activities.
  • Taking Action with Evidence Implementation Roadmap (Association of MCH Programs (AMCHP) and WCHPC). Archived webinars and additional learning and implementation resources.
  • Historical Resources from the MCH Digital Library (NCEMCH). This bibliography is automatically generated to pull resources from MCHLine, the MCH Library's online catalog of seminal resources, in support of NPM 13. Coming soon.

Additional Resources

  • National Maternal and Child Oral Health Resource Center: An MCHB-funded technical assistance resource center, this project supports NPM 13 topic areas.
    • 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.
  • Implementation Toolkit for National Performance Measure 13 (AMCHP). This toolkit contains examples of state strategies being used to address NPM 13 in Title V programs.
  • 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.
  • Data Resource Center for Child and Adolescent Health (DRC): A project of the Child and Adolescent Health Measurement Initiative, the DRC is a national data resource providing easy access to children’s health data on a variety of important topics, including the health and well-being of children and access to quality care.

This project is supported by the Health Resources and Services Administration (HRSA) of the U.S. Department of Health and Human Services (HHS) under grant number U02MC31613, MCH Advanced Education Policy, $3.5 M. This information or content and conclusions are those of the author and should not be construed as the official position or policy of, nor should any endorsements be inferred by HRSA, HHS or the U.S. Government.