MCHbest. NPM 13.1: Preventive Dental Visit: Pregnancy

Strategy. Information about Teledentistry

Approach. Provide information about opportunities and barriers related to teledentistry (e.g., state statutes, practice acts, reimbursement policies) to key state and/or local oral health stakeholders.

Overview. States and jurisdictions contemplating the use of teledentistry could benefit from an understanding of the science behind the practice as well as opportunities and barriers associated with teledentistry. Providing information about services is an evidence-based strategy that has shown utility in increasing use of professional services other than oral health by MCH population groups. While limited research has been conducted to verify results with populations in need of oral health services, this research can serve as a proxy to gauge effect.¹

Evidence. Expert opinion. Strategies with this rating are recommended by credible, impartial experts and are consistent with accepted theoretical frameworks. However, the strategies have limited research documenting effects; further research, often with stronger designs, is needed to confirm effects. This strategy was drawn from Holt K, Louie R. 2019. Strengthening State and Jurisdiction Efforts Related to Title V Maternal and Child Health National Performance Measure 13 (Oral Health). Washington, DC: National Maternal and Child Oral Health Resource Center. This expert opinion is based on multiple resources.² (Read more about understanding evidence ratings).

Telemedicine has been shown by the Robert Wood Johnson Foundation to be scientifically supported. In addition, systematic reviews have established teledentistry as an equally effective practice.³

Target Audience. Key stakeholders may include the state MCH program; the state oral health program, if not involved in planning strategy; the state Medicaid office; the state health officer; state dental and dental hygiene associations; the state dental board; the state oral health coalition; and policymakers.

Outcome. Understanding of teledentistry. For detailed outcomes related to each study supporting this strategy, click on the peer-reviewed evidence link above and read the “Intervention Results” for each study.

Examples from the Field. Access descriptions of current ESMs that use this strategy directly or intervention components that align with this strategy. You can use these ESMs to see how other Title V agencies are addressing the NPM.

Sample ESMs. Using the approach “Provide information about opportunities and barriers related to teledentistry to key state and/or local oral health stakeholders,” here are sample ESMs you can use as a model for your own measures using the Results-Based Accountability framework (for suggestions on how to develop programs to support this strategy, see The Role of Title V in Adapting Strategies):

Quadrant 1:
Measuring Quantity of Effort ("What/how much did we do?")

Number of key stakeholders who received educational resources and indicated that they have reviewed content.
Number of state statutes, practice acts, and reimbursement policies about teledentistry reviewed by state oral health program.
Number of educational efforts (e.g., meetings, presentations, phone calls, letters) conducted by state oral health program to provide information about opportunities and barriers related to teledentistry to key stakeholders in the past 12 months.
Number of educational resources about teledentistry provided by state oral health program to key stakeholders.

Quadrant 2:
Measuring Quality of Effort ("How well did we do it?")

Percent of key stakeholders who received educational resources and indicated that they have reviewed content.
Percent of state statutes, practice acts, and reimbursement policies about teledentistry reviewed by state oral health program.
Percent of educational efforts (e.g., meetings, presentations, phone calls, letters) conducted by state oral health program to provide information about opportunities and barriers related to teledentistry to key stakeholders in the past 12 months.
Percent of educational resources about teledentistry provided by state oral health program to key stakeholders.

Quadrant 3:
Measuring Quantity of Effect ("Is anyone better off?")

Number of improved practice acts or reimbursement policies about teledentistry as a result of review by state oral health programs.
Number of key stakeholders who participated in educational efforts aimed to provide information about teledentistry who also increased knowledge of teledentistry.
Number of key stakeholders who received educational resources who indicated increased knowledge of teledentistry.

Quadrant 4:
Measuring Quality of Effect ("How are they better off?")

Percent of improved practice acts or reimbursement policies about teledentistry as a result of review by state oral health programs.
Percent of key stakeholders who participated in educational efforts aimed to provide information about teledentistry who also increased knowledge of teledentistry.
Percent of key stakeholders who received educational resources who indicated increased knowledge of teledentistry.

Note. ESMs become stronger as they move from measuring quantity to measuring quality (moving from Quadrants 1 and 3, respectively, to Quadrants 2 and 4) and from measuring effort to measuring effect (moving from Quadrants 1 and 2, respectively, to Quadrants 3 and 4).

Possible Data Sources for ESMs:

State oral health program data

Learn More. Read how to create stronger ESMs and how to measure ESM impact more meaningfully through Results-Based Accountability.

References:

¹ Perkins, R. B., Zisblatt, L., Legler, A., Trucks, E., Hanchate, A., & Gorin, S. S. (2015). Effectiveness of a provider-focused intervention to improve HPV vaccination rates in boys and girls. Vaccine, 33(9), 1223-1229.

² Resources used to establish expert opinion:

Association of State and Territorial Dental Directors, Best Practice Committee. 2019. Best Practice Approach: Perinatal Oral Health. Reno, NV: Association of State and Territorial Dental Directors.
Casamassimo P, Holt K, eds. 2016. Bright Futures in Practice: Oral Health—Pocket Guide(3rd ed.).Washington, DC: National Maternal and Child Oral Health Resource Center.
Clark MB, Douglass AB, Maier R, Deutchman M, Gonsalves W, Silk H, Wrightson AS, Quinonez R, Dolce M, Dalal M, Rizzolo D. 2010. Smiles for Life: A National Oral Health Curriculum(3rd ed.). Leawood, KS: Society of Teachers of Family Medicine.
Lorenzo S, Goodman H, Stemmler P, Holt K, Barzel R, eds. 2019.The Maternal and Child Health Bureau–Funded Perinatal and Infant Oral Health Quality Improvement (PIOHQI) Initiative 2013–2019: Final Report. Washington, DC: National Maternal and Child Oral Health Resource Center.
Oral Health Care During Pregnancy Expert Workgroup. 2012. Oral Health Care During Pregnancy: A National Consensus Statement. Washington, DC: National Maternal and Child Oral Health Resource Center.
Maternal and Child Oral Health Resource Center. 2010. Open Wide: Oral Health Training for Health Professionals. Washington, DC: National Maternal and Child Oral Health Resource Center.
Wells J. 2019. Improving Oral Health Outcomes for Pregnant Women and Infants by Educating Home Visitors. Washington, DC: Association of Maternal and Child Health Programs.

³ Systematic reviews of teledentistry:

Alabdullah JH, Daniel SJ. A Systematic Review on the Validity of Teledentistry. Telemed J E Health. 2018;24(8):639‐648. doi:10.1089/tmj.2017.0132
Estai M, Kanagasingam Y, Tennant M, Bunt S. A systematic review of the research evidence for the benefits of teledentistry. J Telemed Telecare. 2018;24(3):147‐156.

Evidence Tools MCHbest. NPM 13.1: Preventive Dental Visit: Pregnancy

Strategy. Information about Teledentistry

Approach. Provide information about opportunities and barriers related to teledentistry (e.g., state statutes, practice acts, reimbursement policies) to key state and/or local oral health stakeholders.

Evidence Tools
MCHbest. NPM 13.1: Preventive Dental Visit: Pregnancy