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Strengthen the Evidence for Maternal and Child Health Programs

New: MCHbest strategies database for sample ESMs

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

MCHbest Logo young woman receiving oral health exam

Strategy. Teledentistry

Approach. Develop and provide training (or professional development) for oral health professionals at the state and/or local level about teledentistry (including state practice acts and reimbursement policies), and provide teledentistry services for pregnant people.

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Overview. Telemedicine, sometimes called telehealth, uses telcommunications technology to deliver consultative, diagnostic, and health care treatment services.1 Teledentistry is the remote facilitating of dental treatment, guidance, and education via the use of information technology instead of direct face-to-face contact with patients.2 Teledentistry offered an innovative solution to resume dental practice during the COVID-19 pandemic, and may be especially important for pregnant people who need to receive dental care, especially during the second trimester.3

Provider education 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.4,5 As an incentive for oral health professionals to complete training, offer continuing education credits. Examples of preventive oral health care include risk assessment, education and anticipatory guidance (eating practices, oral hygiene practices, smoking prevention/cessation), and fluoride varnish applications. See 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.3 (Read more about understanding evidence ratings).

Evidence. Scientifically rigorous. 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.6 Programs based on this strategy are likely to work. This strategy has been tested more than once and results trend positive overall. 

Target Audience. Providers.

Outcome. Increased understanding and uptake of teledentistry; proportion of people with a dental claim. 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 “Develop and provide training for oral health professionals at the state and/or local level about teledentistry, and provide teledentistry services for pregnant women,” 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 oral health professionals who successfully completed teledentistry training in the past 12 months.
  • Number of settings (e.g., clinics, health centers, health departments, offices) equipped to provide preventive oral health care via teledentistry.

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

  • Percent of oral health professionals who successfully completed teledentistry training in the past 12 months.
  • Percent of settings (e.g., clinics, health centers, health departments, offices) equipped to provide preventive oral health care via teledentistry.

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

  • Number of oral health professionals who successfully completed teledentistry training and indicated an increase in knowledge/skills.
  • Number of oral health professionals who successfully completed teledentistry training and provided teledentistry services in the past 12 months.
  • Number of pregnant people who received preventive oral health care via teledentistry in the past 12 months.

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

  • Percent of oral health professionals who successfully completed teledentistry training and indicated an increase in knowledge/skills.
  • Percent of oral health professionals who successfully completed teledentistry training and provided teledentistry services in the past 12 months.
  • Percent of pregnant people who received preventive oral health care via teledentistry in the past 12 months.

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:

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


References:

1 Ghai S. Teledentistry during COVID-19 pandemic. Diabetes & Metabolic Syndrome: Clinical Research & Reviews. 2020 Sep 1;14(5):933-5.

2 Shaygani F, Marzaleh MA. COVID-19 Pandemic: An Opportunity for Using Tele-Dentistry for a Better Dental Care. Prehospital and Disaster Medicine. 2022 Sep 15:1-3.

3 Lipper J. Advancing Oral Health through the Women, Infants, and Children Program: A New Hampshire Pilot Project. (2016). Center for Health Care Strategies.

4 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.

5 Additional Resources:

6 Systematic reviews of teledentistry:

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.