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Strengthen the Evidence for Maternal and Child Health Programs

New: MCHbest strategies database for sample ESMs

Evidence Tools
MCHbest. NPM 13.2: Preventive Dental Visit: Childhood

MCHbest Logo young girl 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 children and adolescents.

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Overview. Teledentistry has been utilized in the pediatric population for the purpose of oral health education and promotion, remote diagnosis and monitoring, and behavior guidance.1 Studies have shown that teledentistry is beneficial to provide dental treatment in remote locations with little access to pediatric dental specialists, monitor patients between appointments, conduct remote diagnosis and screening programs, promote oral health of children through dental education, and in pre-appointment behavior guidance, and was particularly useful during the COVID-19 pandemic.2

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.3,4 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 and additional resources.5

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. Programs based on these strategies are likely to work. These strategies have been tested more than once and results trend positive overall.4 (Read more about understanding evidence ratings).

Target Audience. Providers.

Outcome. Increased understanding and uptake of teledentistry; proportion of children and adolescents 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 the "telehealth" 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 children and adolescents,” 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 children and adolescents 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 children and adolescents 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 Sharma H, Suprabha BS, Rao A. Teledentistry and its applications in paediatric dentistry: A literature review. Pediatric Dental Journal. 2021 Dec 1;31(3):203-15.

2 Ibid

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.