Oral Health Services
Category
Child & Family Health
Child's Age
Prenatal, 0-1 years, 1-2 years, 2-3 years, 3-4 years, 4-5 years
Participant
Children, Parents/Guardian
Languages
English
Brief Description
Dental services for uninsured and underinsured children and/or pregnant people via the provision of standard dental care practices with a qualified licensed dental professional.
Expected Impact
- Increased positive oral health outcomes for children & families
Core Components for Model Fidelity
- Patient Visits: Visits with a licensed medical provider for medically defined preventative or responsive care
Ideally, services are provided through or in coordination with the patient's primary dental home.
Languages Materials are Available in
English
Delivery Mode
In-person dental services.
Dosage
As needed, based on the reccomendation of a licensed provider.
Infrastructure for Implementation
Other: Please note that Smart Start funds can only be used to provide services not covered by Medicaid. As a network, Smart Start does not duplicate existing services.
Staffing Requirements
Oral health services are provided by qualified, licensed medical professionals.
Training for Model Fidelity
Training varies based on recommendations and requirements of relevant professional associations.
Contact Information
LPs will need to coordinate with licensed medical providers and are encouraged to convene all relevant providers in their community.
Cost Estimates
Cost estimates vary based on local market rates.
Purpose Service Code (PSC)
5407 - Oral Health Services
Program Identifier (PID)
Oral Health Services
Minimal Outputs for NCPC Reporting
FY 24-25:
- Number of children receiving theraputic interventions
- Number of Pregnant people receiving theraputic interventions†
Minimal Outcomes for NCPC Reporting
FY 24-25:
- Increase in developmental screenings or assessments, referrals, and child use of services OR Increase in parent use of services
Minimal Measures for NCPC Reporting
FY 24-25:
- Child Screenings, Referrals, and Use of Services Calculation: Child- Dental Home Use OR Parent Use of Services Calculation: Parent- Dental Home Use
NCPC Evidence Categorization
Evidence Informed- Industry Standard
Research Summary
Two of the most relevant publications on oral health services include a report from the United States Department of Health and Human Services1 and a manuscript.2 These publications state that, in the last twenty years, the prevalence of untreated dental caries, also known as tooth decay, among young children has decreased dramatically. This is largely due to the expansion of dental insurance coverage between 2000 to 2020, as 9 in 10 children now have access to dental insurance. Dental caries are the most common chronic disease of childhood despite being highly preventable. Integrating screening, referrals, and preventive dental services into routine family and pediatric medical services has increased access to oral health care services as children can receive preventive services during regular medical visits. Using technology to share information with caregivers promotes oral health literacy and is a promising new direction for increasing parent knowledge about oral health.
Socioeconomic health inequities continue to impact access to oral care. About half of all children in the U.S. do not receive regular dental care as a result of social, economic, and geographic barriers. Pregnant people are a vulnerable population and their oral health practices have a great impact on their children's oral health experiences. Pregnant people with poor oral health are at a higher risk of transmitting streptococcus mutans to their infants. Oral health problems are approximately 5 times more common among children whose mothers have poor oral health. Children with special health care needs are another vulnerable population. Nearly 20% of children have special health care needs that may stem from developmental disorders, physical disabilities, or orofacial conditions (such as cleft lip or cleft palate). These conditions can make it challenging to receive routine dental care and subsequently impact children's quality of life and oral health. Treatment for children with special health care needs has seen little progress between 2000 to 2020. Prioritizing oral health literacy for adults and children, adequate and updated provider training, and state funding for preventive care rather than emergency care is critical to promote change and improvements in oral health care.
The North Carolina Dental Board provides clear guidelines and resources about licensure for dental/oral health providers. Additionally, North Carolina state legislation includes statutes regarding oral health professions, N.C.G.S. § 90-2, N.C.G.S. § 90-2A, N.C.G.S. § 90-16, and N.C.G.S. § 93B. These statutes provide clear practice guidelines which all services provided through a Smart Start local partnership must adhere to, ensuring the safety and well-being of children and families across NC.
- ^ See United States Department of Health and Human Services (2021). This report describes oral health in the United States from 2000 to 2020, written by over 400 contributors and experts in the field. Section 2A: Oral Health Access Across the Lifespan: Children discusses current practices, advances, and challenges in improving oral health for children in infancy and early childhood. In the last twenty years, the prevalence of untreated dental caries, also known as tooth decay, among young children has decreased dramatically. This is largely due to the expansion of dental insurance coverage between 2000 to 2020, as 9 in 10 children now have access to dental insurance. Integrating screening, referrals, and preventive dental services into routine family and pediatric medical services has increased access to oral health care services as children can receive preventive services during regular medical visits. Using technology to share information with caregivers promotes oral health literacy and is a promising new direction for increasing parent knowledge about oral health. Socioeconomic health inequities continue to impact access to oral care. About half of all children in the U.S. do not receive regular dental care as a result of social, economic, and geographic barriers. Nearly 20% of children have special health care needs that may stem from developmental disorders, physical disabilities, or orofacial conditions (such as cleft lip or cleft palate). These conditions can make it challenging to receive routine dental care and subsequently impact children's quality of life and oral health. Treatment for children with special health care needs has seen little progress between 2000 to 2020.
- ^ See Bersell (2017). This manuscript addresses the barriers and implications of oral health care access in the United States. Barriers to adequate dental care include poverty, a shortage of providers, poor oral health literacy, and a lack of a safety net. Children and pregnant people are two vulnerable, underserved populations. In 2012, 17 million children from low-income families did not receive any preventive dental care. People living in impoverished and/or rural areas lack access to an adequate number of oral health care providers. These individuals are more likely to have dental caries, tooth loss, and limited access to both private dental insurance and public dental services. Low oral health literacy is associated with decreased utilization of preventive care services and increased utilization of emergency department services. Individuals without a regular oral health care provider often seek emergency care at hospitals. The majority of these dental-related emergencies are nontraumatic. Emergency department physicians lack proper training to provide comprehensive dental care and typically provide patients with a referral to a dentist, antibiotics, and/or pain medication. Children are particularly vulnerable as they are dependent on others for appointments, daily oral hygiene, and nutritional health. Dental caries are the most common chronic disease of childhood despite being highly preventable. Dental sealant programs in schools are a cost-effective way to reduce the likelihood of dental caries by up to 80% in the two years after placement, yet 80% of states lack such programs. Pregnant people are also a vulnerable population and have a great impact on their children's oral health experiences. Pregnant people with poor oral health are at a higher risk of transmitting streptococcus mutans to their infants. Oral health problems are approximately 5 times more common among children whose mothers have poor oral health. Many providers are hesitant to provide care during pregnancy due to concerns about liability, fetal or maternal safety, lack of training for this population, and other concerns. Prioritizing oral health literacy for adults and children, adequate and updated provider training, and state funding for preventive care rather than emergency care is critical to promote change and improvements in oral health care.
Bersell, C. H. (2017). Access to Oral Health Care: A National Crisis and Call for Reform. American Dental Hygienists' Association, 91(1), 6-14. https://jdh.adha.org/content/91/1/6
N.C. Gen. Stat. § 90-16 (2022). https://www.ncleg.gov/EnactedLegislation/Statutes/HTML/ByArticle/Chapter_90/Article_16.html
N.C. Gen. Stat. § 90-2 (2022). https://www.ncleg.gov/EnactedLegislation/Statutes/HTML/ByArticle/Chapter_90/Article_2.html
N.C. Gen. Stat. § 90-2A (2022). https://www.ncleg.gov/EnactedLegislation/Statutes/HTML/ByArticle/Chapter_90/Article_2A.html
N.C. Gen. Stat. § 93B (2022). https://www.ncleg.gov/EnactedLegislation/Statutes/PDF/ByChapter/Chapter_93B.pdf
North Carolina State Board of Dental Examiners. (n.d.). License and Permit Information. https://www.ncdentalboard.org/license.htm
United States Department of Health and Human Services. (2021). Section 2A: Oral Health Access Across the Lifespan: Children. In Oral Health in America: Advances and Challenges. https://www.nidcr.nih.gov/sites/default/files/2021-12/Oral-Health-in-America-Advances-and-Challenges.pdf
Local Partnerships Currently Implementing
Local Partnerships in purple have adopted Oral Health Services. Local Partnership contact information can be found here.