State Efforts to Improve Children's Oral Health

Most children enjoy optimal oral health.  For a significant number of children, bad oral health is a painful and chronic reality.  Needlessly limited by a preventable disease, these children experience weight loss and fall behind in school and social development.  By the time they get care, many must see specialists or be treated in a hospital operating room.  Most children affected are from low-income families.

Most of these cases could be avoided, and states can use a combination of approaches to improve the quality of children's oral health.  With regular access to competent care as well as prudent prevention and education, these children could experience the same high level of oral health as most children do.   To this end, states are addressing the following problems:

Promoting Education and Prevention.  Much of the disease experienced by children could be prevented with better personal care and water fluoridation.  Several states have launched public awareness campaigns to educate parents and children about proper dental care and to build public support for children's oral health policy initiatives.

Increasing Coverage and Access. Though many low- income children have dental coverage through Medicaid, most receive no preventive dentist visits. Many states are trying to strengthen the safety net by encouraging providers to participate in Medicaid and by including dental benefits in State Children's Health Insurance Programs (SCHIP).  Any coverage expansions would increase state costs.

Enhancing the Dental Workforce.  Many states are trying to attract dentists to chronically underserved areas, yet the number of dentists graduating from dental school is decreasing nationally.  To succeed, states are using loan forgiveness, tax credits, and other incentives and are trying to enhance dentist training to adequately address pediatric needs.   

Improving Financing and Reimbursement.  Many providers refuse to participate in Medicaid because of the low rate at which they are reimbursed. Some states have increased provider reimbursements in Medicaid to attract new dentists as well as to bring back dentists who have stopped participating.  As with coverage expansions, this strategy would increase state costs.

Improving the Quality of Data and Surveillance.  The lack of reliable state-level data often makes assessing and monitoring the oral health of children a challenge for states. States are working with their public health departments as well as local universities, policy institutes, and the Centers for Disease Control and Prevention to develop reliable methods to track the prevalence of dental disease.