February 2008

Introduction

This knowledge path about oral health and pregnant women, infants, children, and adolescents has been compiled by the National Maternal and Child Oral Health Resource Center (OHRC) and the Maternal and Child Health Library at Georgetown University. It offers a selection of current, high-quality resources that analyze data, describe effective programs, and report on policy and research aimed at improving access to oral health care and quality of oral health for pregnant women, infants, children and adolescents. Separate sections identify resources on specific aspects of oral health including child care and Head Start (HS), dental sealants, early childhood caries (ECC), fluoride varnish, K-12 education, pregnancy, and school-based care. A separate section lists oral health resources for consumers. This knowledge path is aimed at health professionals, program administrators, educators, policymakers, and consumers, and it will be updated annually.

Related knowledge path topics: See Child and adolescent health insurance and access to care.

Resources for Professionals

Overview

The Surgeon General's Call to action urges that oral health promotion, disease prevention, and care have a presence in all health policy agendas set at local, state, and national levels. Intrinsic to this goal is the concept of integrating oral health into general health. Many states have developed plans that integrate key oral health components into the state's general health plan. Building oral health into existing health programs will maximize the integration of oral health into general-health programs and will ensure that oral health is included where appropriate in other state health initiatives.

Web Sites of National Organizations

• Academy of General Dentistry (AGD). Provides continuing education (CE) information, journal articles, and membership news. Also see AGD's directory of dentists and resources for consumers, which include fact sheets about dental sealants.
  
  
• American Academy of Pediatric Dentistry (AAPD). Offers a reference manual containing definitions, policies, clinical guidelines, endorsements, and resources for improving pediatric oral health. Also provides a press kit with 15 story ideas addressing common pediatric oral health issues, journal article abstracts, and meeting and CE information. Initiatives include

  Dental Home Resource Center. Presents information about the dental home concept and resources to support the delivery of oral health care to all children, with a focus on infants. Recent materials include

  • Establishing the dental home: Using the American Academy of Pediatric Dentistry's Caries-Risk Assessment Tool (CAT) as a first step. (2007).
    
    
  • Dental home: It's never too early to start. (2007).

  Also see AAPD's directory of pediatric dentists and its resources for parents, which include information about dental sealants.

• American Academy of Pediatrics: Oral Health. Presents training and program information to promote improved child oral health by offering pediatricians and other child health professionals the tools and support they need to provide community-based, collaborative care. Offers a database of community pediatric oral health projects, a newsletter, policy statements, journal articles, and links to other resources. Also see AAP's Oral health risk assessment: Training for pediatricians and other child health professionals, rev. ed. (2008).
  
  
• American Association for Community Dental Programs (AACDP). Offers membership information, a newsletter, annual meeting materials, and resources to support those serving the oral health needs of vulnerable populations at the community level.
  
  
• American Association of Public Health Dentistry (AAPHD). Contains program information for accredited dental public health residencies, a contact list for schools of public health and public health programs, meeting information, and a newsletter.
  
  
• American Dental Association (ADA). Contains journal articles, position statements, policy analyses, news releases, and information about products, CE opportunities, meetings, and membership. Recent resources and initiatives include

  Give Kids a Smile! Provides background information and resources for this initiative to provide free oral health services to children from families with low incomes across the country during the first Friday in February each year.

  Methamphetamine use and oral health. (2007).

  National Children's Dental Health Month (NCDHM). Presents information about this nationwide observance held every February to raise awareness about the importance of oral health. Resources for oral health professionals and teachers include a program planning kit, posters, classroom ideas, and activity sheets for children.

  Also see ADA's directory of dentists, resources for consumers, resources about ECC and topical fluoride, and the Smile Smarts! Oral Health Curriculum.

• American Dental Hygienists' Association (ADHA). Offers online CE courses, position papers, information about programs and grants, and testimony about infant, child, and adolescent oral health and access to care. Also see ADHA's resources for consumers.
  
  
• Association of State and Territorial Dental Directors (ASTDD). Contains project reports and program information for federally funded oral health activities, information about and links to each state and territory oral health program, links to resources and tools to support state and territorial dental directors in their efforts to build high-quality oral health programs, a newsletter, and a list of members by state. ASTDD collaborates with the Centers for Disease Control and Prevention (CDC) in the development of oral health data systems. Recent resources and initiatives include

  Best Practice Approaches. Presents information about proven and promising practices for developing effective state, territorial, and community oral health programs. Includes a set of reports that describe public health strategies, summarize supporting evidence, review best practice criteria, and use current practices to illustrate successful implementation methods. Also offers a database of successful state public oral health activities.

  Got a sweet tooth? Monitoring the prevalence of obesity and tooth decay in children. (2007). [PowerPoint presentations and accompanying materials from a Webcast co-sponsored by the Association of State and Territorial Health Officials].

  Guidelines for state and territorial oral health programs, rev. ed. (2007).

  Protecting children from methamphetamine. (2007).

  Summary report: Synopsis of state dental public health programs -- Data for FY 2005-2006. (2007).

  Also see ASTDD's distance learning resources, the Safety net dental clinic manual and the Mobile-portable dental manual, and ASTDD's brief about fluoride varnish.

• Centers for Disease Control and Prevention (CDC). Supports several oral health initiatives:

  CDC's Division of Oral Health. Contains data systems, guidelines and recommendations, fact sheets, journal articles, and other resources to enhance oral disease prevention in state and community settings. Dental caries and fluoride supplements are among the oral health topics addressed. Resources include

  • Community Water Fluoridation. Presents a collection of resources about the benefits, safety, engineering support, and other factors to consider with community water fluoridation and fluorides.
    
    
  • Impact and value: Telling your program's story. (2007). This workbook helps public health program administrators systematically document public health program achievements, pull together details into a coherent narrative, and use "success stories" to generate program support.
    
    
  • Oral health: Preventing cavities, gum disease, and tooth loss, rev. ed. (2007).
    
    
  • State Oral Health Programs. Offers information about CDC funding for state oral health programs, oral health program infrastructure development tools, oral health information by state and territory, and state oral health plans.

  CDC's Guide to Community Preventive Services: Oral Health. Contains recommendations for population-based interventions addressing oral health.

  CDC's National Center for Health Statistics (NCHS). Provides data about oral health. Recent publications include

  • FASTATS: Oral and dental health, rev. ed. (2007).
    
    
  • Trends in oral health status: United States, 1988-1994 and 1999-2004. (2007).
    
    
  • Also see the NCHS database, Data2010.
    
    
• Centers for Medicare & Medicaid Services. Provides information about Medicaid oral health coverage for eligible individuals under age 21 as a required component of the Early and Periodic Screening, Diagnostic and Treatment (EPSDT) benefit. Also briefly describes the oral health services available through the State Children's Health Insurance Program (SCHIP). Also see the HRSA Medicaid Primer and the Medicaid Benefits database.
  
  
• Children's Dental Health Project (CDHP). Contains program information and resources about children's oral health, particularly on issues involving access to care, financing programs, and health disparities. Publications include issue briefs, fact sheets, conference presentations, articles, and reports. Recent publications include

  SCHIP reauthorization: Recommended dental program modifications. (2007).

  Successful state Medicaid dental reforms. (2007). This collection of reports summarizes Medicaid innovations in six states that have increased both dentist participation and dental access for child beneficiaries.

• Community Voices (CV). Contains program descriptions, articles, and policy briefs about community efforts to improve oral health for underserved populations. CV is an initiative of the W. K. Kellogg Foundation. Recent publications include

  Oral health: Who cares? Who should care? (2007).

• Healthy People 2010. Offers information about this national health-promotion and disease-prevention initiative. It is coordinated by the Office of Disease Prevention and Health Promotion (ODPHP). Healthy People 2010 addresses 467 objectives in 28 focus areas. Focus area 21 presents the oral-health-promotion and disease-prevention agenda. Healthy People 2010 provides background information on the initiative; the complete text (online and searchable), Healthy People 2010: Understanding and improving health, 2nd ed. (2000) and Healthy People 2010 midcourse review (2006); data; a list of the Healthy People partners and related sites; and other Healthy People publications. Also see the NIDCR oral health tool kit and the HP2010 Information Access Project for access to published literature related to the Healthy People 2010 oral health objectives.
  
  
• HRSA Medicaid Primer. Offers information to assist state and local health officials in understanding how Medicaid works and how it can ensure access to health services for underserved populations. A section is devoted to oral health services under Medicaid. This primer is provided by the Health Resources and Services Administration (HRSA).
  
  
• Medicaid/SCHIP Dental Association (MSDA). Presents links to publications about state and national Medicaid and SCHIP oral health policies and practices. MSDA aims to provide state and national leadership and support in the development of sound Medicaid/SCHIP oral health policy.
  
  
• National Health Law Program (NHeLP). Offers issue briefs, case dockets, and other resources about Medicaid, SCHIP, and children's access to health care, including oral health care. NHeLP is a national public-interest law firm that aims to improve health care for families with low incomes, minorities, the elderly, and people with disabilities. Publications include

  Docket of Medicaid cases to improve dental access, rev. ed. (2007).

  Medicaid Early and Periodic Screening, Diagnosis and Treatment: State innovation leads to improved oral health participation rates. (2007).

• National Institute of Dental and Craniofacial Research (NIDCR). Contains fact sheets, brochures, news releases, and other resources about oral diseases and conditions. Includes resources about oral health management for individuals with special health care needs. Also offers information about research, funding, clinical trials, and training. Some materials are available in Spanish. NIDCR also offers an oral and craniofacial data system, a newsletter, suggestions for finding dental care, resources for consumers, and oral-health-education classroom materials. NIDCR is part of the National Institutes of Health (NIH). Important resources include

  Healthy People 2010: Oral health toolkit. (2004). This toolkit reviews the Healthy People 2010 oral health objectives and provides practical advice, methods, resources, and examples to help in planning, implementing, and evaluating oral health objectives at the state, territorial, tribal, and community levels.

  Integral role of behavioral and social sciences in a systems approach to oral health research. (2007).

  National call to action to promote oral health: A public-private partnership under the leadership of the Office of the Surgeon General. (2003). This document outlines goals, visions, and guiding principles for building upon the major findings of the Surgeon General's report, Oral health in America, to stimulate initiatives and expand efforts to improve oral health.

  Oral health in America: A report of the Surgeon General. (2000).

• National Maternal and Child Oral Health Resource Center (OHRC). Provides information and materials to assist health professionals, program administrators, educators, policymakers, and others in improving oral health services for pregnant women, infants, children, and adolescents. Offers a searchable collection of print and electronic materials. The Oral health resource bulletin lists recent, noteworthy items in the collection, and OHRC's A-Z List links to materials by topic. OHRC also offers a database describing oral health projects funded by the Maternal and Child Health Bureau (MCHB) and a database of projects funded by the Office of Head Start (OHS), news alerts and online discussion lists, distance learning curricula, meeting materials, and links to resources about oral health. OHRC is supported by MCHB, and it collaborates with the Maternal and Child Health Library on its oral health collection development. Resources include

  Bright Futures Oral Health Toolbox. Links to guides, curricula, screening/risk assessment tools, and anticipatory guidance tools for health professionals and human services providers serving pregnant women, infants, children, and adolescents.

  Recent OHRC publications include

  A way with words: Guidelines for writing oral health materials for audiences with limited literacy. (2008).

  Oral health resource bulletin. (2007).

  Web-based manuals for professionals working to improve the public's oral health. (2007).

  Web-based oral health curricula for health professionals and human service providers. (2007).

  Also see OHRC's resources for consumers and resources about Head Start (HS), dental sealants, ECC, fluoride varnish, pregnancy, and school-based care.

• National Oral Health Policy Center. Presents materials and links to resources to inform policy development and improve the oral health status of vulnerable populations, with a particular focus on children from families with low incomes who are eligible for Medicaid. The center is part of the University of California, Los Angeles, Center for Healthier Children, Families and Communities. Recent publications include

  Assuring comprehensive dental services in Medicaid and Head Start programs: Planning and implementation considerations. (2007).

• Oral Health America (OHA). Contains information about its public-education campaigns to address oral health issues such as dental caries, spit tobacco, dental sealants, water fluoridation, and disparities in oral health and access to care. Also publishes a newsletter. Initiatives include

  Campaign for Oral Health Parity. Describes this communications initiative to place oral health needs on equal footing with other health care needs and to promote access to oral health care for all Americans. Campaign strategies include the release of state-by-state report cards and targeted media campaigns to bring oral health disparities to the attention of opinion leaders, policymakers, and the public.

  National Center for Fluoridation (NCF). Provides data and information on the positive impact of community water fluoridation.

  National Spit Tobacco Education Program (NSTEP). Contains resources about spit tobacco use, prevention, and cessation.

  Also see OHA's school-based oral health initiatives.

• Pipeline, Profession, and Practice: Community-Based Dental Education Program. Presents information and background resources for this collaborative of 15 U.S. dental schools that work to reduce oral health disparities through the recruitment and retention of underrepresented minority and lower-income students and the integration of community-based student rotations into curricula. The Pipeline is a national program of the Robert Wood Johnson Foundation (RWJF).
  
  
• Special Care Dentistry (SCD). Links to educational modules, a product guide, and other resources about the oral health care of individuals with special needs.
  
  
• Special Olympics Special Smiles. Describes this initiative to increase access to oral health care for Special Olympics athletes as well as for all people with intellectual disabilities. Includes a guide to help develop and maintain a complete oral hygiene program for individuals with special health care needs, a handbook to implement a Special Olympics Special Smiles event, and a training manual for oral health screening. Special Olympics is an international organization dedicated to empowering individuals with intellectual disabilities to become physically fit, productive, and respected members of society through sports training and competition.
  

  
  

Additional Resources from National Organizations

• American Dental Education Association (ADEA). 2007. Second ADEA advanced dental education summit: The convergence of specialties in advanced dental education. Challenges and opportunities. Proceedings. Washington, DC: American Dental Education Association. These proceedings describe a summit about dental education that focused on five themes: (1) improve compensation and work force conditions, (2) encourage uniformity (and reform) of national licensure, (3) require an advanced postgraduate year, (4) promote interdisciplinary interaction, and (5) engage in the accreditation of nonrecognized specialty interest areas.
  
  
• Committee on Oversight and Government Reform, Subcommittee on Domestic Policy. 2007. Oversight adequacy of the pediatric dental program for Medicaid eligible children. Washington, DC: U.S. House of Representatives. This collection of hearing testimony examines the adequacy of the Centers for Medicare and Medicaid Services' oversight mechanisms used to evaluate the ability of Medicaid programs to ensure children's access to dental health.
  
  
• Department of Health and Human Services Office of Inspector General. 2007. Improper payments for Medicaid pediatric dental services. Washington, DC: Department of Health and Human Services (DHHS). This report presents findings from an assessment of the appropriateness of Medicaid payments for pediatric dental services.
  
  
• Gehshan S, Wyatt M. 2007. Improving oral health care for young children. Portland, ME: National Academy for State Health Policy (NASHP). This report focuses on financing and work force challenges, describes promising models of care, and examines options for policymakers seeking to improve access to oral health care for young children.
  
  
• George Washington University School of Public Health and Health Services, Rapid Public Health Policy Response Project. 2008. Pediatric dentistry: How can dental care for low-income children be improved? Washington, DC: George Washington University School of Public Health and Health Services. This paper describes the causes and consequences of oral diseases that disproportionately affect the nation's most vulnerable children and the strategies available to address them. Topics include disparities in oral disease, the consequences of oral disease in children, unmet needs for pediatric dentistry, and strategies to increase access to appropriate oral health services for children.
  
  
• Kaiser Commission on Medicaid and the Uninsured. 2007. Dental coverage and care for low-income children: The role of Medicaid and SCHIP. Washington, DC: Kaiser Family Foundation (KFF). This fact sheet provides an overview of oral health care access and coverage for children from families with low incomes. Topics include the importance of oral health care for children, disparities in children's oral disease and care, coverage for oral health care in Medicaid and the SCHIP, and initiatives to increase access to oral health care for children.
  
  
• Ruddy G. 2007. Health centers' role in addressing the oral health needs of the medically underserved. Washington, DC: National Association of Community Health Centers. This issue brief describes health centers' role in meeting the oral health needs of low-income and at-risk populations, the importance of improving access to oral health services, and funding challenges.
  

  
  

Web Sites of State Organizations

• Arizona Office of Oral Health. Presents reports about oral health status, trends, and disparities among children in Arizona. Also offers information about oral-health-promotion programs, including a school-based dental sealant program and a school fluoride mouthrinse program, and media campaign materials about ECC. Recent publications include

  Arizona dental workforce survey: 2003-2004. (2007).

  Arizona dental hygiene workforce survey: 2003-2004. (2007).

• Colorado Department of Public Health and Environment: Oral Health Program. Contains information about and resources to support a school-based dental sealant program, a school fluoride mouthrinse program, community water fluoridation, and an oral health surveillance system. Other resources include a dental emergency flip chart, oral health program guidelines for school districts, an ECC fact sheet, and reports about the oral health status of children in Colorado. Some materials are available in Spanish. Recent publications include

  Oral health resource guide. (2007).

• Illinois Department of Public Health: Division of Oral Health. Includes materials for Illinois' school-based oral examination program, oral health fact sheets for consumers on topics that include ECC, dental sealants, and oral health during pregnancy, and a coloring book for children.
  
  
• Iowa Department of Public Health: Oral Health Bureau. Contains program information and reports about Iowa's efforts to improve the oral health of all residents. Oral health programs for pregnant women, infants, children, and adolescents include a school-based dental sealant program, a fluoride varnish program, an EPSDT oral services program, and the Iowa Access to Baby and Child Dentistry Program.
  
  
• Kansas Department of Health and the Environment: Oral Health Initiative. Offers information about efforts to improve oral health in Kansas via oral health education, oral disease prevention, oral health assessment, and access to oral health care. Includes a collection of oral health fact sheets on topics that include toothbrushing techniques, fluoride varnish, dental first aid, ECC, tooth eruption, and nutrition. Recent publications include

  Kansas oral health plan. (2007).

  Optimum oral health for children with special health care needs: Oral Health Kansas and Partners. (2007).

  Smiles Across Kansas: 2007 update. (2007).

• Maine Oral Health Program. Describes the state of oral health and oral health care for Maine residents and Maine's school oral health program. Also presents a set of fact sheets for consumers on topics that include oral health for children with special health care needs, community water fluoridation, early childhood oral health, oral health care during pregnancy, preventing dental caries, and dental sealants. Recent publications include

  Dental clinics and services for low income persons in Maine. (2007).

  Improving MaineCare dental access for Maine children: 9th annual report to the Joint Standing Committee on Health and Human Services. (2007).

  Maine oral health improvement plan: A framework for the improvement of state and local policies for oral health. (2007).

• New York State Department of Health: Oral Health. Offers information and resources about the connection between oral health and general health, oral health across the lifespan, the impact of oral disease, and New York's oral health programs and initiatives, many of which are targeted to pregnant women, infants, children, and adolescents. Also see the CE activity, Oral health care during pregnancy and early childhood.
  
  
• Tennessee Department of Health: Oral Health Services. Presents information about the history of the oral health program in Tennessee, a school-based oral health promotion project, dental clinics, and fluoride programs, including a fluoride varnish program and community water fluoridation programs. Also presents a set of oral health fact sheets about healthy oral development, the importance and care of children's teeth, primary and permanent tooth eruption, ECC, fluoride, dental sealants, mouth guards, nutrition, pregnancy, preventing tooth decay, periodontal disease, oral-injury prevention, and tobacco use. Recent publications include

  Standards of practice for dental public health, rev. ed. (2007).

• Washington State Department of Health: Oral Health Program. Offers information and resources about the importance of oral health to general health, common oral health concerns, community water fluoridation, dental sealants, and oral health for children with special health care needs. Also offers data about oral health in the state, legislative news, and links to oral health laws. Recent publications and initiatives include

  Access to Baby and Child Dentistry (ABCD). Presents program information and materials that can be used to replicate this model program focusing on preventive and restorative dental care for Medicaid-eligible infants and children from birth to age 6, with emphasis on enrollment by age 1. This ABCD program operates throughout Washington State.

  Access to Baby and Child Dentistry (ABCD) program: Supplemental billing instructions. (2007).

  Citizens' Watch for Oral Health. Presents facts about oral disease in Washington State and information about this campaign to improve oral health, particularly among infants, children, adolescents, and the elderly. Citizens' Watch is an initiative of the Washington Dental Service Foundation.

  Dental program for clients through age 20: Billing instructions. (2007).

  Impact of oral disease on the lives of Washingtonians: The Washington State oral disease burden document. (2007).

• Wisconsin Oral Health Program. Contains program information, reports, and fact sheets on topics such as ECC, dental sealants, fluoride, and smokeless tobacco. Also provides training resources, including samples of agency protocols for the placement of dental sealants and the application of fluoride varnish in public health settings; training materials for integrating oral-health-promotion and oral-health-prevention services into health care visits; and a training manual for oral health professionals about oral health and pregnancy and ECC.
  
  
• Also see the following for state-specific reports and/or state oral health program information: Association of State and Territorial Dental Directors (ASTDD), CDC's Division of Oral Health, Children's Dental Health Project (CDHP), HRSA Medicaid Primer, National Health Law Program (NHeLP), National Institute of Dental and Craniofacial Research (NIDCR), National Maternal and Child Oral Health Resource Center (OHRC), National Oral Health Policy Center, Oral Health America (OHA), and the Additional Resources From National Organizations section. Also see the Safety net dental clinic manual (2003-). In addition, several items by and about state oral health programs are listed in the data and programs database sections and in the sections within Resources on Specific Aspects of Oral Health.
  

  
  

Additional Resources from State Organizations

• Alaska Dental Action Coalition. 2007. Oral health and dental access: Perspectives and recommendations from the Alaska Dental Action Coalition. Juneau, AK: State of Alaska Department of Health and Social Services. This document reports on the oral health status of Alaskans, particularly children and older adults; presents information about the oral health work force; and makes recommendations about oral health prevention, education, access to care, and financing.
  
  
• Bethel LA. 2007. 2007-2009 Massachusetts children with special health care needs oral health action plan. Boston, MA: Office of Oral Health, Massachusetts Department of Public Health. This document outlines the goals and objectives to address oral health care issues for children with special health care needs in Massachusetts. A companion document, Massachusetts state / territorial oral health forums for children with special health care needs leading to an action plan (2007), is available.
  
  
• California HealthCare Foundation. 2007. Denti-Cal facts and figures: A look at California's Medicaid dental program. Oakland, CA: California HealthCare Foundation. This report explains how Denti-Cal, Medi-Cal's fee-for-service dental program, is funded and organized, the demographics of the population it serves, and the challenges it faces in making oral health care available to all individuals in California eligible for the program.
  
  
• Carlson V, Veschucio C. 2007. South Carolina takes action: The burden of oral disease. Columbia, SC: South Carolina Department of Health and Environmental Control. This document reports on the oral disease burden of South Carolina residents. It highlights groups and regions in South Carolina that are at highest risk of oral health problems and discusses strategies for prevention and improved access to oral health care.
  
  
• Children's Partnership. 2007. Meeting the health care needs of California's children: The role of telemedicine. Santa Monica, CA: Children's Partnership. This issue brief describes how telemedicine can address the health care needs of children in California, particularly children from families with low incomes who live in medically underserved areas. The brief explains how telemedicine can be used for oral health care.
  
  
• Clarke J. 2007. Snapshot of oral health in South Dakota. Pierre, SD: South Dakota Department of Health. This report describes the oral health status of people in South Dakota. Topics include children's and adults' oral health status, demographics, results from the oral health screening of students in third grade, access to oral health care, pregnancy and oral health, chronic disease and oral health, oral cancer, and community water fluoridation.
  
  
• Clarke J. 2007. South Dakota oral health survey 2006. Pierre, SD: South Dakota Department of Health. This report presents an analysis of data collected from a statewide oral health survey of students in third grade in South Dakota.
  
  
• Connecticut Oral Health Initiative. 2007. Oral health improvement plan for Connecticut 2007-2012. Hartford, CT: Connecticut Oral Health Initiative. This report presents the vision and intent of a plan to improve the oral health of Connecticut residents in four areas: (1) to increase the integration of oral health promotion into all aspects of public health, (2) to ensure that there is an adequate work force to meet the needs of Connecticut residents, (3) to build a strong and sustainable oral health infrastructure, and (4) to advance best practices for oral health. Also see the companion document, Oral health in Connecticut (2007), which provides baseline data on the oral health status of Connecticut residents.
  
  
• Diringer J, Bonalos K. 2007. Putting teeth into health care reform. Oakland, CA: Dental Health Foundation (DHF). This policy brief focuses on the importance of including oral health in health care reform efforts in California, the extent of current dental coverage, barriers to utilization, and policy considerations for improving the oral health of all Californians.
  
  
• Douglass J. 2007. HUSKY A dental care: Avoiding the repercussions of poor dental care for children on Medicaid. New Britain, CT: Connecticut Health Foundation. This policy brief summarizes findings on the low utilization rate of oral health services among children enrolled in HUSKY A, Connecticut's Medicaid program, and the repercussions of poor oral health care for children.
  
  
• Hughes D. 2007. Access, use, and costs of dental services in the Healthy Kids program. Washington, DC: Urban Institute. This brief presents data on dental coverage benefits and enrollee's access and use of dental services through the Healthy Kids program in San Mateo County, California.
  
  
• IFLOSS Coalition. 2007. CSHCN oral health final report: Illinois IFLOSS Coalition. Springfield, IL: IFLOSS Coalition. This report gives a brief history of oral health measures since 2002 in Illinois for preventing oral disease in special populations including the underinsured, minority groups, and children with special health care needs.
  
  
• IFLOSS Coalition. 2007. Oral health care in Illinois: Comprehensive care for children and families. Springfield, IL: IFLOSS Coalition. This document presents an action plan for improved oral health for children with special health care needs in Illinois.
  
  
• Landers GM, Koskela L, Duval TE. 2007. Children's oral health in Georgia: Progress and opportunities. Atlanta, GA: Georgia Health Policy Center. This issue brief outlines progress in preventing oral disease among children in Georgia and identifies opportunities for improving oral health practices and outcomes.
  
  
• Maryland Department of Health and Mental Hygiene, Dental Action Committee. 2007. Access to dental services for Medicaid children in Maryland. Baltimore, MD: Maryland Department of Health and Mental Hygiene. This report presents a series of recommendations developed by the Maryland Dental Action Committee to help guide the Maryland Department of Health and Mental Hygiene in increasing access to oral health services for children enrolled in Medicaid.
  
  
• Mertz E. 2007. California survey of dental hygienists 2005-2006: Descriptive findings. San Francisco, CA: Center for the Health Professions, University of California, San Francisco. This report presents data on the registered dental hygiene work force in California, including demographic characteristics, geographic distribution, practice characteristics, populations served, scope of practice, productivity and work hours, collaboration with other health professionals, interest in performing in a more independent role, and willingness to provide care in underserved communities.
  
  
• Ohio Department of Health. 2007. Oral health and access to dental care for Ohioans. Columbus, OH: Ohio Department of Health. This brief highlights oral health findings from four recent surveys in Ohio about child and adult oral health status and access to care, oral health infrastructure, and dentist participation in Medicaid.
  
  
• Ohio Department of Health, Bureau of Oral Health Services. 2007. Make your smile count! A survey of the oral health of Ohio schoolchildren, 2004-2005. Columbus, OH: Ohio Department of Health. This report presents findings from a statewide survey to assess the oral health of students in third grade in Ohio.
  
  
• Simpson E, Braun B. 2007. Oral health among low-income rural families: Implications for policy and programs. College Park, MD: Department of Family Studies, University of Maryland. This policy brief describes the oral health status of rural families with low incomes who reside in Maryland, and it recommends strategies to improve access, broaden the provider network, and educate consumers.
  
  
• Texas Department of State Health Services, Oral Health Program. 2007. Oral health in Texas. Austin, TX: Texas Department of State Health Services. This document reports on the oral health status of Texans, the burden of oral disease, the implication for socioeconomic resources and services, and policy implications.
  

  
  

Distance Learning Resources

• Dental Education in Care of Persons with Disabilities (DECOD): Education and Training. Offers a videotape lecture series and self-directed modules about the oral management of individuals with disabilities, including children and adolescents with special health care needs. DECOD is a program of the University of Washington School of Dentistry that treats individuals with severe disabilities and prepares dental professionals to meet these individuals' special oral health care needs.
  
  
• Dental Health Screening and Fluoride Varnish Application. This CE course covers the etiology and prevention of tooth decay, strategies for prevention, oral health screening and examination, the fluoride varnish application procedure, and the billing process. This course is presented by the University of Minnesota.
  
  
• Health Services and Epidemiological Research at the University of Michigan School of Dentistry. Offers two education programs for health professionals. The first presents dental caries diagnosis, risk assessment, and management protocols, and the second is a set of guidelines for clinical staff about oral health and tobacco cessation in a primary care setting. Also see the university's online training program about dental caries.
  
  
• Mobile-portable dental manual. (2007). This reference tool focuses on using public health approaches to create health care systems to serve populations that have difficulty accessing the traditional system of oral health service delivery. The manual was published with the Association of State and Territorial Dental Directors (ASTDD) and cross-references and links to the companion reference tool, Safety net dental clinic manual (2003-).
  
  
• National Maternal and Child Oral Health Resource Center (OHRC). Presents several sets of curricula:

  Health professional's guide to pediatric oral health management. (2003). This series of seven self-study modules is designed to assist health professionals in managing the oral health of infants and young children.

  Open wide: Oral health training for health professionals. (2004). This series of four self-study modules is designed to help health and early childhood professionals working in community settings (e.g., HS and WIC staff) promote oral health in the course of promoting general health for infants, children, and their families.

  Special care: An oral health professional's guide to serving young children with special health care needs. (2006). This curriculum provides oral health professionals with information to ensure that young children with special health care needs have access to health-promotion and disease-prevention services that address their unique oral health needs in a comprehensive, family-centered, and community-based manner.

  Also see Seal America: The prevention invention, 2nd. ed. (2007).

• Oral health risk assessment: Training for pediatricians and other child health professionals, rev. ed. (2008). This online training module for pediatricians and other primary care health professionals describes how to conduct an oral health risk assessment and triage for infants and young children. Topics include the role of the child health professional in assessing children's oral health, the pathogenesis of dental caries, oral health risk assessment, prevention strategies, establishing a dental home, and oral health education. The module is presented by the American Academy of Pediatrics (AAP).
  
  
• Safety net dental clinic manual, rev. ed. (2003-). Presents a training manual highlighting all aspects of dental clinic development as well as ongoing operations. Topics include partnerships and planning, facilities and staffing, financing, clinic operations, quality assurance, and quality improvement. The manual is a collaboration between the Ohio Department of Health, the Indian Health Service, and the Association of State and Territorial Dental Directors (ASTDD), and it is continually updated. Also see the companion tool, Mobile-portable dental manual (2007).
  
  
• Smiles for life: A national oral health curriculum for family medicine. (2005-). Presents an oral health curriculum and resources for physicians designed to be implemented in residencies or medical school pre-doctoral programs. The curriculum contains six modules about the relationship between oral and systemic health, child and adult oral health, emergencies, pregnancy, and topical fluoride application. The Web site also provides an implementation guide, educational objectives, test questions, resources for further learning, pocket cards, PDA applications, and posters in English and Spanish. The curriculum is produced by the Society of Teachers of Family Medicine (STFM), Group on Oral Health.
  
  
• Also see the American Academy of Pediatrics (AAP), the American Dental Hygienists' Association (ADHA), Special Care Dentistry, and Special Olympics Special Smiles. See New York State's CE activity, Oral health care during pregnancy and early childhood, and the Wisconsin Oral Health Program. See the training programs about ECC: Dental Caries, Early Childhood Caries: A Medical and Dental Perspective, First Smiles, and the Oral Health Web-based Curriculum; the training manual about fluoride varnishes, Smiles for Ohio; and the California Childcare Health Program (CCHP) curriculum.
  

  
  

Databases

The databases listed below are excellent tools for identifying data, additional literature and research, and programs about oral health and pregnant women, infants, children, and adolescents. Many of the entries below contain tips on how to use the databases efficiently. Please note that databases vary in how terms should be entered; for example, some require quotation marks and others don't. Enter search phrases as shown in bold below.

Data

• Childstats.gov. Presents statistics and reports about children and families, including population and family characteristics, economic security, health, behavior, and social environment, and education. Includes statistics about oral health. ChildStats.gov is a service of the Federal Interagency Forum on Child and Family Statistics. The Forum's annual report, America's children: Key national indicators of well-being, details the status of children and families in the United States.
  
  
• Child Trends DataBank. Reports on national trends and research on over 100 key indicators of child and adolescent well-being, including unmet oral health needs, and offers information about the types of programs and interventions that may influence particular outcomes. Child Trends is a nonprofit, nonpartisan research organization providing research and data to inform decision-making that affects children and adolescents.
  
  
• Data2010: The Healthy People 2010 Database. Contains the most recent monitoring data for tracking Healthy People 2010. To obtain oral health data, click on the field, Data by Focus Area. Under the field, Select a Focus Area, choose 21-Oral Health from the pop-up menu. Next, click on the button, Include Related Objectives from Other Focus Areas in the Table. Click on the Submit button, or use the other fields to narrow your search. This data set is provided by the National Center for Health Statistics (NCHS) via CDC Wonder.
  
  
• Data Resource Center for Child and Adolescent Health (DRC). Provides access to and use of data from the National Survey of Children's Health, 2003, and the National Survey of Children with Special Health Care Needs, 2001 & 2005/2006. Users can search and compare results on over 100 indicators of child health and well-being; view state and regional profiles on key measures; explore survey content relevant to Healthy People 2010 objectives; and compare findings at all levels for children by age, race and ethnicity, income, or health status. Several health indicators address oral health. DRC is a project of the Child and Adolescent Health Measurement Initiative (CAHMI).
  
  
• Dental, Oral and Craniofacial Data Resource Center (DRC). Maintains a catalog of oral health surveys and a data-query system that is used to produce an annual chartbook of statistics about oral and craniofacial health. DRC is a collaborative effort between the National Institute of Dental and Craniofacial Research (NIDCR) and CDC's Division of Oral Health.
  
  
• Healthcare Cost and Utilization Project (HCUP): HCUPnet. Provides access to health statistics and information on hospital inpatient and emergency department utilization at the national, regional, and state levels. To identify data about hospital use related to oral health and infants, children, and adolescents, select National Statistics on Children. Select Researcher, medical professional. Under type of query, select Statistics on specific diagnoses or procedures. Select a year (e.g., 2003). Select Diagnoses grouped by Clinical Classifications Software (CCS). Select Principal diagnosis. Under the field, Browse all CCS categories, scroll to 136 Disorders of teeth and jaw and 137 Disease of mouth. Hold the control key down and click to select both categories. Click on Next. Select the outcomes and measures of interest (e.g., Number of discharges) and click on Next. Select patient and hospital characteristics (e.g., All patients in all hospitals) and click on Next. View your results. HCUP is an initiative of the Agency for Healthcare Research and Quality (AHRQ).
  
  
• Medical Expenditure Panel Survey (MEPS): Dental. Presents information on dental events from this set of large-scale surveys of families and individuals, their health professionals, and employers across the United States. Includes source of payment, total payment and total charge, type of health professional seen, and procedures associated with each dental event. MEPS is a service of the Agency for Healthcare Research and Quality (AHRQ). Recent statistical briefs include

  Dental expenditures in the 10 largest states, 2005. (2008).

  Dental use, expenses, dental coverage, and changes, 1996 and 2004. (2007).

• National Quality Measures Clearinghouse (NQMC). Contains evidence-based health care quality measures and measure sets for health professionals, hospitals, and health plans to evaluate and improve the quality of health care for clients. To identify quality measures about oral health, enter the term dentistry in the search box. The database is sponsored by the Agency for Healthcare Research and Quality (AHRQ).
  
  
• Oral Health Resources: Data Systems. Presents a collection of oral health data systems to monitor the prevalence of oral diseases and the factors influencing oral health in the United States. These systems are a collaborative effort between CDC's Division of Oral Health and the Association of State and Territorial Dental Directors (ASTDD). The data systems are