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Oral Health for Infants, Children, Adolescents, and Pregnant Women

Knowledge Path

February 2010

Introduction

This knowledge path about oral health for infants, children, adolescents, and pregnant women 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 infants, children, adolescents, and pregnant women. A separate section lists resources for consumers. The final part of the knowledge path presents resources on specific aspects of oral health: child care and Head Start, dental caries, dental sealants, fluoride varnish, K–12 education, pregnancy, school-based and school-linked care, and special health care needs. This knowledge path is designed for health professionals, program administrators, educators, policymakers, and consumers, and it will be updated annually.

Related knowledge path: See Health Insurance and Access to Care for Children and Adolescents.

Overview

For many Americans, oral health status has improved during the last two decades, and oral disease has declined significantly among school-age children in particular. However, dental caries remains the most prevalent chronic disease of childhood, and among children ages 2–5, the incidence of dental caries in the primary teeth has increased. Children and adolescents with special health care needs, as well as those from certain racial and ethnic groups, experience disproportionately high incidences of oral disease.

To help ensure optimal oral health status, it is imperative that oral health promotion, oral disease prevention, and oral health care be a part of local, state, and national health policy agendas. Policies are needed that better integrate oral health and systemic health; increase access to health-promotion activities, preventive care, and treatment; and reduce financial and other barriers to care. In particular, policies must address oral health concerns and unmet treatment needs, especially among vulnerable populations.

Resources for Professionals

Web Sites of National Organizations

• Academy of General Dentistry (AGD). Continuing education (CE) information and tools; journal articles; policies, guidelines, position statements, and fact sheets; and state and federal legislative and regulatory news and information. Some information is accessible to members only. Also see AGD’s Find an AGD Dentist and KnowYourTeeth.
  
  
• American Academy of Pediatric Dentistry (AAPD). A collection of definitions, policies, clinical guidelines, endorsements, and resources for improving pediatric oral health. Also provides a press kit with facts, tips, and information about common pediatric oral health issues, journal article abstracts, and meeting and CE information. AAPD collaborates with the Children’s Dental Health Project on the Improving Perinatal and Infant Oral Health Project. Recent AAPD resources include
  
  Dental Home Online Resource Center. Information about the dental home concept and resources to support the delivery of oral health care to all children, with a focus on infants.
  
  Guideline on Infant Oral Health Care, rev. ed. (2009).
  
  Guideline on Periodicity of Examination, Preventive Dental Services, Anticipatory Guidance, and Oral Treatment for Children, rev. ed. (2009).
  
  Policy on Patient’s Bill of Rights and Responsibilities. (2009).
  
  Also see AAPD’s Find a Pediatric Dentist, Parent Resource Center, Head Start Dental Home Initiative, guideline about perinatal health, and materials about caring for individuals with special health care needs.
  
  
• American Academy of Pediatrics (AAP): Oral Health Initiative. Training and program information and other resources 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. Presents information about a preceptorship program and grant projects; a database of community pediatric oral health projects; distance learning resources; a newsletter; policy statements; journal articles; and a collection of fluoride resources. Recent materials include
  
  Special Issue on Children’s Oral Health. The November-December 2009 issue of Academic Pediatrics focuses on strategies to advance children’s oral health and access to oral health services. The issue contains the background papers, agenda, and list of speakers and attendees from AAP's National Summit on Children’s Oral Health held in November 2008. It also includes highlights of the 2008 AAP Periodic Survey of Pediatricians' Office Practices in Oral Health.
  
  
• American Association for Community Dental Programs (AACDP). 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). 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). Journal articles, position statements, policy analyses, federal and state legislative information, profiles of state Medicaid and Children’s Health Insurance Program (CHIP) oral health programs, news releases, and information about products, CE opportunities, meetings, and membership. Recent resources and initiatives include
  
  Give Kids a Smile! 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. View the proceedings for the 2009 Give Kids a Smile Symposium, Maintaining Momentum Through Continuity of Care: Finding Dental Homes for America’s Children.
  
  Medicaid Dental Payment Rates for Children. (2009). [Chart].
  
  National Children’s Dental Health Month (NCDHM). 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, classroom ideas, and English- and Spanish-language posters and activity sheets for children.
  
  Proceedings of the March 23–25, 2009 Access to Dental Care Summit. (2009).
  
  Also see ADA’s library catalog; Find a Dentist; resources for consumers; resources about dental caries, dental sealants, and topical fluoride; and the Smile Smarts! Oral Health Curriculum.
  
  
• American Dental Education Association (ADEA). Membership, meeting, and professional-development information and resources for dental educators and students in dental-education programs. Also offers dental-education policy and advocacy resources on topics that include federal legislation and regulation (see ADEA's newsletter), diversity and equity, recruitment and retention, work force issues, and access to care.
  
  
• American Dental Hygienists' Association (ADHA). CE courses; position papers; information about membership, programs, and grants; testimony about oral health and access to care; and resources for consumers. Recent resources include
  
  Direct Access States. (2009). This compilation summarizes laws by state about direct access to oral health services through dental hygienists.
  
  States Which Directly Reimburse Dental Hygienists for Services Under the Medicaid Program. (2009). [Compilation].
  
  
• Association of State and Territorial Dental Directors (ASTDD). 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 many organizations, including the Centers for Disease Control and Prevention (CDC) in the development of oral health data systems among other resources, with the Maternal and Child Health Bureau (MCHB), and with the Children’s Dental Health Project (CDHP) in the National Oral Health Policy Center. Recent resources and initiatives include
  
  ASTDD Competencies for State Oral Health Programs. (2009). [Companion tool to ASTDD Guidelines for State and Territorial Oral Health Programs, rev. ed. (2006)].
  
  Best Practice Approaches. 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 oral health public health activities.
  
  Dental Public Health Infrastructure: Failing to Meet the Needs of the Underserved. (2009). [Issue brief].
  
  Also see ASTDD’s Safety Net Dental Clinic Manual (2003–), Mobile-Portable Dental Manual (2007), and resources about Head Start, fluoride varnish, school oral health programs, and children with special health care needs.
  
  
• Centers for Disease Control and Prevention (CDC): Division of Oral Health. Guidelines and recommendations, data systems, fact sheets, journal articles, and other resources to enhance oral-disease prevention in state and community settings. Resources include
  
  Community Water Fluoridation. A collection of resources about the benefits, safety, statistics, engineering support, guidelines and recommendations, and other factors to consider with community water fluoridation and other fluoride products.
  
  Oral Health: Preventing Cavities, Gum Disease, and Tooth Loss, rev. ed. (2009). [Issue brief].
  
  Prevention of 2009 H1N1 Influenza Transmission in Dental Health Care Settings. (2009). [Guidelines].
  
  State Oral Health Programs. 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.
  
  Also see CDC’s resource about school-based dental sealant programs.
  
  Other resources about oral health from CDC:
  
  Guide to Community Preventive Services: Oral Health. Contains recommendations for population-based interventions addressing dental caries, oral and pharyngeal cancers, and oral and facial injuries.
  
  National Center for Health Statistics (NCHS). Presents the fact sheet, FastStats: Oral and Dental Health, rev. ed. (2009). Also see the NCHS database, Data2010.
  
  
• Centers for Medicare & Medicaid Services (CMS). 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. Includes information about the oral health services available through CHIP and a letter to state health officials with general guidance on some of the oral-health-related provisions in the Children's Health Insurance Program Reauthorization Act of 2009 (CHIPRA). Presents promising oral health practices in use by states for their Medicaid and CHIP programs. Also see the ADA profiles of state Medicaid and CHIP oral health programs, the Health Resources and Services Administration (HRSA): Medicaid Primer and the Medicaid database.
  
  
• Children’s Dental Health Project (CDHP). Policy briefs, Congressional testimony, fact sheets, talking points, videos and other social media, and program information about children’s oral health, with a focus on prevention, financing, public health, equity, and awareness. Recent publications and initiatives include
  
  CHIP Reauthorization: Renewed Support for Children’s Oral Health. (2009). [Policy brief].
  
  Health Information Technology: Opportunities to Improve Children's Oral Health. (2009). [Policy brief].
  
  Senate Health Reform Toolbox. (2009).
  
  Shifting Paradigms in Promoting Oral Health for Young Children. (2009). [Article].
  
  Training New Dental Health Providers in the U.S. (2009). [Report, Executive summary, Policy brief].
  
  National Oral Health Policy Center (NOHPC). Policy briefs and a newsletter to address ongoing disparities in children’s oral health. NOHPC at CDHP collaborates with the Association of Maternal and Child Health Programs (AMCHP), the Association of State and Territorial Dental Directors (ASTDD), the Medicaid/SCHIP Dental Association (MSDA), and the National Academy of State Health Policy (NASHP).
  
  Also see the Improving Perinatal and Infant Oral Health Project.
  
  
• Health Resources and Services Administration (HRSA): Medicaid Primer. 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.
  
  
• Healthy People 2010. Information and publications about this national health-promotion and disease-prevention initiative that is coordinated by the Office of Disease Prevention and Health Promotion (ODPHP) and includes an oral health agenda. See Data2010: The Healthy People 2010 Database and the HP2010 Information Access Project for access to published literature related to the Healthy People 2010 oral health objectives. Also view proposed Healthy People 2020 objectives for oral health.
  
  
• Medicaid/SCHIP Dental Association (MSDA). Links to publications, meeting presentations, advocacy materials, and other resources about state and national Medicaid and CHIP oral health policies and practices. MSDA collaborates with the Children’s Dental Health Project (CDHP) in the National Oral Health Policy Center.
  
  
• National Academy for State Health Policy (NASHP): Oral Health. Issue briefs, reports, webinars, and PowerPoint presentations about improving access to oral health care for vulnerable populations. NASHP collaborates with the Children’s Dental Health Project (CDHP) in the National Oral Health Policy Center. Recent publications include
  
  Engaging Medical Providers in Children’s Oral Health. (2009). [Issue brief, Webinar recording]
  
  Help Wanted: A Policymaker's Guide to New Dental Providers. (2009). [Report, Issue brief].
  
  Increasing Access to Dental Care in Medicaid: Targeted Programs for Four Populations. (2009). [Report].
  
  Improving EPSDT Periodicity Schedules to Promote Healthy Development. (2009). [Issue brief].
  
  
• National Conference of State Legislatures (NCSL): Children’s Oral health. Information about the role that state legislators can play in improving children’s oral health. Topics include Medicaid and CHIP, access to services, work force issues, and prevention and awareness. Describes and links to exemplary state programs in each topic area. Also links to NCSL newsletter and magazine articles and other resources that address state efforts to improve children’s oral health.
  
  
• National Institute of Dental and Craniofacial Research (NIDCR). An oral and craniofacial data system, a newsletter, suggestions for finding oral health care, and resources about oral health care for individuals with special health care needs. Also includes information about research, funding, clinical trials, and training. Some resources are available in Spanish.
  
  
• National Maternal and Child Oral Health Resource Center (OHRC). A searchable library of print and electronic materials. The Oral Health Resource Bulletin lists recent, noteworthy items in the library, and OHRC's A–Z List links to materials by topic. OHRC also offers news alerts and online discussion lists, distance-learning curricula, and links to resources about oral health. OHRC is supported by the Maternal and Child Health Bureau (MCHB). Resources include
  
  Bright Futures Oral Health Toolbox. Guides, curricula, screening and risk-assessment tools, and anticipatory guidance tools.
  
  Dental Home: Summary from an MCHB Expert Meeting. (2009). [Report, Presentation].
  
  Oral Health Resource Bulletin. (2009).
  
  Resource Highlights: Focus on Fluoridated Community Water. (2009). [Resource brief].
  
  Resource Highlights: Focus on Health Literacy. (2009). [Resource brief].
  
  Also see OHRC’s resources for consumers and resources about Head Start, early childhood caries (ECC), dental sealants, fluoride varnish, school oral health education, pregnancy, school-based care, and special health care needs.
  
  
• National Network for Oral Health Access (NNOHA). Practice management resources, webinars, articles, a newsletter and online discussion list, and other resources for establishing and operating a community oral health clinic. NNOHA is a nationwide network of oral health professionals who care for patients in migrant, homeless, and community health centers. Recent resources include
  
  Dental Forms Library. A collection of forms, standard letters, policies, procedures, patient information, guidelines, and instructions used by oral health clinics.
  
  2008 Prevention Summit: A Summary Paper—Bringing Evidence and Best Practices into Health Center Dental Programs: Improving Childhood Oral Health. (2009).
  
  
• Oral Health America (OHA). Information about its public-education campaigns to address oral health issues such as dental caries, spit tobacco, dental sealants, community water fluoridation, and disparities in oral health and access to care. In addition to a newsletter, recent publications include
  
  Keep Kansas Smiling: Oral Health in the Sunflower State—Kansas Oral Health Grading Project 2009. (2009).
  
  National Smile Month Handbook 2009. (2009).
  
  Also see OHA’s school-based oral health initiative.
  
  
• Pew Center on the States: Children’s Dental Health. Information about Pew's initiative to ensure that more children receive oral health care and benefit from policies proven to prevent dental caries. Includes background information, reports, letters to Congress, testimony, and statements. Recent resources include
  
  Keeping Kids Healthy: Engaging Medical Providers in Children’s Dental Health. (2009). [Webinar recording, Agenda, Issue brief].
  
  Reimbursing Physicians for Fluoride Varnish: A Cost-Effective Solution to Improving Access. (2009). [Fact sheet].
  
  
• Pipeline, Profession, and Practice: Community-Based Dental Education Program (Dental Pipeline). Information and background resources for this collaborative of U.S. dental schools that works 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 Dental Pipeline is a national program supported by the Robert Wood Johnson Foundation (RWJF).
  

  
  

Additional Resources from National Organizations

• Association of State and Territorial Health Officials (ASTHO). 2009. Community Water Fluoridation. Arlington, VA: Association of State and Territorial Health Officials (ASTHO). This position statement describes the effects of fluoridation on public health and outlines ASTHO's support for increasing community water fluoridation coverage in the United States.
  
  
• C. S. Mott Children’s Hospital, National Poll on Children’s Health. 2009. For 12 Million Uninsured Children, High Barriers to Dental Care. Ann Arbor, MI: C. S. Mott Children’s Hospital. This document reports data and findings from a national survey of parents with children (ages 3–17) about oral health care and oral health concerns for their children. Topics include use of oral health care, dental insurance, out-of-pocket costs for care, barriers to care, and unmet needs.
  
  
• Doescher MP, Keppel GA, Skillman SM, Rosenblatt RA. 2009. The Crisis in Rural Dentistry. Seattle, WA: WWAMI Rural Health Research Center. This issue brief describes the lack of access to oral health professionals and services in rural areas and suggests potential solutions for improving the situation.
  
  
• Government Accountability Office (GAO). 2009. Medicaid: State and Federal Actions Have Been Taken to Improve Children’s Access to Dental Services, but Gaps Remain. Washington, DC: Government Accountability Office (GAO). This report describes actions taken to improve access to oral health services for children enrolled in Medicaid, obstacles to further improvement, and recommendations for overcoming the obstacles.
  
  
• Harris TA and Board on Health Care Services. 2009. The U.S. Oral Health Workforce in the Coming Decade: Workshop Summary. Washington, DC: National Academies Press. This report summarizes a 2009 workshop to consider the current status of access to oral health services, what work force strategies can improve access, and how the regulation and structure of oral health care delivery be improved to increase access.
  
  
• Leigh WA, Wheatley AL. 2009. Trends in Child Health 1997-2006: Assessing Racial/Ethnic Disparities in Unmet Dental Care Needs. Washington, DC: Joint Center for Political and Economic Studies. This issue brief examines the prevalence of unmet oral health needs among children under age 18 who are African American, Hispanic, or white. Sociodemographic factors such as area of residence, marital status, family type, and educational attainment are also examined.
  
  
• Paradise J. 2009. Oral Health Coverage and Care for Low-Income Children: The Role of Medicaid and CHIP, rev. ed. Washington, DC: Kaiser Commission on Medicaid and the Uninsured. This policy brief describes oral health care access and insurance coverage for children from families with low incomes.
  

  
  

Web Sites of State Organizations

• California Dental Association (CDA) Foundation: Access to Care. Information about programs to increase access to oral health care for underserved populations, including infants and young children and children with special health care needs. Recent publications include
  
  Emergency Department Visits for Preventable Dental Conditions in California. (2009). [Report].
  
  First 5 Commission Investments in Oral Health 2005–2009. (2009). [Report].
  
  Impact of Federal Stimulus Funds on Oral Health Services in California. (2009). [Fact sheet}.
  
  Managing California's Medicaid Dental Program: Lessons from Other States. (2009). [Report].
  
  Also see CDA’s patient-education tools and First Smiles.
  
  
• Iowa Department of Public Health: Oral Health Bureau. 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 the I-Smile Dental Home Initiative, a school-based dental sealant program, a fluoride mouthrinse program, an EPSDT oral health services program, and a program for children, adolescents, and young adults with special health care needs. Also includes a collection of oral-health-education-materials and resources to support Iowa’s school oral screening requirement. Other recent resources are
  
  2009 Third Grade Open Mouth Survey Report. (2009).
  
  IDPH School-Based Sealant Program Annual Report: School Year 2008–2009. (2009).
  
  Inside I-Smile™ 2009: An Update on Iowa's Dental Home Initiative for Children. (2010). [Report].
  
  I-Smile™ Dental Home Initiative. (2010). [Policy brief].
  
  Why Worry About Baby Teeth? (2009). [Brochure, Spanish version].
  
  
• Massachusetts Department of Public Health: Office of Oral Health. Fact sheets and reports about community water fluoridation, the dental work force, dental sealants, pregnancy, fluoride mouthrinse, and fluoride varnish applications (available in nine languages). Recent publications include
  
  Status of Oral Disease in Massachusetts: A Great Unmet Need. (2009). [Report].
  
  Also see the Massachusetts guide to tooth brushing in child care.
  
  
• New York State Department of Health: Oral Health. 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, adolescents, and children and adolescents with special health care needs. Also see the CE activity, Oral Health Care During Pregnancy and Early Childhood.
  
  
• North Carolina Division of Public Health: Oral Health Section (OHS). A collection of oral-health-education materials about oral hygiene, dental plaque, dental sealants, fluoride, nutrition, safety and first aid, and tooth anatomy and development. Some materials are available in Spanish. Includes information about North Carolina's efforts to assess the oral health of state residents, prevent oral disease, and increase access to oral health care. Initiatives include
  
  Into the Mouths of Babes (IMB). Information about this training program for health professionals about delivering preventive oral health services to high-risk children from the time of tooth eruption until age 3. Training covers oral screening, parent and caregiver education, and fluoride varnish application. Training materials include a toolkit and newsletter.
  
  
• Ohio Department of Health: Bureau of Oral Health Services. Program information, data, reports, and education and training materials for community-based oral-disease-prevention programs and safety net oral health programs. Also presents fact sheets in English and Spanish on topics that include fluoride varnish, ECC, methamphetamine use and oral health, oral piercings, and pregnancy. Recent publications include
  
  Strategic and Implementation Plans of the Director of Health's Task Force on Oral Health and Access to Dental Care. (2009).
  
  Also see the Ohio Dental Safety Net Information Center and Ohio’s school-based dental sealant program manual.
  
  
• South Carolina Department of Health and Environmental Control (SCDHEC) Division of Oral Health. Materials for professionals and families on topics that include water fluoridation, fluoride varnishes, pregnancy, early childhood oral health, school-based oral health, and oral health evaluations. Recent materials include
  
  Community Water Fluoridation. (2009). [Fact sheet].
  
  
• Tennessee Department of Health: Oral Health Services. Information about community water fluoridation, a fluoride varnish initiative, oral health services offered through public health dental clinics, a school-based oral health prevention project, mobile dental clinics, and dental funding initiatives. 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, fluoride, dental sealants, mouth guards, nutrition, pregnancy, preventing dental caries, periodontal disease, oral-injury prevention, and tobacco use. Recent publications include
  
  Standards of Practice for Dental Public Health, rev. ed. (2009).
  
  Update on Oral Health Services. (2009).
  
  
• Virginia Department of Health: Maternal and Early Child Oral Health. Program information, presentations, and educational brochures in English and Spanish about maternal and early childhood oral health for health professionals and families. Also see Virginia's resources about school-age oral health education and oral health for children with special health care needs.
  
  
• Washington Dental Service (WDS) Foundation: Access to Baby and Child Dentistry (ABCD). Program information and materials that can be used to replicate this model program focusing on preventive and restorative oral health care for infants and children from birth to age 6 who are eligible for Medicaid, with emphasis on enrollment by age 1. This ABCD program operates throughout Washington State.
  
  
• Wisconsin Oral Health Program. Program information, reports, and fact sheets on topics such as ECC, dental sealants, fluoride, healthy oral development, 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 and training materials for integrating oral-health-promotion and oral-health-prevention services into health visits.
  
  
• Many of the resources listed in the sections Web Sites of National Organizations and Additional Resources from National Organizations offer state-specific reports and/or state oral health program information. In addition, several items by and about state oral health programs are listed in the data and programs database sections and in the subsections within the Resources on Specific Aspects of Oral Health section.
  

  
  

Additional Resources from State Organizations

• Conis E. 2009. Steps to Improve Oral Health in Kentucky. Atlanta, GA: Emory University Rollins School of Public Health. This policy paper describes the rationale behind a law passed in Kentucky in 2008 that requires 5- or 6-year-old children enrolling in public school for the first time to show proof of an oral examination prior to enrollment.
  
  
• Governor's Task Force on Children and Oral Health. 2009. Governor's Task Force on Children and Oral Health: Final Report. Oklahoma City, OK: Oklahoma Dental Association. This report describes the oral health status of Oklahoma children and presents recommendations about how the state can better provide programs that address the oral health needs of children, including those with special health care needs.
  
  
• Missouri Oral Health Program. 2009. Oral Health Program: 2009 Annual Report. Jefferson City, MO: Missouri Department of Health and Senior Services. This report describes Missouri's program to monitor and reduce oral disease among Missouri citizens, particularly children and adolescents, and highlights key accomplishments in 2009.
  
  
• Missouri Oral Health Task Force. 2009. Creating a Healthier Missouri: A Statewide Oral Health Plan. Jefferson City, MO: Missouri Department of Health and Senior Services. This oral health plan identifies Missouri's oral health challenges and presents strategies for improving oral health education, access to care, and work force development.
  
  
• Skillman SM, Andrilla CHA, Alves-Dunkerson JA, Mouradian WE, Comenduley M, Yi J, Doescher MP. 2009. Washington State’s Oral Health Workforce. Seattle, WA: WWAMI Center for Health Workforce Studies. This report describes Washington State’s oral health work force, how components of the work force contribute to the delivery of oral health services in the state, and factors affecting the future supply of the work force. The report presents work force options to consider in developing programs that will enhance oral health services delivery.
  
  
• South Dakota Department of Health. 2009. Great Faces. Great Smiles. Oral Health Plan for South Dakota. Pierre, SD: South Dakota Department of Health. This plan addresses the burden of oral disease in South Dakota and identifies strategies to address oral health surveillance, oral disease prevention, work force development, and access to oral health care.
  
  
• Washington State Oral Health Coalition. 2009. Washington State Collaborative Oral Health Improvement Plan 2009–2014. Olympia, WA: Washington State Oral Health Coalition. This state plan describes the oral health needs of Washington state residents and presents goals and objectives to address those needs in six areas: (1) system infrastructure, (2) oral health data, (3) oral health promotion, (4) oral disease prevention, (5) access to care, and (6) implementation and sustainability.
  

  
  

Distance Learning Resources

• American Academy of Pediatrics: Oral Health Trainings and Videos. Video clips and modules about oral health and infants, children, and adolescents, including
  
  Oral Health in the 21st Century: Something to Smile About—Pediatrician's Role in Oral Health. (2008). [Symposium video presentations, Slides, Poster presentations].
  
  Oral Health Risk Assessment: Training for Pediatricians and Other Child Health Professionals. (2008). [Training module].
  
  Protecting All Children’s Teeth (PACT): A Pediatric Oral Health Training Program. (2009). [Training module].
  
  
• Maternal and Child Health Bureau: MCHCOM.com. Video and audio webcasts to support communication and collaboration between state and federal maternal and child health (MCH) professionals. Slides, transcripts, and background materials accompany each webcast. Recent webcasts about oral health include
  
  Accessing Oral Health Care through WIC. (2009).
  
  Engaging Providers to Improve Perinatal and Infant Oral Health: Innovative Strategies. (2009).
  
  Medicaid Portability: Eliminating Gaps in Health Care, Optimizing Oral Health, for Migrant Children and Their Families. (2009).
  
  
• National Maternal and Child Oral Health Resource Center (OHRC): Distance Learning Curricula and Manuals. OHRC curricula include
  
  A Health Professional’s Guide to Pediatric Oral Health Management. (2003). These seven self-study modules are designed to assist health professionals in managing the oral health of infants and young children, including those with special health care needs.
  
  Open Wide: Oral Health Training for Health Professionals. (2004). These four self-study modules are designed for health and early childhood professionals working in community settings (e.g., Head Start and WIC staff)].
  
  Seal America: The Prevention Invention, 2nd ed. (2007).
  
  Special Care: An Oral Health Professional's Guide to Serving Young Children with Special Health Care Needs. (2006).
  
  Also see the distance learning curricula developed by OHRC for the Ohio Dental Safety Net Information Center, Head Start Oral Health Curricula: At-a-Glance (2008) and a bibliography of oral health curricula.
  
  
• Ohio Dental Safety Net Information Center. Tools and information to start and maintain the operations and delivery of health care services in safety net dental clinics in Ohio. Offers several distance learning opportunities:
  
  Caries Prevention, Risk Assessment, Diagnosis, and Treatment. (2009). These five self-study modules for professionals working in safety net dental clinics in Ohio provide a framework for assessing patients’ risk for dental caries and determining prevention, treatment, and education strategies based on that patient’s risk category.
  
  Clinical Operations for Safety Net Dental Clinics. (2008). These six self-study modules address safety net dental clinic policies and procedures, human resources, health records, forms, billing and collections, purchasing and inventory management, patient appointments and care, infection control, environmental health, and safety.
  
  Financial Management for Safety Net Dental Clinics. (2008). These five self-study modules for dental clinic staff address strategic planning, revenue, expenses, managing finances, and securing external funding.
  
  Oral Health Care for Young Children. (2008). These four self-study modules are designed to help oral health professionals learn about providing care to infants and children from birth through age 3.
  
  School-Based Dental Sealant Programs. (2009). These five self-study modules address infection control, tooth selection and assessment for dental sealants, materials and application techniques, and program operations.
  
  
• University of Connecticut Health Center: Oral Health Resources for Health Professionals. Resources for physicians, residents, medical students, and other health professionals to improve their effectiveness in providing oral health services to infants and children. Materials include lectures in videoclip and PowerPoint formats and case studies on topics such as teething and tooth eruption, caries etiology and risk assessment, toothbrushing, nutrition, barriers to oral health care, and fluoride treatments. Also presents patient-education posters in English and Spanish and physician reference materials.
  
  
• Association of State and Territorial Dental Directors (ASTDD) with American Association for Community Dental Programs (AACDP). 2007. Mobile-Portable Dental Manual. New Bern, NC: Association of State and Territorial Dental Directors (ASTDD). This online manual presents information to create mobile and portable systems of oral health care to serve populations that have difficulty accessing the traditional system of oral health services delivery. The manual cross-references and links to the companion reference tool, Safety Net Dental Clinic Manual.
  
  
• Minnesota Department of Health, Minnesota Department of Human Services. 2009. Oral Health Screening Online Module. St. Paul, MN: Minnesota Department of Health. This online training program for health professionals and program administrators presents information about the oral health component of Minnesota's EPSDT program. The module covers oral health screening, common oral health problems in infants and children, dental caries prevention strategies, and anticipatory guidance about oral health.
  
  
• Ohio Department of Health, Indian Health Service, and Association of State and Territorial Dental Directors (ASTDD). 2003–. Safety Net Dental Clinic Manual. Columbus, OH: Ohio Department of Health. This training manual highlights 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 continually updated. Also see the companion tool, Mobile-Portable Dental Manual.
  
  
• Society of Teachers of Family Medicine Group on Oral Health. 2009. Smiles for Life: A National Oral Health Curriculum, 2nd ed. Leawood, KS: Society of Teachers of Family Medicine (STFM). This oral health curriculum for primary care health professionals contains seven modules that address the relationship between oral and systemic health, child and adult oral health, emergencies, pregnancy, fluoride varnish, and the oral examination. Accompanying the curriculum are an implementation guide, educational objectives, test questions, resources for further learning, pocket cards, portable digital assistant applications, and posters in English and Spanish.
  
  
• See the following professional associations for CE information: Academy of General Dentistry (AGD), American Academy of Pediatric Dentistry (AAPD), American Dental Association (ADA), American Dental Education Association (ADEA), American Dental Hygienists' Association (ADHA), and Special Care Dentistry Association (SCDA). Also see Resources on Specific Aspects of Oral Health for additional distance learning resources.
  

  
  

Databases

The databases listed below are excellent tools for identifying data, additional literature and research, and programs about oral health and infants, children, adolescents, and pregnant women. 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. Statistics and reports about children and families, including family and social environment, economic circumstances, health care, physical environment and safety, behavior, education, and health. 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.
  
  
• Community Health Status Indicators (CHSI). County-specific data on health status indicators obtained from a variety of federal agencies including the Department of Health and Human Services, the Environmental Protection Agency, the Census Bureau, and the Department of Labor. Use the indicators to compare a county with counties similar in population composition and selected demographics and to characterize the overall health of a county and its citizens to support health planning. Select a state and county and click on Access to Care to view the number of dentists per 100,000 people. CHSI is a service of the Department of Health and Human Services (DHHS).
  
  
• Data2010: The Healthy People 2010 Database. 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). Data from the National Survey of Children’s Health, 2003 & 2007, 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 national and state 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 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). A catalog of oral health surveys and archive of procedures related to oral health and a data-query system for oral health data from national health survey databases. 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. Health statistics and information on hospital in-patient 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., 2006). 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 or Apple command 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). Information from this set of large-scale surveys of families and individuals, their health professionals, and employers across the United States. Includes information about dental visits, type of oral health professional, treatments and services performed, and prescribed medicines. MEPS is a service of the Agency for Healthcare Research and Quality (AHRQ). Recent statistical briefs include
  
  Dental Expenditures in the 10 Largest States, 2006. (2009).
  
  
• National Quality Measures Clearinghouse (NQMC). 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 patients. To identify quality measures about oral health, enter the term "oral health" OR dental in the search box. Click on Search to get your results. The database is sponsored by the Agency for Healthcare Research and Quality (AHRQ).
  
  
• Oral Health Data Systems. 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
  
  My Water's Fluoride. Information about the status of local water fluoridation systems. This database is currently available only for states that voluntarily participate in the Water Fluoridation Reporting System (WFRS).
  
  National Oral Health Surveillance System (NOHSS). Oral-health-surveillance indicators by state for dental visits, teeth cleaning, tooth loss (complete and partial), fluoridation status, dental sealants, dental caries experience, untreated dental caries, and cancer of the oral cavity and pharynx.
  
  Oral Health Maps. Indicators of oral health and preventive interventions for oral health by state or county using an interactive mapping application. Oral health indicators for children include dental caries experience, untreated dental caries, and dental sealants.
  
  Water Fluoridation Reporting System (WFRS). A water-fluoridation-monitoring tool for state and tribal water fluoridation program managers and oral health program directors or managers. This system requires special authorization for access. WFRS is the data source for the annual fluoridation information in the National Oral Health Surveillance System (NOHSS).
  
  Also see the Synopses of State and Territorial Dental Public Health Programs and the Dental, Oral and Craniofacial Data Resource Center (DRC).
  
  
• statehealthfacts.org. State-level data on more than 500 health topics. Click on a state for individual state profiles, or click on specific topics to compare data for all states. For either option, select Health Status. Scroll down on the left sidebar and select Child Access to Medical and Dental Care. Scroll further to the Oral Health section (Note: this data focuses on adults only) and make a selection. Return to the home page for another search. Select Providers and Service Use. Scroll down on the left sidebar and select Dental Health Professional Shortage Areas. Scroll further to the Dentists section to find the number of dentists overall, per capita, by gender, and by specialty field, including dental public health, orthodontics, and pedodontics. Information can be displayed as tables, graphs, or color-coded maps. This database is a service of the Kaiser Family Foundation (KFF).
  
  
• State Health Workforce Profiles. Data on supply, demand, distribution, education, and use of health personnel, including dentists, dental hygienists, and dental assistants. Estimated numbers of workers indicate the size of the state's health work force. Per capita ratios facilitate comparisons with other states and the nation. The profiles were developed by the Center for Health Workforce Studies at the State University of New York at Albany.
  
  
• Title V Information System (Title V IS). Data from annual Title V Block Grant applications and reports submitted by all 59 U.S. states and jurisdictions. To learn about states' efforts to address oral health, conduct several searches. Select Measurement and Indicator Data. Under National Data, select National Performance Measures. Choose a report option (e.g., Most Recent Year Available). Select a state or region and Performance Measure #09 to find the percentage of third-grade students who have received protective sealants on at least one permanent molar tooth. Click on Start Search to get your results. Return to Measurement and Indicator Data and scroll to the section, State Data. Select State Priority Needs Keyword Search; Keyword: Oral Health; Population: Children (1 through 21); and the desired state or region to learn about programmatic efforts to improve oral health. Click on Start Search to get your results. Repeat the search and substitute Population: Pregnant Women. Return to Measurement and Indicator Data and scroll to the section, State Data. Select State Performance Measures and click on Search by Keyword/Population. Select Keyword: Oral Health and Population: Children (1 through 21). Click on Start Search to get your results. Repeat the search and substitute Population: Pregnant Women. Title V IS is a service of the Maternal and Child Health Bureau (MCHB).
  
  
• Also see the National Center for Health Statistics (NCHS).
  

Literature and Research Databases

• American Dental Association (ADA) Online Library Catalog. Information about books, reports, guidelines, proceedings, dissertations, historical materials, and journal titles on a wide range of dentistry and oral health topics.
  
  
• ClinicalTrials.gov. Information about clinical research studies in human health, including oral health. Included are a summary of the purpose of the study, recruiting status, criteria for participation, location of the trial, and contact information. To identify oral-health-related studies involving infants, children, and adolescents, click on Search for Clinical Trials and select Advanced Search. Type mouth diseases OR tooth diseases in the Conditions field. Scroll to Age Group and select Child (birth–17). Click on Search to get your results. To identify oral-health-related studies involving pregnant women, click on Search for Clinical Trials and select Advanced Search. Type pregnancy in the Search Terms field and mouth diseases OR tooth diseases in the Conditions field. Click on Search to get your results. To narrow either search, click on the tab, Results by Topic. Click on By Category under the heading, Conditions. Click on Mouth and Tooth Diseases to see the breakdown of your search results by topic. ClinicalTrials.gov is a service of the National Institutes of Health (NIH) and is developed by the National Library of Medicine (NLM).
  
  
• Cochrane Database of Systematic Reviews. Systematic reviews of health care interventions internationally. Provides access to abstracts that can be browsed by title or by topic such as Oral Health. Access to the full-text article requires a per-view payment or a subscription that is available in many hospital and university health sciences libraries. The database is published by the Cochrane Collaboration, an international nonprofit organization based in the United Kingdom.
  
  
• Database of Abstracts of Reviews of Effects (DARE). Summaries of systematic reviews that have met strict quality criteria. Included reviews must be about the effects of interventions. Each summary also provides a critical commentary on the quality of the review. Type ("oral health" OR dental) AND (infants OR children OR adolescents OR pregnancy) in the search field and click on search to identify abstracts. Select a publication date range to further limit your search. DARE is produced and maintained by the Centre for Reviews and Dissemination at the University of York.
  
  
• Health Workforce Information Center (HWIC): Dental Occupations. Information about resources, organizations, funding, events, and news that focus on the national dental work force (i.e., dental assistants, dental hygienists, dental laboratory technicians, and dentists). HWIC is operated by the University of North Dakota School of Medicine and Health Sciences.
  
  
• HP2010 Information Access Project: Oral Health. Automatic search mechanism for published literature indexed in PubMed and related to the Healthy People 2010 oral health objectives. Also links to the narratives for each of these objectives and the complete chapter about oral health in the text, Healthy People 2010: Understanding and Improving Health (2nd ed.). (2000). This service is provided by the Partners in Information Access for the Public Health Workforce, a collaboration of federal agencies, public health organizations, and health sciences libraries.
  
  
• Maternal and Child Health Library at the National Center for Education in Maternal and Child Health (NCEMCH), Georgetown University. Databases to collect, manage, and disseminate knowledge about MCH, with special emphasis on knowledge gained from initiatives and programs supported by the Maternal and Child Health Bureau (MCHB). The library collaborates with the National Maternal and Child Oral Health Resource Center (OHRC) on the oral health content of its databases. The library's bibliographic database is
  
  MCHLine^®. Online catalog of materials in the Maternal and Child Health Library. The OHRC collection of oral health print and electronic materials is also accessible via MCHLine^®.
  
  Also see the MCH Organizations Database.
  
  
• National Guideline Clearinghouse (NGC). Evidence-based clinical practice guidelines and related materials for health professionals. Identify guidelines by entering the following search phrase in the Search box: ("oral health" OR "dental health services") AND (infant OR child OR adolescent OR pregnancy). Click on Search to get your results. NGC is an initiative of the Agency for Healthcare Research and Quality (AHRQ).
  
  
• National Institutes of Health (NIH) Research Portfolio Online Reporting Tool (RePORT): RePORTER. Reports, data, and analyses of NIH research activities, including information on NIH expenditures and the results of NIH-supported research. To identify information on the topic, conduct several searches. First, enter "oral health" infants in the search field and click on Submit query to get your results. Conduct additional searches using the following search phrases (must be searched separately): "oral health" children; "oral health" adolescents; "oral health" pregnancy; dental infants; dental children; dental adolescents; dental pregnancy. There will be some overlap in your search results. Narrow your searches by selecting a state or adding terms to other search fields.
  
  
• PubMed. More than 19 million citations for biomedical articles from MEDLINE and life science journals. Citations may include links to full-text articles from PubMed Central or publisher Web sites. To identify articles about oral health and pregnancy, enter the search phrase, (oral health OR dental health services) AND pregnancy. Click on Limits and make the following selections on the page: select a date (e.g. Published in the last 2 years); click on Languages: English; Click on Species: Humans; and select Search Field Tags: MeSH Major Topic. Click on Search to get your results. To identify articles about oral health and infants, children, and adolescents, conduct a separate search. Enter the search phrase, oral health OR dental health services. Click on Limits and make the following selections on the page: select a date (e.g. Published in the last 2 years); click on Languages: English; Click on Species: Humans; Click on Ages: All Child: 0-18 years; and select Search Field Tags: MeSH Major Topic. Click on Search to get your results. Add search terms to further limit your searches (e.g., (oral health OR dental health services) AND dental caries). Use the MeSH (Medical Subject Headings) database to identify search terms. PubMed is a service of the National Library of Medicine (NLM). Also see the HP2010 Information Access Project for access to published literature related to the Healthy People 2010 oral health objectives.
  
  
• Also see the Education Resources Information Center (ERIC) Database and the NIDCR Special Care Database.
  

Programs Databases

• Community Pediatrics Grants Database. Archive of community pediatrics grant projects. Identify projects by selecting Oral/Dental Health in the topic field. Click on Basic Submit to get your results. To narrow your search, select a target population and/or a state, territory, or country. The database is a service of the American Academy of Pediatrics (AAP). AAP also supports oral health grants via its Community Access to Child Health Program and the Healthy Tomorrows Partnership for Children Program.
  
  
• Discretionary Grant Information System (DGIS). Information about more than 900 grants issued by the Maternal and Child Health Bureau (MCHB). To view performance measure data for three MCHB programs about oral health, select Performance Measures. Click on Program. Data about the three programs must be searched and viewed separately, as follows: (1) under Child and Adolescent Health, select Children’s Oral Healthcare Access Program; click on Next; select the performance measure; and click on Next to view the data; (2) under Child and Adolescent Health, select Oral Health; click on Next; select the performance measure; and click on Next to view the data; and (3) under Training, select Pediatric Dentistry; click on Next; select a performance measure; and click on Next to view the data. For program information about grants related to oral health, select Abstracts. Type dental dentist =oral in the search box, select Any of the words, and click on Search to get your results. To find products and publications produced by MCHB training grantees, select Program Data; click on Training; and click on Search Products and Publications. Type dental dentist =oral in the search box; select Any of the words; and click on Search to get your results.
  
  
• Health Care Innovations Exchange. Profiles of successful and attempted innovations and tools to improve health care delivery with a particular emphasis on reducing disparities in health care and health among racial, ethnic, and socioeconomic groups. View the profiles, Dental Health Care. The exchange is an initiative of the Agency for Healthcare Research and Quality (AHRQ).
  
  
• Health Services Research Projects in Progress (HSRProj). Information about ongoing health services research and public health projects. To identify projects, enter ("oral health" OR dental) AND (infant OR child OR adolescent OR pregnancy) in the search box. Click on Search to get your results. HSRProj is funded by the National Library of Medicine (NLM).
  
  
• MCH Organizations Database. Information on over 2,000 government, professional, and voluntary organizations involved in MCH activities, primarily at a national level. View OHRC's list of links to clearinghouses and resource centers, government agencies (federal and state), foundations, Head Start–related centers and offices, policy and research centers, professional associations, programs and initiatives, and voluntary organizations. For a broader list of oral health organizations, enter "oral health" in the keyword field of the database search form. Click on Search to get your results. The database is a service of the Maternal and Child Health Library.
  
  
• Medicaid Benefits: Online Database. Information about benefits covered, populations served, and the limitations, co-payments, and reimbursement policies that apply to Medicaid benefits for all 50 states, the District of Columbia, and U.S. territories. Search by state or for benefits by service (Select Practitioner Services, Dental Services). This database is a service of the Kaiser Family Foundation (KFF).
  
  
• State and Territorial Dental Public Health Activities. Descriptive summaries for oral health public health activities that states and territories have reported as successful within the context of their environment and resources. Contact information is given with the summaries. The database is searchable by topic and state. This database is a product of the Association of State and Territorial Dental Directors (ASTDD).
  
  
• Synopses of State and Territorial Dental Public Health Programs (Synopses). Characteristics of and programs conducted by state and territorial oral health programs, including water-fluoridation programs, dental sealant programs, oral-health-education programs, and oral-health-screening programs. This information is useful in tracking progress toward the Healthy People 2010 oral health objectives. Synopses is a collaborative effort between CDC’s Division of Oral Health and the Association of State and Territorial Dental Directors (ASTDD).
  
  

  
  

Newsletters and Online Discussion Lists

• American Academy of Pediatrics (AAP): Oral Health E-Newsletter. This monthly newsletter provides information about news, funding opportunities, training and career development, conferences, and resources related to infant, child, and adolescent oral health.
  
  
• American Association for Community Dental Programs (AACDP): The Bellwether: Leading Local Efforts to Improve the Nation’s Oral Health. This newsletter, for those serving vulnerable populations at the community level, highlights innovative or promising programs and shares information about the association's activities.
  
  
• American Association of Public Health Dentistry (AAPHD): Communique. This newsletter presents news, conference and continuing education announcements, and information about resources that focus on public health dentistry.
  
  
• American Dental Education Association (ADEA): Washington Update. Published monthly when Congress is in session, this electronic newsletter reports on federal legislative and regulatory news about oral health, dental education, and dental research.
  
  
• Association of State and Territorial Dental Directors (ASTDD): Oral Health Matters. This newsletter reports on oral health programs, grants, meetings, and resources for public health professionals.
  
  
• Dental Public Health Discussion List. This online discussion group about dental public health is open to dental public health professionals and policymakers. It is supported by the University of Pittsburgh as a public service.
  
  
• National Institute of Dental and Craniofacial Research (NIDCR): News from NIDCR. Published several times a year, this newsletter reports on oral health funding opportunities and research from NIDCR and the National Institutes of Health (NIH).
  
  
• National Maternal and Child Oral Health Resource Center (OHRC): Electronic Lists and Newsletters.
  
  Community Oral Health Programs Discussion List. This online discussion list focuses on the operation of local oral health programs.
  
  OHRC Announcements. This e-mail alert service highlights publications, Web site features, and other news from OHRC.
  
  Oral Health Alert: Focus on Head Start. This monthly newsletter highlights national campaigns and initiatives, materials, and journal articles.
  
  
• National Network for Oral Health Access (NNOHA): NNOHA News. This quarterly newsletter reports on meetings, resources, and success stories for and about oral health professionals who care for individuals in migrant, homeless, and community health centers. NNOHA also provides an online discussion list for oral health professionals in public health centers to exchange experiences and ideas.
  
  
• National Oral Health Policy Center: TrendNotes. This electronic newsletter highlights emerging trends in children’s oral health and promotes policies and programmatic solutions that are grounded in evidence-based research and practice.
  
  
• Oral Health America: eNewsletter. This newsletter is published periodically and provides oral health news, legislative updates, and links to articles and reports.
  

  
  

Resources on Specific Aspects of Oral Health

• Child Care and Head Start
• Dental Caries
• Dental Sealants
• Fluoride Varnish
• K–12 Education
• Pregnancy
• School-Based and School-Linked Care
• Special Health Care Needs

Child Care and Head Start

• American Academy of Pediatric Dentistry (AAPD): Head Start Dental Home Initiative. Information about this partnership at the national, regional, state, and local levels to develop a national network of dentists to link children enrolled in Head Start and Early Head Start with dental homes. Includes contact information for Head Start initiative state leaders and regional consultants. This initiative is a collaborative effort between AAPD and the Office of Head Start (OHS).
  
  
• California Childcare Health Program (CCHP). Fact sheets, briefs, posters, and other resources to help child care professionals and families achieve healthy and safe practices in child care settings. Oral health topics include dental caries, tooth and mouth care, toothbrush care, limiting the consumption of foods high in sugar, dental injuries, and oral health for children with special health care needs. Many materials are available in Spanish. Also presents an oral health curriculum in English and Spanish for health and child care professionals. CCHP is a program of the University of California, San Francisco, School of Nursing.
  
  
• National Maternal and Child Oral Health Resource Center (OHRC): Head Start. A collection of resources to share with those working to improve access to and enhance the quality of oral health services for infants, children, and pregnant women enrolled in Early Head Start and Head Start. Includes materials from a series of national, professional, regional, and state forums about improving oral health status in the Early Head Start and Head Start community and a compilation of answers to frequently asked questions from Head Start program staff. Also includes Oral Health Alert: Focus on Head Start, a monthly newsletter about Head Start initiatives and resources. OHRC has developed materials for the Head Start community; recent publications include
  
  Be an Oral Health Champion. (2009). [Booklet].
  
  Resource Highlights: Focus on Head Start. (2009). [Resource brief].
  
  Wisconsin Final Report Format: Follow-up Activities to EHS/HS State/Territorial Oral Health Forums. (2009).
  
  Also see Open Wide: Oral Health Training for Health Professionals (2004), which is appropriate for Early Head Start and Head Start professionals, and Head Start Oral Health Curricula: At-a-Glance (2008). For additional Head Start oral health information and resources, see OHRC’s collection of oral health print and electronic materials, including non-English-language materials, and a list of links to Head Start–related Web sites.
  
  
• Project Ready Smile: Children’s Oral Health Initiative. Program information and materials for this initiative to improve the oral health of infants and children from birth to age 6 from families with low incomes residing in selected counties in Kansas and Missouri and enrolled in early-childhood-education programs. Services include oral health screenings, fluoride-varnish applications, referrals for free oral health treatment and care, and oral health education. Recent publications include
  
  Project Ready Smile Evaluation Status Report. (2009).
  
  
• South Carolina Department of Health and Environmental Control Division of Oral Health: Early Childhood Oral Health. A resource guide, curricula, presentation materials, and other educational materials for child care professionals, early childhood educators, and parents to prevent oral diseases and oral injuries and to teach young children about their mouths and how to take care of their teeth.
  
  
• Geurink K, Isman B. 2009. Head Start Oral Health Project: Evaluation Report, 2001–2008. New Bern, NC: Association of State and Territorial Dental Directors (ASTDD). This report summarizes the activities and evaluation of a project to improve the oral health of children in Early Head Start and Head Start between 2001 and 2007. Also see the report summary.
  
  
• Massachusetts Office of Oral Health. 2009. Growing Healthy Smiles in the Child Care Setting: Implementing a Tooth Brushing Program to Promote Oral Health and Prevent Tooth Decay in the Child Care Setting. Massachusetts Office of Oral Health. This guide for child care professionals describes the problem of oral disease in children, the causes of dental caries and prevention, new state regulations for toothbrushing in the child care setting, and strategies to implement a toothbrushing program in a child care setting.
  
  
• National Training Institute for Child Care Health Consultants (NTI). 2007. Healthy Smiles Through Child Care Health Consultation: A Distance Learning Course. Chapel Hill, NC: National Training Institute for Child Care Health Consultants (NTI). This online course about infant and child oral health is designed for child care health consultants. Topics address tooth development, major oral diseases, prevention strategies, access to oral health care, techniques for oral health promotion, and oral health for children with special health care needs.
  
  
• Office of Head Start (OHS). 2006. Program Instruction in Oral Health, rev. ed. Washington, DC: Administration for Children and Families (ACF). These guidelines explain OHS policies and expectations for grantee compliance with selected oral health requirements. The guidelines are also available in Spanish.
  
  
• Schwarz R, Sykes T, Stanton C. 2009. Oral Health Resource Guide for Children Ages 0–5. Tempe, AZ: Arizona Head Start Association. This guide describes resources that can be used to educate expecting parents, parents of infants, and children up to age 5 about oral health.
  
  
• Tein N. 2009. Developing an Oral Health Medicaid Portability Model for Migrant and Seasonal Head Start Children: An Expert Meeting—Meeting Summary Report. Washington, DC: Altarum Institute. This summary reports on a 2008 meeting about opportunities and challenges in addressing Medicaid eligibility and enrollment for children of migrant and seasonal farmworkers enrolled in Head Start. A presentation accompanies the report.
  
  
• Also see First Smiles. The section Web Sites for Consumers contains materials that can be used in child care and Head Start settings.
  

  
  

Dental Caries

• American Dental Association (ADA): Tooth Decay and Dental Caries. Journal articles, caries-risk-assessment forms, and other materials for health professionals about dental caries. A recent publication is
  
  Symposium on Early Childhood Caries in American Indian and Alaska Native Children (2009). [Report].
  
  Also see ADA’s materials for parents about ECC and dental caries.
  
  
• Center to Address Disparities in Children’s Oral Health (CAN DO Center). Information about research programs to understand, prevent, and reduce oral health disparities among young children. CAN DO’s primary focus is preventing ECC. CAN DO is located at the University of California, San Francisco, School of Dentistry.
  
  
• First Smiles. Education resources and training tools for oral health, health, and early childhood education professionals, as well as materials for parents of young children, including those with special health care needs, on the prevention of ECC. Includes a resource guide for creating, implementing, and evaluating community-based oral health programs for young children in rural areas. Also presents a brochure for families, Healthy Teeth Begin at Birth (2005) which is available in 10 languages. First Smiles was a joint effort of the California Dental Association (CDA) Foundation and the Dental Health Foundation that ended in 2008. View the initiative’s final evaluation report.
  
  
• See the National Maternal and Child Oral Health Resource Center (OHRC) resource guide, Resource Highlights: Focus on Early Childhood Caries. (2009).
  
  
• Several of the Web sites listed in the sections Web Sites of State Organizations, Distance Learning Resources, and Web Sites for Consumers address dental caries.
  

  
  

Dental Sealants

• American Dental Association (ADA): Pit-and-Fissure Sealants. Materials for health professionals about dental sealants, including evidence-based clinical recommendations.
  
  
• Medical University of South Carolina College of Dental Medicine: Protecting Children’s Teeth. Information and resources for families, teachers, students, and oral health professionals about protecting children’s teeth with dental sealants.
  
  
• National Maternal and Child Oral Health Resource Center (OHRC): Dental Sealants. A resource guide and fact sheet about dental sealants and how to promote their use in preventing dental caries. Also offers an online manual for individuals who wish to start a school-based dental sealant program. Also see OHRC’s bibliography about dental sealants.
  
  
• Several of the Web sites listed in the section Web Sites of State Organizations offer information about dental sealants. The section School-Based and School-Linked Care presents information about several school-based dental sealant programs.
  

  
  

Fluoride Varnish

• American Academy of Pediatrics (AAP) Oral Health Initiative: Fluoride. A chart and map with information about Medicaid reimbursement by state for oral health screening and fluoride varnish application by physicians. Also includes a fluoride varnish product list and instructions for families in English, Spanish, Cambodian, Hmong, Oromo, Somali, and Vietnamese about care after fluoride varnish treatment.
  
  
• Maryland Mouth Matters: Fluoride Varnish and Oral Health Screening Program for Kids. Program information and materials for EPSDT health professionals in Maryland, including
  
  Fluoride Varnish and Oral Health Screening Program Manual for Early and Periodic Screening, Diagnosis and Treatment (EPSDT) Medical Providers in Maryland: Procedures, Policies and Protocols. (2009).
  
  What You Need to Know About ... Fluoride Varnish. (2009). [Brochure].
  
  
• North Dakota Oral Health Program: Fluoride Varnish. A collection of resources about fluoride varnish including a brochure for parents of young children, a research brief on the evidence base for fluoride varnish, a reference guide for health professionals, Medicaid reimbursement guidelines, the North Dakota legal authorities to apply fluoride varnish, a sample parental consent form, a sample standing medical order, and a list of supplies.
  
  
• Altarum Institute. 2009. Topical Fluoride Recommendations for High-Risk Children: Development of Decision Support Matrix—Recommendations from MCHB Expert Panel. Washington, DC: Altarum Institute. This report summarizes recommendations from an expert panel on the use of topical fluoride in preventing and controlling dental caries in children. A decision support matrix accompanies the report and offers recommendations on the use of topical fluoride.
  
  
• Texas Oral Health Program. 2009. Fluoride Varnish Manual: Happy Child, Bright Smile. Austin, TX: Texas Department of State Health Services. This manual for implementing a fluoride varnish program in Texas contains information about fluoride varnish benefits and application protocols. The manual includes sample forms and parent-education-materials in English and Spanish, a fluoride varnish products list and ordering information, and a supply list.
  
  
• See the American Dental Association (ADA) report, Evidence-Based Clinical Recommendations: Professionally Applied Topical Fluoride (2006). An executive summary is available.
  
  
• See the Association of State and Territorial Dental Directors (ASTDD) research brief, Fluoride Varnish: An Evidence-Based Approach (2007) to help public health professionals design and evaluate community-based programs that use fluoride varnish.
  
  
• See the National Maternal and Child Oral Health Resource Center (OHRC) bibliography about fluoride varnish.
  
  
• Also see Smiles for Life: A National Oral Health Curriculum for Family Medicine. Several of the Web sites listed in the section Web Sites of State Organizations offer information about fluoride varnish.
  

  
  

K–12 Education

• American Dental Association (ADA): Smile Smarts! Oral Health Curriculum. An oral health curriculum for students in preschool through grade 8 offering lesson plans, support materials, hands-on classroom demonstrations, student activity sheets, and suggestions for supplemental oral health activities. Also see ADA’s classroom resources for National Children’s Dental Health Month (NCDHM).
  
  
• Education Resources Information Center (ERIC) Database. Information about journal articles, research reports, teaching guides, curricula, conference papers, and books covering all aspects of education-related issues. To identify resources on the topic, click on Advanced Search. Type "dental health" OR "oral health" in the Search Term(s) box. Go to the Publication Date field to select a date range. Click on the Search button to get your results. ERIC is sponsored by the Department of Education.
  
  
• KidsHealth in the Classroom. Guides for teaching students about oral health in preschool through grade 2, grades 6–8, and grades 9–12. The guides include discussion questions, activities, and handouts. Enter teeth in the search box to get the guides and supporting materials. KidsHealth is a service of the Nemours Foundation.
  
  
• Virginia Division of Dental Health: Curriculum Resources for Schools. A curriculum to educate students about the impact of health behaviors on oral and overall health. The curriculum includes lesson plans for school staff to use with elementary, middle, and high school students; PowerPoint presentations; and activity sheets.
  
  
• Maryland Office of Oral Health. 2009. Children’s Dental Health Bulletin Board. Baltimore, MD: Maryland Department of Health and Mental Hygiene. This set of 11 sheets is designed to hang on a bulletin board and covers the basics of oral health care.
  
  
• See the National Maternal and Child Oral Health Resource Center (OHRC) publication, Promoting Oral Health in Schools: A Resource Guide (2009).
  
  
• The section Web Sites for Consumers contains materials that can be used in the classroom.
  

  
  

Pregnancy

• Children’s Dental Health Project (CDHP): Improving Perinatal and Infant Oral Health Project. Information about the activities and accomplishments of this program to promote the oral health of pregnant women and children and to increase awareness of the importance of perinatal and infant oral health among health professionals, policymakers, and the public. The project is a collaborative effort between CDHP and the American Academy of Pediatric Dentistry (AAPD). Recent resources include
  
  Medicaid Coverage of Dental Care for Pregnant Women. (2009). [Policy brief].
  
  
• National Maternal and Child Oral Health Resource Center (OHRC): Perinatal. Materials about pregnancy and oral health for health professionals and consumers. Also see OHRC’s bibliographies about pregnancy and periodontal health for consumers and professionals. Recent publications include
  
  Resource Highlights: Focus on Pregnancy and Periodontal Health. (2009). [Resource brief].
  
  Two Healthy Smiles: Tips to Keep You and Your Baby Healthy, rev. ed./Dos Sonrisas Saludables: Consejos para Mantenerte a Ti y a Tu Bebé Sanos, rev. ed. (2009).[Brochures].
  
  
• Brown A. 2009. Improving Perinatal Oral Health: Moving Forward—An Expert Meeting, Meeting Summary Report. Washington, DC: Altarum Institute. This report summarizes a 2008 meeting convened to foster partnerships and identify strategies for improving perinatal oral health.
  
  
• Kumar J, Samelson R, eds. 2006. Oral Health Care During Pregnancy and Early Childhood: Practice Guidelines. Albany, NY: New York State Department of Health. These practice guidelines are intended for use by prenatal, oral health, and child health professionals in bringing about changes in the health care delivery system and improving the overall standard of care for pregnant women and young children. Also see OHRC's summary of the practice guidelines.
  
  
• Northwest Center to Reduce Oral Health Disparities. 2009. Guidelines for Oral Health Care in Pregnancy. Seattle, WA: University of Washington School of Dentistry. This document provides guidelines and recommendations for providing oral health care to women during their pregnancies. It discusses treatment considerations related to hypertension, diabetes, the use of heparin, and the risk of aspiration and need for proper patient positioning during dental procedures. A chart summarizes recommendations during various pregnancy stages and provides some cautions.
  
  
• South Carolina Division of Oral Health. 2010. Dental Care Before, During and After Pregnancy. Columbia, SC: South Carolina Department of Health and Environmental Control. This brochure for women highlights the importance of good perinatal oral health care.
  
  
• See the American Academy of Pediatric Dentistry (AAPD) clinical practice guidelines, Guideline on Perinatal Oral Health Care (2009).
  
  
• Also see Smiles for Life: A National Oral Health Curriculum for Family Medicine and the MCHCOM.com webcasts. Several of the Web sites listed in the sections Web Sites of State Organizations and Web Sites for Consumers contain resources about perinatal oral health.
  

  
  

School-Based and School-Linked Care

• Association of State and Territorial Dental Directors (ASTDD): School and Adolescent Oral Health. Information about school and adolescent oral health programs, tools for integrating oral health into coordinated school health programs, and state profiles about school and adolescent oral health. ASTDD's resource, Best Practice Approaches, presents state and community practice examples and reports about school fluoride and dental sealant programs.
  
  
• Center for Health and Health Care in Schools (CHHCS): School-Based Dental Health. A collection of resources about school-based oral health services including background papers, tools for clinic operations and management, papers on financing issues, model state and local oral health policies and program information, links to additional resources, and a bibliography.
  
  
• Centers for Disease Control and Prevention (CDC): School-Based Dental Sealant Programs. Information about dental sealants and the role of school-based programs. Includes recommendations for practitioners in school-based programs.
  
  
• National Maternal and Child Oral Health Resource Center (OHRC). A bibliography about school-based oral health programs. Other materials include
  
  Promoting Oral Health in Schools: A Resource Guide (2009). This guide includes a section with resources about school-based oral health screenings, examinations, and care.
  
  Seal America: The Prevention Invention, 2nd ed. (2007). This online manual is designed to assist health professionals with initiating and implementing a school-based dental sealant program. The manual was developed by Nancy Carter with assistance from the American Association for Community Dental Programs (AACDP) and OHRC.
  
  
• Oral Health America (OHA): Smiles Across America. Information about this oral-disease-prevention and health-promotion initiative linking corporate, government, and community support in advancing school-based or school-linked oral health programs for families without access to routine oral health care.
  
  
• Crespin M, Ordinans K, Tatro BJ. 2009. Partnering to Seal-a-Smile: A Report on the Success of Wisconsin School-Based Dental Sealant Programs. Milwaukee, WI: Children’s Health Alliance of Wisconsin. This report describes the Seal-a-Smile Program, which provides school-based oral health services to children in Wisconsin, and highlights the program's accomplishments. An executive summary accompanies the report.
  
  
• Montana Oral Health Program. 2009. School Based Fluoride Mouthrinse Program: To Promote Oral Health and Reduce Tooth Decay. Helena, MT: Montana Department of Public Health and Human Services. This fact sheet describes a fluoride mouthrinse program for Montana students in kindergarten through grade 6 who do not have access to optimal levels of fluoride in community water.
  
  
• Ohio Bureau of Oral Health Services. 2009. School-Based Dental Sealant Program Manual. Columbus, OH: Ohio Department of Health. This manual outlines expectations and standards for school-based dental sealant programs funded by the Ohio Department of Health (ODH). The manual addresses local program operations, regulatory compliance, compliance with ODH policies, sealant program eligibility, sample program forms, clinical materials and methods, retention checks, Medicaid billing and collection, performance benchmarks and performance standards, reporting, and program reviews. Also see School-Based Dental Sealant Programs (2009), a series of online learning modules for program staff that covers infection control, tooth selection and assessment for dental sealants, materials and application techniques, and program operations, with an emphasis on the specific requirements that apply
  
  
• Texas Oral Health Program. 2009. Seal a Smile Texas Style: A Sealant Manual for the Oral Health Program, rev. ed. Austin, TX: Texas Department of State Health Services. This manual for implementing a dental sealant program in Texas schools contains information about dental sealant benefits, planning for a school clinic, challenges to establishing a program, equipment and supplies needed, referral and follow-up procedures, and sample forms and parent-education materials in English and Spanish.
  
  
• Several of the resources listed in the section Web Sites of State Organizations offer information about state-supported, school-based oral health programs.
  

  
  

Special Health Care Needs

• Association of State and Territorial Dental Directors (ASTDD): Children with Special Health Care Needs. Information about efforts in states and territories to improve the oral health of children with special health care needs. Includes a collection of state forum reports and action plans and links to materials to support state efforts. Recent publications include
  
  ASTDD Support for State CSHCN Oral Health Forums, Action Plans and Follow-Up Activities: Interim Evaluation Summary. (2009).
  
  Also see ASTDD’s resource, Best Practice Approaches, which presents state and community practice examples and reports about improving the oral health of children, adolescents, and adults with special health care needs.
  
  
• National Foundation of Dentistry for the Handicapped (NFDH). Information about its programs to provide oral health services to individuals with special health care needs and elderly citizens through oral health professionals who donate their services. NFDH is an affiliate of the American Dental Association (ADA).
  
  
• National Institute of Dental and Craniofacial Research (NIDCR): Special Needs. A series of booklets for health professionals and families about delivering oral health care to individuals with special health care needs. Also presents information and resources for health professionals and consumers about managing and preventing oral complications of systemic diseases (cancer treatment, developmental disabilities, diabetes mellitus, heart disease, and HIV and AIDS). NIDCR also offers
  
  NIDCR Special Care Database. Citations for materials that focus on care for individuals with genetic or systemic disorders that affect oral, dental, or craniofacial health, whose medical treatments cause oral problems, or whose intellectual or physical disabilities complicate oral hygiene or dental treatment. Materials include fact sheets, brochures, audiovisuals, and other educational materials for consumers and health professionals.
  
  
• National Maternal and Child Oral Health Resource Center (OHRC): Children with Special Health Care Needs. Policy brief, resource guide, fact sheet, and tip sheet about planning, developing, and implementing efforts to ensure that children and adolescents with special health care needs receive optimal oral health care. Other resources include
  
  Oral Health for Children with Special Health Care Needs: Priorities for Action—Recommendations from an MCHB Expert Meeting. (2009). [Report, Presentation].
  
  Special Care: An Oral Health Professional's Guide to Serving Young Children with Special Health Care Needs. (2006). This series of five self-study modules 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 OHRC’s bibliography about oral health for children and adolescents with special health care needs.
  
  
• New York State Developmental Disabilities Planning Council. Pamphlets about oral health for individuals with disabilities, their families and caregivers, and oral health professionals:
  
  All About Oral Health: Dentistry for Individuals with Disabilities. (2009).
  
  Making a Dental Home for You and Your Child: Dentistry for Individuals with Disabilities. (2009).
  
  Medicaid and State Health Insurance Coverage: Oral Health Care for Individuals with Disabilities. (2009).
  
  Preparing for the Dental Visit: Dentistry for Individuals with Disabilities. (2009).
  
  Taking Care of Your Baby’s Teeth: Dentistry for Individuals with Disabilities. (2009).
  
  Taking Care of Your Teeth and Gums. (2009).
  
  Things You Should Know About X-Rays and Sedation: Dentistry for Individuals with Disabilities. (2009).
  
  
• Pacific Center for Special Care. Information about its programs and efforts to improve access to oral health care for individuals with special health care needs, including people who have difficulty maintaining good oral health or accessing oral health services because of developmental, medical, physical, or social conditions. The center is an organization within the Arthur A. Dugoni School of Dentistry.
  
  
• Special Care Dentistry Association (SCDA). Links to educational modules, a product guide, and other resources about the oral health care of individuals with special health care needs. Access to most resources is limited to SCDA members or is available for a fee.
  
  
• Special Olympics: Healthy Athletes. Information about this initiative to provide health screenings to athletes free of charge at Special Olympics competitions. Health screenings are offered in seven areas, one of which is oral health (Special Smiles). Presents information for health professionals about volunteering in the program and resources for health professionals that include training manuals, handbooks, forms, and patient-education materials. Also offers an online directory of local health professionals who have experience in the needs and care of people with intellectual disabilities. 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.
  
  
• Virginia Division of Dental Health: Children with Special Health Care Needs Oral Health. Information about state oral health initiatives for children with special health care needs. Recent materials for parents include
  
  A Healthy Mouth for Children with Special Health Care Needs: A Parent's Guide. (2009). [Brochure].
  
  Oral Health Care Tips for: Children with Special Health Care Needs (CSHCN). (2009). [Fact sheet].
  
  Visiting the Dentist: Children with Special Health Care Needs. (2009). [Brochure].
  
  
• Family Voices. 2009. Friday's Child: Special Oral Health Edition. Albuquerque, NM: Family Voices. This newsletter issue describes efforts in Kansas to ensure that children with special health care needs have access to appropriate oral health services. The newsletter also describes the oral health provisions in the federal Children’s Health Insurance Program.
  
  
• See the American Academy of Pediatric Dentistry (AAPD) clinical practice guidelines, Management of Dental Patients with Special Health Care Needs, rev. ed. (2008) and the policy statement, Model Dental Benefits for Infants, Children, Adolescents, and Individuals with Special Health Care Needs (2008).
  
  
• Also see Healthy Smiles Through Child Care Health Consultation and First Smiles. Several of the Web sites listed in the section Web Sites of State Organizations contain resources about oral health for individuals with special health care needs.

Oral Health for Infants, Children, Adolescents, and Pregnant Women: Knowledge Path, 11th ed. (July 2010).
Authors: Susan Brune Lorenzo, M.L.S., Maternal and Child Health Library; Katrina Holt, M.P.H., M.S., R.D., OHRC.
Contributors: Jolene Bertness, M.Ed., OHRC; Elizabeth Lowe, M.P.H., R.D.H., OHRC; Ebony Stoutmiles, OHRC.
Reviewers: Sarah Kolo, OHRC; Pamella Vodicka, M.S., R.D., Maternal and Child Health Bureau.

 

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