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

January 2009

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 sealants, early childhood caries (ECC), fluoride varnish, K-12 education, pregnancy, school-based care, school evaluation mandates, 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 topics: See Health insurance and access to care for children and adolescents.

Resources for Professionals

Overview

For many Americans, oral health status has improved during the last two decades. However, although oral disease has declined significantly among school-age children, 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.

Web Sites of National Organizations

• Academy of General Dentistry (AGD). Provides 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. Recent publications include
  
  White paper on increasing access to and utilization of oral health care services. (2008).
  
  
• American Academy of Pediatric Dentistry (AAPD). Offers 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. Recent resources include
  
  Dental Home AAPD Online Resource Center. Presents information about the dental home concept and resources to support the delivery of oral health care to all children, with a focus on infants.
  
  Fluoride therapy, rev. ed. (2008). [Guidelines].
  
  One year later: Medicaid's response to systemic problems revealed by the death of Deamonte Driver: Testimony of James J. Crall, D.D.S., Sc.D. (2008). [Congressional testimony].
  
  Also see AAPD's Find a Pediatric Dentist, Parent Resource Center, the Head Start Dental Home Initiative, policy statements about ECC, a policy statement for school entrance exams, and materials about caring for individuals with special health care needs.
  
  
• American Academy of Pediatrics (AAP): Oral Health. Presents training and program information to promote improved child oral health by offering pediatricians and other child health professionals the tools and support they need to provide community-based, collaborative care. Offers a database of community pediatric oral health projects, a newsletter, policy statements, journal articles, and links to other resources. Recent materials include
  
  States with Medicaid funding for physical oral health screening and fluoride varnish. (2008). [Map and chart].
  
  Also see AAP's training module, Oral Health Risk Assessment: Training for Pediatricians and Other Child Health Professionals, and Patient Education Online.
  
  
• American Association for Community Dental Programs (AACDP). Offers membership information; a newsletter, The Bellwether; annual meeting materials; and resources to support those serving the oral health needs of vulnerable populations at the community level.
  
  
• American Association of Public Health Dentistry (AAPHD). Contains program information for accredited dental public health residencies; a contact list for schools of public health and public health programs; meeting information; and a newsletter, Communique.
  
  
• American Dental Association (ADA). Contains journal articles, position statements, policy analyses, federal and state legislative information, news releases, and information about products, CE opportunities, meetings, and membership. Recent resources and initiatives include
  
  American Indian and Alaska Native Oral Health Access Summit: Summary report. (2008).
  
  Bisphenol A and dental materials, rev. ed. (2008). [Position statement].
  
  Give Kids a Smile! Provides background information and resources for this initiative to provide free oral health services to children from families with low incomes across the country during the first Friday in February each year.
  
  National Children's Dental Health Month (NCDHM). Presents information about this nationwide observance held every February to raise awareness about the importance of oral health. Resources for oral health professionals and teachers include a program-planning kit, posters, classroom ideas, and activity sheets for children.
  
  Report on the June 23, 2008, Medicaid Provider Symposium. (2008).
  
  Also see ADA's library catalog, Find a Dentist, resources for consumers; resources about dental sealants, ECC, and topical fluoride; and the Smile Smarts! Oral Health Curriculum.
  
  
• American Dental Education Association (ADEA). Presents 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, Washington Update), diversity and equity, recruitment and retention, work force, and access to health care. Recent publications include
  
  Oral health care: Essential to health care reform. (2008). [Policy statement].
  
  
• American Dental Hygienists' Association (ADHA). Offers CE courses, position papers, information about programs and grants, and testimony about oral health and access to care. Also see ADHA's resources for consumers.
  
  
• Association of State and Territorial Dental Directors (ASTDD). Contains project reports and program information for federally funded oral health activities; information about and links to each state and territory oral health program; links to resources and tools to support state and territorial dental directors in their efforts to build high-quality oral health programs; a newsletter, Oral Health Matters; and a list of members by state. ASTDD collaborates with the Centers for Disease Control and Prevention (CDC) in the development of oral health data systems and with the Children's Dental Health Project (CDHP) in the National Oral Health Policy Center. Recent resources and initiatives include
  
  Best Practice Approaches. Presents information about proven and promising practices for developing effective state, territorial, and community oral health programs. Includes a set of reports that describe public health strategies, summarize supporting evidence, review best practice criteria, and use current practices to illustrate successful implementation methods. Also offers a database of successful state oral health public health activities. For background information about this resource, see A history of the ASTDD Best Practices Project: The journey taken from 2000 to 2008 (2008).
  
  State data/surveillance template. (2008). This tool provides links to online data sources with state and national estimates for key oral health indicators to assist dental directors in finding oral health data relevant to the population they serve. The tool can be modified to create a personalized template, adding indicators and links to additional state and local data sources that are more current or that are available through collaboration with state and local partners.
  
  Synopses of state dental public health programs: Data for FY 2006-2007. (2008). [Report].
  
  Also see ASTDD's Safety net dental clinic manual, Mobile-portable dental manual, and brief about fluoride varnish.
  
  
• Centers for Disease Control and Prevention (CDC). Supports several oral health initiatives:
  
  CDC's Division of Oral Health. Contains data systems, guidelines and recommendations, fact sheets, journal articles, and other resources to enhance oral disease prevention in state and community settings. Resources include
  
  
  • Community Water Fluoridation. Presents 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. (2008). [Issue brief].
    
    
  • Populations receiving optimally fluoridated public drinking water—United States, 1992-2006. (2008). [Report].
    
    
  • State Oral Health Programs. Offers information about CDC funding for state oral health programs, oral health program infrastructure development tools, oral health information by state and territory, and state oral health plans.
    
    
  • 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 oral health.
  
  National Center for Health Statistics (NCHS). Presents the fact sheet, FASTATS: Oral and dental health, rev. ed. (2008). Also see the NCHS database, Data2010.
  
  
• Centers for Medicare & Medicaid Services (CMS). Provides information about Medicaid oral health coverage for eligible individuals under age 21 as a required component of the Early and Periodic Screening, Diagnostic and Treatment (EPSDT) benefit. Also briefly describes the oral health services available through the State Children's Health Insurance Program (SCHIP). Recent resources include
  
  2008 national dental summary report. (2009).
  
  Medicaid and SCHIP Promising Practices. Describes promising oral health practices in use by states for their Medicaid and SCHIP programs.
  
  Medicaid/SCHIP state dental contacts. (2008). [Directory].
  
  Policy issues in the delivery of dental services to Medicaid children and their families. (2008). [Guideline].
  
  State reports 2008. (2009). This collection of reports reviews state EPSDT oral health services.
  
  Also see the Health Resources and Services Administration (HRSA): Medicaid Primer and the Medicaid Benefits database.
  
  
• Children's Dental Health Project (CDHP). Contains publications and program information about children's oral health, particularly on issues involving access to care, financing programs, health disparities, and work force. Recent publications include
  
  National Oral Health Policy Center launched. (2008). [Press release]. Children's Dental Health Project in collaboration 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) was awarded a 3-year grant to implement the policy center.
  
  Necessary reform to pediatric dental care under Medicaid. (2008). [Congressional testimony].
  
  One year later: Medicaid’s response to systemic problems revealed by the death of Deamonte Driver: Testimony of Burton L. Edelstein D.D.S., M.P.H. (2008). [Congressional testimony].
  
  Also see the National Oral Health Policy Center's issue brief about state laws requiring oral health screenings for school registration.
  
  
• Healthy People 2010. Offers 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 learn how to participate in the development of Healthy People 2020.
  
  
• Health Resources and Services Administration (HRSA): Medicaid Primer. Offers information to assist state and local health officials in understanding how Medicaid works and how it can ensure access to health services for underserved populations. A section is devoted to oral health services under Medicaid.
  
  
• Medicaid/SCHIP Dental Association (MSDA). Presents links to publications, meeting presentations, and other resources about state and national Medicaid and SCHIP oral health policies and practices. MSDA collaborates with the Children's Dental Health Project (CDHP) in the National Oral Health Policy Center. MSDA aims to provide state and national leadership and support to improve the delivery of oral health care to those enrolled in Medicaid and SCHIP.
  
  
• National Conference of State Legislatures (NCSL): Children's Oral health. Presents information about the role that state legislators can play in improving children's oral health. Topics include Medicaid and SCHIP, access to services, work force, 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 Health Law Program (NHeLP). Offers issue briefs, case dockets, and other resources about Medicaid, SCHIP, and children's access to health care, including oral health care. NHeLP is a national public-interest law firm that aims to improve health care for families with low incomes or in minority groups, the elderly, and people with disabilities.
  
  
• National Institute of Dental and Craniofacial Research (NIDCR). Offers an oral and craniofacial data system, News from NIDCR, resources for consumers, suggestions for finding dental 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. NIDCR is part of the National Institutes of Health (NIH).
  
  
• National Maternal and Child Oral Health Resource Center (OHRC). Offers a searchable collection of print and electronic materials. The Oral health resource bulletin lists recent, noteworthy items in the collection, and OHRC's A-Z List links to materials by topic. OHRC also offers a database describing oral health projects funded by the Maternal and Child Health Bureau (MCHB) and a database of projects funded by the Office of Head Start (OHS), news alerts and online discussion lists, distance learning curricula, and links to resources about oral health. OHRC is supported by MCHB. Resources include
  
  A way with words: Guidelines for writing oral health materials for audiences with limited literacy. (2008).
  
  Bright Futures Oral Health Toolbox. Links to guides, curricula, screening and risk-assessment tools, and anticipatory guidance tools.
  
  Oral health resource bulletin. (2008).
  
  Also see OHRC's resources for consumers and resources about Head Start, dental sealants, ECC, fluoride varnish, pregnancy, school-based care, and special health care needs.
  
  
• National Network for Oral Health Access (NNOHA). Presents forms, manuals, articles and other background information, a newsletter, patient-education materials, 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.
  
  
• Oral Health America (OHA). Contains 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. A recent report is
  
  Keep Kansas smiling: Oral health in the sunflower state—Kansas Oral Health Grading Project 2009. (2009).
  
  OHA also publishes a newsletter and two school-based oral health initiatives.
  
  
• Pipeline, Profession, and Practice: Community-Based Dental Education Program (Dental Pipeline). Presents 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

• Agency for Healthcare Research and Quality (AHRQ). 2003-. National healthcare disparities report. Rockville, MD: Agency for Healthcare Research and Quality (AHRQ). This annual report provides an overview of disparities in quality of and access to health care among racial, ethnic, and socioeconomic groups in the United States and tracks the nation's progress toward reducing disparities. View the chapter, Maternal and child health, to view measures relevant to children and adolescents ages 2-17 with untreated dental caries by race, ethnicity, and income (Fig. 4.44) and children and adolescents ages 2-17 with a dental visit in the past year by race, ethnicity, and income (Fig 4.45).
  
  
• Alliance for Health Reform, Kaiser Commission on Medicaid and the Uninsured (KCMU). 2008. Dental health: Nurturing the health care system’s neglected stepchild. Washington, DC: Alliance for Health Reform, Kaiser Commission on Medicaid and the Uninsured. This collection of resources is from a July 2008 briefing that examined oral health in the broader conversation of improving the quality of and expanding access to health care. Resources include transcripts, an event summary, an online video, a Webcast, a Podcast, speaker presentations, and source documents and background materials.
  
  
• Borchgrevink A, Snyder A, Gehshan S. 2008. The effects of Medicaid reimbursement rates on access to dental care. Portland, ME: National Academy for State Health Policy (NASHP). This report presents findings from a study to assess the effects of raising Medicaid reimbursement rates on access to oral health care in six states (Alabama, Michigan, South Carolina, Tennessee, Virginia, and Washington) and to compare these states' experiences to California's.
  
  
• Children's Defense Fund Healthy Child Campaign. 2008. Disparities in children's health and health coverage. Washington, DC: Children's Defense Fund (CDF). This fact sheet describes disparities in health and health insurance coverage for infants, children, and adolescents in minority groups from before birth into adulthood compared to white infants, children, and adolescents. Facts are presented about oral health disparities as well as about disparities in prenatal care, low birthweight, infant mortality, asthma, lead poisoning, and childhood obesity.
  
  
• Council of State Governments (CSG), Healthy States Initiative. 2008. Promoting improved oral health. Lexington, KY: Council of State Governments (CSG). This policy brief provides suggestions about what state legislators need to know about oral health and what they can do to improve it. Contents include examples of policies in Arkansas, Colorado, Tennessee, and Ohio.
  
  
• Council of State Governments (CSG), Healthy States Initiative. 2008. Talking points: Preventing tooth decay. Lexington, KY: Council of State Governments (CSG). This fact sheet presents talking points for state legislators about tooth-decay prevention. Topics include the importance of preventing tooth decay, the costs of oral diseases and oral health care, tooth decay in children, how tooth decay can be prevented, and what legislators can do to help promote oral health.
  
  
• Felland LE, Lauer JR., Cunningham PJ. 2008. Community efforts to expand dental services for low-income people. Washington, DC: Center for Studying Health System Change. This brief describes barriers to good oral health and programs offered to increase access to oral health services. Topics include challenges people with low incomes face in obtaining oral health coverage and care, federal programs affecting access to oral health services, significant gaps in the dental safety net, and community efforts to expand oral health services.
  
  
• Gehshan S, Snyder A, Paradise J. 2008. Filling an urgent need: Improving children's access to dental care in Medicaid and SCHIP. Washington, DC: Kaiser Commission on Medicaid and the Uninsured (KCMU); Portland, ME: National Academy for State Health Policy (NASHP). This report describes a meeting of state and national experts held in October 2007 to address children's access to oral health care in Medicaid and SCHIP programs and to exchange information and assessments about what has worked best to improve access. Topics include provider participation, the oral health work force, dental benefits, oral health education and patient support, data collection, monitoring, and evaluation, and systemic reforms in managing oral disease as a chronic disease.
  
  
• George Washington University School of Public Health and Health Services, Rapid Public Health Policy Response Project. 2008. Pediatric dentistry: How can dental care for low-income children be improved? Washington, DC: George Washington University School of Public Health and Health Services. This paper describes the causes and consequences of oral diseases that disproportionately affect the nation's most vulnerable children and the strategies available to address these diseases.
  
  
• Government Accountability Office (GAO). 2008. Medicaid: Extent of dental disease in children has not decreased, and millions are estimated to have untreated tooth decay. Washington, DC: U.S. Government Accountability Office (GAO). This report presents information from national health surveys on key indicators of the oral health status of children in Medicaid, specifically, the rate of oral disease, children's receipt of oral health care, and changes in these indicators over time.
  
  
• Grantmakers in Health. 2008. Critical services for our children: Integrating mental and oral health into primary care. Washington, DC: Grantmakers in Health. This issue brief summarizes an April 2007 discussion among grantmakers and health services researchers about improving the pediatric health care system by better integrating oral and mental health services into primary care. An executive summary is available.
  
  
• Kaiser Commission on Medicaid and the Uninsured (KCMU). 2008. Dental coverage and care for low-income children: The role of Medicaid and SCHIP, rev. ed. Washington, DC: Kaiser Commission on Medicaid and the Uninsured (KCMU). This fact sheet outlines the importance of oral health care for children, disparities in children's oral disease and access to oral health care, coverage of oral health care in Medicaid and SCHIP, and initiatives to increase access to care for children.
  
  
• Martin AB, Wang E, Probst JC, Hale N, Johnson AO. 2008. Dental health and access to care among rural children: A national and state portrait. Columbia, SC: South Carolina Rural Health Research Center. This executive summary provides highlights of oral health status, use of preventive services, and dental insurance among rural children compared to urban children.
  
  
• Maternal and Child Health Information Resource Center (MCHIRC). 2008. National and state surveillance efforts to monitor oral health disparities in children. Rockville, MD: Maternal and Child Health Bureau (MCHB). This collection of resources is from an April 2008 Web-based conference for maternal and child health professionals, researchers, and program planners about recent data on children’s oral health from selected national- and state-level surveillance efforts. The full program in audio and video formats, program transcripts, presenter information, and links to relevant resources are available.
  
  
• National Adolescent Health Information Center (NAHIC). 2008. 2008 fact sheet on health care access and utilization: Adolescents and young adults. San Francisco, CA: National Adolescent Health Information Center (NAHIC). This fact sheet provides data on health insurance coverage, preventive and other health services, and unmet health care needs (including unmet oral health care needs) among adolescents and young adults ages 12-24, including those with special health care needs.
  
  
• Pew Center on the States. 2008. Advancing children's dental health. Philadelphia, PA: Pew Charitable Trusts. This fact sheet describes a new initiative by the Pew Center on the States to improve access to oral health care for disadvantaged children.
  
  
• Snyder A, Gehshan S. 2008. State health reform: How do dental benefits fit in?—Options for policy makers. Portland, ME: National Academy for State Health Policy (NASHP). This report explores how states can include dental benefits within a health-care-reform plan and describes the experiences of Maine, Massachusetts, and Vermont.
  

  
  

Web Sites of State Organizations

• California Dental Association (CDA) Foundation: Access to Care. Presents information about its programs to increase access to oral health care for underserved populations, including infants and young children and children with special health care needs. CDA also offers program information and materials for California's kindergarten oral health evaluation requirement. Also see CDA's patient-education tools and First Smiles.
  
  
• Colorado Department of Public Health and Environment: Oral Health Program. Contains information about and resources to support a school-based dental sealant program, a school fluoride mouthrinse program, community water fluoridation, and an oral health surveillance system. Other resources include a dental-emergency flip chart, oral health program guidelines for school districts, an ECC fact sheet, and reports about the oral health status of children in Colorado. Some materials are available in Spanish.
  
  
• Iowa Department of Public Health: Oral Health Bureau. Contains program information and reports about Iowa's efforts to improve the oral health of all residents. Oral health programs for pregnant women, infants, children, and adolescents include a school-based dental sealant program, a fluoride varnish program, an EPSDT oral services program, and the Iowa Access to Baby and Child Dentistry Program. Includes a collection of resources to support Iowa's new school dental screening requirement.
  
  
• Kansas Department of Health and the Environment: Oral Health Initiative. Offers information about efforts to improve oral health in Kansas via oral health education, oral disease prevention, oral health assessment, and access to oral health care. Includes information and resources for its statewide school oral health screening program and a collection of oral health fact sheets.
  
  
• Massachusetts Office of Health and Human Services: Oral Health. Offers fact sheets and reports about community water fluoridation, the dental workforce, dental sealants, diabetes, pregnancy, fluoride mouthrinse, and fluoride varnish applications (available in 9 languages). Also see the Catalyst Institute report about the oral health status of Massachusetts' public school students.
  
  
• New York State Department of Health: Oral Health. Offers information and resources about the connection between oral health and general health, oral health across the lifespan, the impact of oral disease, and New York's oral health programs and initiatives, many of which are targeted to pregnant women, infants, children, 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). Presents 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. Also includes oral health promotion campaign materials and efforts to increase access to oral health care. Also see Into the Mouths of Babes: North Carolina Dental Screening and Varnish Project.
  
  
• South Carolina Department of Health and Environmental Control (SCDHEC) Division of Oral Health. Presents oral health materials for professionals and families on topics that include ECC, water fluoridation and fluoride varnishes, school-based oral health programs, oral health evaluations, and the state oral health plan. Also see South Carolina's collection of materials for early childhood education programs and schools.
  
  
• Tennessee Department of Health: Oral Health Services. Presents information about the history of the oral health program in Tennessee, a school-based oral health care project, dental clinics, and fluoride programs, including a fluoride varnish program and community water fluoridation programs. Also presents a set of oral health fact sheets about healthy oral development, the importance and care of children's teeth, primary and permanent tooth eruption, ECC, fluoride, dental sealants, mouth guards, nutrition, pregnancy, preventing tooth decay, periodontal disease, oral-injury prevention, and tobacco use. Recent publications include
  
  Standards of practice manual for dental public health, rev. ed. (2008).
  
  
• Washington Dental Service (WDS) Foundation: Access to Baby and Child Dentistry (ABCD). Presents program information and materials that can be used to replicate this model program focusing on preventive and restorative 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. Contains program information, reports, and fact sheets on topics such as ECC, dental sealants, fluoride, and smokeless tobacco. Also provides training resources, including samples of agency protocols for the placement of dental sealants and the application of fluoride varnish in public health settings and training materials for integrating oral-health-promotion and oral-health-prevention services into health visits.
  
  
• Also see the Ohio Dental Safety Net Information Center. 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 sections within Resources on Specific Aspects of Oral Health.
  

  
  

Additional Resources from State Organizations

• Bates T, Chapman S. 2008. Diversity in California’s health professions: Dentistry. San Francisco, CA: Center for the Health Professions. This issue brief presents data describing key characteristics of California’s dentistry labor force.
  
  
• Center for Health Care Strategies. 2008. New Jersey Smiles: A Medicaid quality collaborative to improve oral health in kids. Hamilton, NJ: Center for Health Care Strategies. This chart outlines different proposed frameworks in New Jersey to increase the number of infants and children from birth to age 5 who have received an annual oral health visit. The chart outlines identification, outreach, and intervention steps to take and how outcomes will be measured.
  
  
• Diringer J, Phipps K. 2008. Expanding access to dental care through California’s community health centers. Oakland, CA: California HealthCare Foundation. This issue brief examines the difficulties facing federally qualified health centers that want to establish or expand oral health services for Californians with low incomes and offers recommendations for overcoming those difficulties.
  
  
• Hughes D, Howell E, Trenholm C, Hill, Dubay L. 2008. Three independent evaluations of Healthy Kids programs find dramatic gains in children's dental health care. Princeton, NJ: Mathematica Policy Research. This brief presents highlights from independent evaluations of the Healthy Kids programs in three California counties. These programs provide children from families with low incomes with comprehensive health insurance coverage, including a broad range of medical, dental, and vision care, prescription drugs, and mental health services. The brief describes some of the positive impacts that Healthy Kids has had on children's access to and use of oral health services.
  
  
• Mertz E. 2008. Registered dental hygienists in alternative practice: Increasing access to dental care in California. San Francisco, CA: Center for the Health Professions. This paper presents findings from a study to explore ways that policy modifications may improve use of the registered dental hygienist-advanced practice (RDHAP) work force and to examine the evolution of RDHAP practices and their progress toward expanding access to care for vulnerable populations. An executive summary is available. Also see a related report, Registered dental hygienists in California: Regional labor market chart book (2005-2006) (2008).
  
  
• Pourat N.2008. Snapshot: Haves and have-nots: A look at children's use of dental care in California. Oakland, CA: California HealthCare Foundation. This report examines the racial and ethnic differences and other factors that contribute to disparities in oral health care among California's children.
  
  
• Scott MK, Bingham D, Doherty M. 2008. The good practice: Treating underserved dental patients while staying afloat. Oakland, CA: California HealthCare Foundation. This guide aims to help community dental practices design or enhance clinical and business operations to improve the efficiency and effectiveness of the services they deliver. An audio report accompanies the report and recounts the experiences of three community dentists who treat individuals who are uninsured or who participate in Medi-Cal and how these dentists were able to improve their practices.
  
  
• Texas Dental Association. 2008. Building better oral health: A dental home for all Texans. Austin, TX: Texas Dental Association. This report identifies issues, needs, and challenges associated with improving the oral health of all Texans. Topics include the economic, medical, and social consequences of untreated oral disease and reasons why Texas must take action; the oral health care system in Texas (including school-based and Head Start preventive oral health services); state and national comparative data on the oral health status of Texas; and the oral health disparities that exist in Texas, particularly among populations that face special challenges in accessing oral health services.
  
  
• White BA, Monopoli MP, Souza BS. 2008. The oral health of Massachusetts' children. Westborough, MA: Catalyst Institute. This report presents findings from a study to assess the oral health status of Massachusetts' public school students (kindergarten, third grade, and sixth grade) by gathering baseline estimates of dental caries experience and other indicators. An executive summary is available.
  

  
  

Distance Learning Resources

• Mobile-Portable Dental Manual. Presents an online reference tool that focuses on using public health approaches to create health care systems to serve populations that have difficulty accessing the traditional system of oral health service delivery. The manual was published by the Association of State and Territorial Dental Directors (ASTDD) and the American Association for Community Dental Programs (AACDP) and cross-references and links to the companion reference tool, Safety Net Dental Clinic Manual.
  
  
• National Maternal and Child Oral Health Resource Center (OHRC): Distance Learning. Presents a collection of materials:
  
  A Health Professional's Guide to Pediatric Oral Health Management. Comprises seven self-study modules to assist health professionals in managing the oral health of infants and young children.
  
  Open Wide: Oral Health Training for Health Professionals. Presents four self-study modules to help health and early childhood professionals working in community settings (e.g., Head Start and WIC staff) promote oral health in the course of promoting general health for infants, children, and their families.
  
  Seal America: The Prevention Invention, 2nd ed.
  
  Special Care: An Oral Health Professional's Guide to Serving Young Children with Special Health Care Needs.
  
  Also see the three 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.
  
  
• National Public Health Training Center (PHTC) Network Distance Education Center. Offers a database of PHTC-developed distance learning resources to train a broad audience of health professionals in the core public health competencies to strengthen skills of public health workers. For training resources about oral health, go to 4. Select Subject Area(s); select Oral Health; and click on Search to get your results. PHTCs are funded by the Health Resources and Services Administration (HRSA), and the database is a service of the Association of Schools of Public Health (ASPH).
  
  
• Ohio Dental Safety Net Information Center. Presents tools and information to start and maintain the operations and delivery of health care services in safety net dental clinics in Ohio. Offers three distance learning opportunities:
  
  Clinical Operations for Safety Net Dental Clinics in Ohio. Comprises six self-study modules about 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 in Ohio. Offers five self-study modules for dental clinic staff about strategic planning, revenue, expenses, managing finances, and securing external funding.
  
  Oral Health Care for Young Children in Ohio. Presents four self-study modules to help oral health professionals learn about providing care to infants and children from birth through age 3. The modules cover anticipatory guidance and prevention, behavior management, restorative treatment, and managing dental emergencies.
  
  
• Oral Health Risk Assessment: Training for Pediatricians and Other Child Health Professionals. This online training module for pediatricians and other primary care health professionals describes how to conduct an oral health risk assessment and triage for infants and young children. Topics include the role of the child health professional in assessing children's oral health, the pathogenesis of dental caries, oral health risk assessment, prevention strategies, establishing a dental home, and oral health education. The module is presented by the American Academy of Pediatrics (AAP).
  
  
• Oral Health Resources for Health Professionals. Offers a collection of distance learning materials for physicians, residents, and medical students to improve their effectiveness in providing oral health services to infants and children. Materials include lectures in videotape 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. This collection is presented by the University of Connecticut Health Center.
  
  
• Safety Net Dental Clinic Manual. Presents a training manual highlighting all aspects of dental clinic development as well as ongoing operations. Topics include partnerships and planning, facilities and staffing, financing, clinic operations, quality assurance, and quality improvement. The manual is a collaboration between the Ohio Department of Health, the Indian Health Service, and the Association of State and Territorial Dental Directors (ASTDD), and it is continually updated. Also see the companion tool, Mobile-Portable Dental Manual.
  
  
• Smiles for Life: A National Oral Health Curriculum. Presents an oral health curriculum and resources for primary care health professionals. The curriculum contains seven modules about the relationship between oral and systemic health, child and adult oral health, emergencies, pregnancy, fluoride varnish, and the oral examination. The Web site also provides an implementation guide, educational objectives, test questions, resources for further learning, pocket cards, PDA applications, and posters in English and Spanish. The curriculum is produced by the Society of Teachers of Family Medicine (STFM).
  
  
• 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. 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. Presents statistics and reports about children and families, including population and family characteristics, economic security, health, behavior, social environment, and education. Includes statistics about oral health. ChildStats.gov is a service of the Federal Interagency Forum on Child and Family Statistics. The Forum's annual report, America's children: Key national indicators of well-being, details the status of children and families in the United States.
  
  
• Community Health Status Indicators (CHSI). Presents 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