Fluoride VarnishA Resource GuideSecond Edition

Fluoride Varnish: a resource Guide

second edition

PrePared by

Jolene bertness, M.ed., chesKatrina holt, M.P.h., M.s., r.d., Fand

october 2016

Cite asBertness J, Holt K, eds. 2016. Fluoride Varnish: A Resource Guide (2nd ed.). Washington, DC: National Maternal and Child Oral Health Resource Center.

Fluoride Varnish: A Resource Guide (2nd ed.) © 2016 by National Maternal and Child Oral Health Resource Center, Georgetown University

This project is supported by the Health Resources and Services Administration (HRSA) of the U.S. Department of Health and Human Services (DHHS) under grant #H47MC00048 in the amount $3,000,000 over 5 years. This information or content and conclusions are those of the authors and should not be construed as the official position or policy of HRSA, DHHS, or the U.S. government, nor should any endorsements be inferred.

Permission is given to save and print this publication and to forward it, in its entirety, to others. Requests for permission to use all or part of the information contained in this publication in other ways should be sent to the address below.

National Maternal and Child Oral Health Resource CenterGeorgetown UniversityBox 571272Washington, DC 20057-1272 Phone: (202) 784-9771 E-mail: OHRCinfo@georgetown.eduWebsite: http://www.mchoralhealth.org

Contents

Introduction v

Acknowledgments vi

Materials 1Data and Surveillance 3Policy 3Professional Education, Tools, and Training 4Public Education 14State and Local Program Reports 15

Organizations 17

Materials Produced by the National Maternal and Child Oral Health Resource Center 23

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IntroduCtIon

The National Maternal and Child Oral Health Resource Center (OHRC) developed this pub-

lication, Fluoride Varnish: A Resource Guide (2nd ed.), to help health professionals, program admin-istrators, educators, parents, and others promote oral health and prevent oral disease in infants, children, and adolescents. The resource guide is divided into two sections. The first section describes materials, such as brochures, fact sheets, guidelines, curricula, and reports published from 2011 through 2016. The second section lists fed-eral agencies, national professional associations, resource centers, and national coalitions that may serve as resources.

Our intent is to share resources that are use-ful and that represent current science and prac-tice. For further information, we encourage you to contact the organizations listed. Your state and local departments of health, state and local oral-health-related associations and societies, state or local oral health coalitions, and university-based libraries are additional sources of information. OHRC will update the resource guide periodi-cally, and we would appreciate hearing from you if you know of any relevant resources that are not included in this edition.

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ACknowledgments

We are grateful to the following Association of State and Territorial Dental Directors Fluorides Committee members for their review and contri-butions to the resource guide.

• Bruce Austin, Oregon Health Authority, Oral Health Unit

• William Bailey, University of Colorado School of Dental Medicine

• Susan Deming, Michigan Department of Health and Human Services, Oral Health Program

• Kip Duchon, Centers for Disease Control and Prevention, Division of Oral Health

• Judith Feinstein, Consultant• LeeAnn Hoaglin-Cooper, Cooper Consulting• Julie Janssen, Consultant• Carolyn Kelly, Consultant• Jayanth Kumar, California Department of Public

Health, Oral Health Program

• Dixianne Parker, Georgia Department of Public Health, Oral Health Prevention Program

• Howard Pollick, University of California San Francisco School of Dentistry

• Jason Roush, West Virginia Department of Health and Human Services, Oral Health Program

• Sandy Sutton, Michigan Department of Health and Human Services, Oral Health Program

• Bradley Whistler, Alaska Department of Health and Social Services, Oral Health Program

• Christine Wood, Association of State and Terri-torial Dental Directors

• Beth Wyatt, Colorado Department of Public Health and Environment, Oral Health Unit

• Kimberlie Yineman, North Dakota Department of Health, Oral Health Program

And we would like to thank those who submit-ted items for inclusion in the guide.

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DATA AND SURVEILLANCE

USE OF DENTAL CARE AND EFFECTIVE PREVENTIVE SERVICES IN PREVENTING TOOTH DECAY AMONG U.S. CHILDREN AND ADOLESCENTS: MEDICAL EXPENDITURE PANEL SURVEY, UNITED STATES, 2003–2009 AND NATIONAL HEALTH AND NUTRITION EXAMINATION SURVEY, UNITED STATES, 2005–2010

This report provides information about the use of oral health care and the receipt of a dental sealant or topical fluoride gel or varnish among infants, children, and adolescents from birth to age 21 within the calendar year. The report pres-ents measures and trends by the infant’s, child’s, or adolescent’s sex, age, race and ethnicity, health insurance status, dental insurance status, and dis-ability status; family income-poverty ratio; and head of household level of educational attainment.

Griffin SO, Barker LK, Wei L, Li C-H, Albuquerque MS, Gooch BE. 2014. Use of dental care and effec-tive preventive services in preventing tooth decay among U.S. children and adolescents: Medical Expenditure Panel Survey, United States, 2003–2009 and National Health and Nutrition Examination Survey, United States, 2005–2010. Morbidity and Mortality Weekly Report 63(2):54–60. http://www.cdc.gov/mmwr/preview/mmwrhtml/su6302a9.htm.

POLICY

HEALTH INVESTMENTS THAT PAY OFF: STRATEGIES TO IMPROVE ORAL HEALTH

This brief outlines oral health interventions to improve population health and the quality of health care and to reduce health care costs. Con-tents include an overview of the problem, strategies to implement and finance evidence-based inter-ventions, and strategies to support data collection related to interventions. Topics include expand-ing dental sealant programs; paying primary care

health professionals to provide fluoride varnish applications; updating and investing in community-water-fluoridation systems; improving data-analy-sis capabilities; expanding scope-of-practice laws and changing Medicaid reimbursement policies; and considering emerging models for new types of health professionals, including dental therapists and advanced dental hygienist practitioners.

Wilkniss S, Tripoli S. 2015. Health Investments That Pay Off: Strategies to Improve Oral Health. Wash-ington, DC: National Governors Association. 9 pp. http://www.nga.org/files/live/sites/NGA/files/pdf/ 2015/1510HealthInvestmentsImproveOralHealth.pdf.

MORE STATE MEDICAID PROGRAMS PAY FOR CHILDREN’S ORAL HEALTH PREVENTION SERVICES IN DOCTORS’ OFFICES

This document provides an overview of efforts by the American Academy of Pediatrics, the Pew Children’s Dental Campaign, and others to expand reimbursement to primary care health profession-als for dental-caries-prevention services during well-child visits. The document presents informa-tion on state Medicaid programs reimbursing pri-mary care health professionals for preventive oral health services in 2008 and in 2012. The document also discusses procedures states cover and efforts to conduct advocacy training, develop resources, and collaborate with policymakers.

American Academy of Pediatrics, Division of State Government Affairs. 2013. More State Medicaid Programs Pay for Children’s Oral Health Preven-tion Services in Doctors’ Offices. Elk Grove Village, IL: American Academy of Pediatrics. 4 pp. http://www2.aap.org/oralhealth/docs/CelebratingOur Wins.pdf.

POLICY ON USE OF FLUORIDE

This statement affirms the use of fluoride as a safe and effective adjunct in reducing the risk of den-tal caries and reversing enamel demineralization. It also encourages public health officials, health

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CARIES PREVENTION SERVICES REIMBURSEMENT TABLE

This document presents survey findings for the 50 states and the District of Columbia on reim-bursement for risk assessment, oral examination, fluoride varnish, anticipatory guidance, and family oral health education. It presents information on the following topics: type of health professional, services, fees, procedure codes, delegation, age limit for services, number of varnish applications reimbursed annually, training requirement, payor, payment by Medicaid or the Children’s Health Insurance Program, and legislative approval to reimburse health professionals. Information about commercial payment and procedure codes is also included.

American Academy of Pediatrics, Oral Health Ini-tiative; Medicaid Medicare CHIP Services Den-tal Association; and National Academy for State Health Policy. 2016. Caries Prevention Services Reimbursement Table. Elk Grove Village, IL: Amer-ican Academy of Pediatrics, Oral Health Initia-tive. 1 v. http://www2.aap.org/commpeds/dochs/oralhealth/docs/OralHealthReimbursementChart.xlsx.

CAVITY FREE AT THREE: PROVIDER RESOURCES

These resources for health professionals focus on preventing dental caries in infants and young children from birth to age 3. Contents include guidelines on providing prenatal and infant oral health care, posters, anticipatory guidance, refer-ral forms and standing orders, and videos. Addi-tional resources include training and presentations in Colorado on topics such as communicating the importance of oral health, evidence and standard of care, screening and risk assessment, applying fluoride varnish, billing, and ordering supplies. Brochures for educating pregnant women, par-ents, and other caregivers are also available.

Colorado Department of Public Health and Envi-ronment. 2010–. Cavity Free at Three: Provider Resources. Denver, CO: Colorado Department of Public Health and Environment. Multiple items. http://www.cavityfreeatthree.org/provider- resources.

professionals, and parents and other caregivers to optimize children’s fluoride exposure. Topics include the anti-caries effect of fluoride varnish and other professional topical fluoride treatments.

American Academy of Pediatric Dentistry. 2013. Policy on Use of Fluoride. Chicago, IL: American Academy of Pediatric Dentistry. 2 pp. http://www.aapd.org/media/Policies_Guidelines/P_Fluoride Use.pdf.

PROFESSIONAL EDUCATION, TOOLS, AND TRAINING

1ST LOOK PROGRAM

These resources are designed to help primary care physicians reduce dental caries in early childhood by performing dental risk assessments, providing anticipatory guidance, applying fluoride varnish, and referring children to a dental home by age 1. Contents include information about fluoride var-nish products and vendors; program participation, certification, and billing; presentation slides and handouts; and educational materials about oral health in infants, young children, and pregnant women. A training course is also available.

Smile Alabama!. 2014–. 1st Look Program. Montgom-ery, AL: Alabama Medicaid Agency. Multiple items. http://medicaid.alabama.gov/CONTENT/4.0_ Programs/4.4.0_Medical_Services/4.4.2.5_1st_Look.aspx.

BE THE DIFFERENCE IN A CHILD’S SMILE!

This fact sheet for primary care health professionals provides information about tooth decay in infants and young children from birth to age 3 and the recommended first dental examination by age 1. The fact sheet also describes opportunities for training and discusses reimbursement for apply-ing fluoride varnish in conjunction with Early and Periodic Screening, Diagnosis, and Treatment (EPSDT) screening.

Iowa Department of Public Health, Bureau of Oral and Health Delivery Systems. 2013. Be the Difference in a Child’s Smile! Des Moines, IA: Iowa Depart-ment of Public Health, Bureau of Oral and Health Delivery Systems. 1 p. http://www.idph.state.ia.us/IDPHChannelsService/file.ashx?file=43017EF7-81F9-4A6F-9755-F18883243402.

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public service announcements in English, Hmong, Karen, Lao, Portuguese, Somali, Spanish, and Viet-namese; and frequently asked questions. A video for parents about fluoride varnish is also avail-able in English, French, Hmong, Oromo, Russian, Somali, and Spanish.

Minnesota Oral Health Project. 2015. Crush Cavi-ties! Minneapolis, MN: Minnesota Oral Health Proj-ect. Multiple items. http://crushcavities.com.

DENTAL CARIES IN CHILDREN FROM BIRTH THROUGH AGE 5 YEARS: SCREENING

These resources summarize the U.S. Preven-tive Services Task Force recommendations and evidence for preventing dental caries in infants and children from birth through age 5. Contents include a recommendation statement, an evidence report, a research plan, a clinical summary, a consumer fact sheet, and an evidence synthesis. Topics include prescribing fluoride supplements for infants and children starting at age 6 months whose water supply is deficient in fluoride and applying fluoride varnish to infants’ and children’s teeth starting upon eruption of the first primary tooth.

U.S. Preventive Services Task Force. 2014. Den-tal Caries in Children from Birth Through Age 5 Years: Screening. Rockville, MD: U.S. Preven-tive Services Task Force. Multiple items. http://www.uspreventiveservicestaskforce.org/Page/Topic/recommendation-summary/dental-caries-in- children-from-birth-through-age-5-years-screening.

FIRST DENTAL HOME

This module was developed to train dentists to provide dental homes for infants and young chil-dren ages 6–35 months. The module includes an overview of services provided at the first dental visit including caries risk assessment, prophylaxis, oral hygiene instruction for primary caregivers, topical fluoride varnish, anticipatory guidance, and a recall schedule. Information on Texas Health Steps (Medicaid) reimbursement and links to related materials such as forms, training materi-als (slides), and questionnaires are included. Edu-cational materials for families are also provided.

Texas Department of State Health Services and Texas Health and Human Services Commis-sion. 2015. First Dental Home. Austin, TX: Texas

CONSIDERATIONS FOR ORAL HEALTH INTEGRATION IN PRIMARY CARE PRACTICE FOR CHILDREN

This document provides oral health information for pediatric primary care health professionals. Topics include the importance of the dental home, dental-caries-risk assessment, anticipatory guidance, and fluoride varnish application. Contents include case studies on recognizing risk factors for caries, apply-ing fluoride varnish during a routine well-child visit, and injury treatment.

Health Resources and Services Administration. 2012. Considerations for Oral Health Integration in Primary Care Practice for Children. Rockville. MD: Health Resources and Services Administration. 85 pp. http://www.hrsa.gov/publichealth/clinical/oralhealth/primarycare/oralhealthprimarycare.pdf.

COVERAGE FOR DENTAL FLUORIDE VARNISH PROVIDED BY PHYSICIANS, NURSE PRACTITIONERS, AND PHYSICIAN ASSISTANTS

This document provides information about reim-bursement for topical fluoride varnish applications and oral evaluations performed by physicians, nurse practitioners, and physician assistants who have successfully completed training requirements. Topics include credentials, limitations of coverage, and billing.

Alaska Medical Assistance Program. 2016. Coverage for Dental Fluoride Varnish Provided by Physicians, Nurse Practitioners, and Physician Assistants. Juneau, AK: Alaska Medical Assistance Program. 1 p. http://manuals.medicaidalaska.com/docs/dnld/Update_Coverage_for_Dental_Fluoride_Varnish.pdf.

CRUSH CAVITIES!

These resources are designed to help primary care health professionals and others understand the eti-ology of dental caries and caregivers’ role in pre-venting caries in infants, children, and adolescents from birth to age 21. Contents include information and resources on finding a physician or dentist, getting care when the first tooth erupts, applying fluoride varnish as part of well child care, prac-ticing good oral hygiene, and consuming healthy foods and drinks. Additional contents include a press release and a governor’s proclamation;

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is and how it is used; evidence on the effective-ness and safety of fluoride varnish; and informa-tion about initiatives, programs, and policies to improve access to and delivery of fluoride varnish applications. [Funded by the Maternal and Child Health Bureau]

Barzel R, Holt K, with the Association of State and Territorial Dental Directors’ Fluorides Committee. 2010. Fluoride Varnish: An Effective Tool for Pre-venting Dental Caries. Washington, DC: National Maternal and Child Oral Health Resource Cen-ter. 4 pp. http://www.mchoralhealth.org/PDFs/Fl Varnishfactsheet.pdf.

FLUORIDE VARNISH: AN EVIDENCE-BASED APPROACH (UPD.)

This brief presents information to help health professionals design, implement, and evaluate community-based programs that apply fluoride varnish. Topics include a definition of fluoride varnish and how it prevents tooth decay; the char-acteristics, effectiveness, and safety of fluoride varnish; and recommendations for using fluoride varnish. The brief also provides tips for selecting cost-effective community and school dental-caries-prevention programs.

Association of State and Territorial Dental Direc-tors, Fluorides Committee. 2016. Fluoride Varnish: An Evidence-Based Approach (upd.). Reno, NV: Association of State and Territorial Dental Direc-tors. 19 pp. http://www.astdd.org/docs/fl-varnish-brief-september-2014-amended-05-2016.docx.

FLUORIDE VARNISH APPLICATION AMONG NORTH DAKOTA FAMILY PRACTICE PHYSICIANS & PEDIATRICIANS: 2016 CHARTBOOK

This report presents findings from a survey of pediatricians and family practice physicians in North Dakota to study fluoride varnish application in clinical practice. Contents include an overview of the study; information about the methods and response demographics; and findings on assess-ment, fluoride varnish application, referral, and need for training and education.

Schroeder S, Ahmed A. 2016. Fluoride Varnish Application Among North Dakota Family Prac-tice Physicians & Pediatricians: 2016 Chartbook.

Department of State Health Services and Texas Health and Human Services Commission. 1 v. http: //www.txhealthsteps.com/cms/?q=catalog/course/ 1824.

FIRST TOOTH TRAIN THE TRAINER PROGRAM

This document describes a program to reduce early childhood caries in Oregon by implementing preventive oral health services for infants and chil-dren using a train-the-trainer model. The intended audience is regional oral health champions who will provide training to local health professionals, oral health professionals, and other community providers with a stake in improving the oral health of infants and young children from birth through age 5. Contents include information about trainer prerequisites, benefits, and requirements; success-ful program completion; and ongoing support.

Oregon Health Authority, Oral Health Unit and Ore-gon Oral Health Coalition. 2012. First Tooth Train the Trainer Program. Wilsonville, OR: Oregon Oral Health Coalition. 2 pp. http://static1.squarespace.com/static/554bd5a0e4b06ed592559a39/t/559b0dbae4b0ee9660c6b040/1436224954891/First+Tooth+Train+the+Trainer+Program+Modified+5.13.pdf.

FLUORIDE VARNISH

This resource for physicians, nurses, and other licensed health professionals in Arkansas describes fluoride varnish and its role in preventing den-tal caries in children. The resource also provides information about the safety and benefits of fluo-ride varnish and state certification requirements for applying fluoride varnish.

Arkansas Department of Health, Office of Oral Health. 2016–. Fluoride Varnish. Little Rock, AR: Arkansas Department of Health, Office of Oral Health. 1 v. http://www.healthy.arkansas.gov/pro gramsServices/oralhealth/Pages/FluorideVarnish.aspx.

FLUORIDE VARNISH: AN EFFECTIVE TOOL FOR PREVENTING DENTAL CARIES

This fact sheet for health professionals provides information about the role of fluoride varnish in preventing dental caries in infants, children, and adolescents. Topics include what fluoride varnish

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FLUORIDE VARNISH IN THE CHILD AND TEEN CHECKUPS (C&TC) SETTING

These resources are designed to help primary care health professionals improve the oral health of infants, children, and adolescents from birth to age 21 who are eligible for Minnesota’s Early and Peri-odic Screening, Diagnosis, and Treatment (EPSDT) program by offering fluoride varnish applications (FVAs). Contents include recommendations for FVAs, requirements for a complete visit, support for FVAs by primary care health professionals, and resources for implementing FVAs.

Minnesota Department of Health, Child and Teen Checkups Program. 2014–. Fluoride Varnish in the Child and Teen Checkups (C&TC) Setting. St. Paul, MN: Minnesota Department of Health, Child and Teen Checkups Program. Multiple items. http://www.health.state.mn.us/divs/cfh/program/ctc/fluoridevarnish.cfm.

FLUORIDE VARNISH MANUAL FOR HEALTH PROFESSIONALS (UPD. ED.)

This manual describes the role of health profes-sionals in applying fluoride varnish to the teeth of children at high to medium risk for dental caries. Contents include information on training and sup-plies, positioning of infants and young children for varnish application, and the importance of estab-lishing a dental home. Resources for consumers are also provided.

South Carolina Department of Health and Envi-ronmental Control, Oral Health Division. 2011. Fluoride Varnish Manual for Health Professionals (upd. ed.). Columbia, SC: South Carolina Depart-ment of Health and Environmental Control, Divi-sion of Oral Health. 7 pp. https://www.scdhec.gov/Health/docs/flour_Fluoride%20Varnish%20Manual%20for%20Health%20Providers.pdf.

FLUORIDE VARNISH PERMISSION SLIP

This form describes a program to provide oral health screening and fluoride varnish applications to students in kindergarten through grade 6. Topics include what fluoride varnish is, why it is recom-mended for children, safety, how it is applied to teeth, and how long it lasts. Space is provided for parents to write their child’s teacher’s name; their child’s name, address, age, grade, gender, home

Grand Forks, ND: University of North Dakota School of Medicine and Health Sciences, Center for Rural Health. 15 pp. https://ruralhealth.und.edu/pdf/fluoride-application-nd-physicians.pdf.

FLUORIDE VARNISH APPLICATION AND INFORMATION

This video for primary care health professionals provides information about and recommenda-tions for applying fluoride varnish in infants and young children ages 6 months through 5 years as part of well-child visits and other visits. Topics include safety and effectiveness, supplies, applica-tion techniques such as knee-to-knee positioning, and after-care instructions including referral to a dental home. The video also provides guidance on obtaining additional information and resources from the Minnesota Oral Health Coalition.

Minnesota Oral Health Coalition. 2016. Fluoride Var-nish Application and Information. Plymouth, MN: Minnesota Oral Health Coalition. 1 video (3 min., 11 sec.). https://wwwyoutubecom/watch?v=OzM4 UQxP67Q.

FLUORIDE VARNISH APPLICATION IN PRIMARY CARE SETTINGS

This fact sheet presents findings from a survey of primary care health professionals in North Dakota to assess their knowledge about fluoride varnish application and determine how many were pro-viding and billing for the service. Contents include information about the percentage of pediatricians and family practice physicians who conducted oral health risk assessments, those who had a list of dentists for client referral, and those who applied fluoride varnish for pediatric clients beginning at age 6 months. Conclusions and recommendations are provided.

University of North Dakota School of Medicine and Health Sciences, Center for Rural Health. 2016. Fluoride Varnish Application in Primary Care Set-tings. Grand Forks, ND: University of North Dakota School of Medicine and Health Sciences, Center for Rural Health. 2 pp. https://ruralhealth.und.edu/pdf/ fluoride-varnish-application-primary-care.pdf.

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FROM THE FIRST TOOTH

These resources provide information about inte-grating oral health assessment, fluoride varnish application, and oral health counseling for parents and other caregivers into health and social service settings where infants and young children (from birth to age 3) receive services. Contents include information about program participation, reim-bursement and training for professionals, sample benefit language for employers, and materials for parents and families.

From the First Tooth. 2014–. From the First Tooth. Portland, ME: From the First Tooth. Multiple items. http://www.fromthefirsttooth.org.

HEAD START ORAL HEALTH TOOL KIT

This document contains information and resources to assist Head Start programs in meeting the oral-health-related Head Start Program Performance Standards and in planning and implementing interventions that promote oral health for children enrolled in Early Head Start and Head Start and their families. Topics include the written health plan; establishing a dental home; determining a child’s oral health status and whether the child needs treatment; the role of toothbrushing and flu-oride in preventing tooth decay; fluoride varnish; establishing an emergency plan; nutrition and oral health; oral health education for children, parents, and staff; family partnerships; the South Carolina Healthy Start Network; and the role of the Head Start community dentist.

South Carolina Department of Health and Environ-mental Control. 2011. Head Start Oral Health Tool Kit. Columbia, SC: South Carolina Department of Health and Environmental Control. 13 pp. http://www.scdhec.gov/library/CR-010054.pdf.

I-SMILE ORAL HEALTH COORDINATOR HANDBOOK (REV.)

This handbook is intended to assist the oral health coordinator (dental hygienist) in providing pri-mary prevention and care-coordination services for young children and their families in Iowa. Topics include the dental home and dental caries screening and treatment services. The handbook contains an overview of Iowa’s I-Smile project, oral health service guidelines including a fluoride

phone, and allergies; and whether they would like their child to participate in the program.

Regional School Unit 40/Maine School Administra-tive District 40, School Health Services. 2014. Fluo-ride Varnish Permission Slip. Union, ME: Regional School Unit 40/Maine School Administrative Dis-trict 40, School Health Services. 1 p. http://www.msad40.org/files/Fluoride_Varnish_Permission_Slip.pdf.

FLUORIDE VARNISH POLICY STATEMENT (UPD.)

This statement supports the use of fluoride var-nish beginning with primary tooth eruption as an effective adjunct in programs designed to reduce lifetime dental caries experience. Topics include the impact of dental caries on health over the life span, dental caries control, systemic and topical fluoride methods, caries reduction attributable to fluoride varnish, caries risk assessment, and fluo-ride varnish safety and efficacy.

Association of State and Territorial Dental Directors. 2015. Fluoride Varnish Policy Statement (upd.). Reno, NV: Association of State and Territorial Den-tal Directors. 6 pp. http://www.astdd.org/docs/ fluoride-varnish-policy-statement-12-15-2015.docx.

FLUORIDE VARNISH TRAINING MANUAL FOR MASSACHUSETTS HEALTH CARE PROFESSIONALS

This manual is designed to help health profession-als implement fluoride varnish applications for infants, children, and adolescents ages 6 months to 21 years who are enrolled in Massachusetts’ Medicaid program. Contents include office-based and online training options; steps for establishing and using fluoride varnish in the office; a template for documenting the oral examination, procedure and post-procedure, and risk factors for dental car-ies; facts on fluoride varnish application; coding, reimbursement, and claim submission; and infor-mation for caregivers about fluoride varnish.

Massachusetts Department of Public Health, Office of Oral Health. 2016. Fluoride Varnish Training Manual for Massachusetts Health Care Profes-sionals. Boston, MA: Massachusetts Department of Public Health, Office of Oral Health. 13 pp. http://www.mass.gov/eohhs/docs/masshealth/provlibrary/fv-manual.pdf.

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are a description of the dental caries process and instructions on how to conduct a dental caries risk assessment. The modules also address the provi-sion of anticipatory guidance, the application of fluoride varnish, and the importance of referring young children to a dentist. [Funded in part by the Maternal and Child Health Bureau]

Tinanoff N, Lowe E, Holt K, Goodman H. 2010. Maryland’s Mouths Matter: Fluoride Varnish and Oral Health Screening Programs for Kids—Train-ing for EPSDT Medical Providers in Maryland. Washington, DC: National Maternal and Child Oral Health Resource Center; Baltimore, MD: Maryland Department of Health and Mental Hygiene, Office of Oral Health. 1 v. http://www.mchoralhealth.org/ flvarnish.

MATERNAL AND CHILD HEALTH SERVICES ADMINISTRATIVE MANUAL SECTION 700

This document describes maternal and child health contract agency responsibilities for ensur-ing access to oral health services in Iowa. Topics include an overview of maternal and child oral health services and funding sources; a description of I-Smile™ Program requirements and strategies; oral health infrastructure building; population-based, enabling, and direct care services provided by agency staff; screening and risk assessment, including school-based screening; referrals; fluo-ride varnish, dental sealants, prophylaxes, and radiographs; oral-health-education guidelines; ser-vice documentation; Medicaid-billable services; and supervision of dental hygienists and dental treatment provided by dentists.

Iowa Department of Public Health, Bureau of Fam-ily Health. 2014. Maternal and Child Health Services Administrative Manual Section 700. Des Moines, IA: Iowa Department of Public Health, Bureau of Family Health. 40 pp. http://www.idph.iowa.gov/ Portals/1/userfiles/58/Section%20700%20REV_10_ 2014.pdf.

MISSISSIPPI SEALS PROGRAM

This resource provides information on efforts to provide oral-health-related prevention services, including screenings, fluoride varnish applica-tions, and dental sealants, to students in Mississippi schools. It describes dental sealants, how the pro-gram works and who is eligible, and how schools and oral health professionals can get involved. A

varnish protocol, oral-health-education guidelines, sample forms, and other resources.

Iowa Department of Public Health, Oral Health Bureau. 2010. I-Smile Oral Health Coordinator Handbook (rev.). Des Moines, IA: Iowa Department of Public Health, Oral Health Bureau. 1 v. http://www.idph.state.ia.us/IDPHChannelsService/file.ashx?file=1D0372E2-249A-4761-89ED-93ABBB31B 4F3.

INTO THE MOUTHS OF BABES/CONNECTING THE DOCS TOOLKIT

This toolkit is for health professionals trained to deliver preventive oral health services (oral evalu-ation and risk assessment, parent or caregiver education, fluoride varnish application, and den-tal home referral) to infants and young children from birth to age 42 months enrolled in Medic-aid in North Carolina. Contents include videos on preventive oral health procedures and the Prior-ity Oral Health Risk Assessment and Referral Tool (PORRT). Additional contents include steps for fluoride varnish application that can be posted in the exam room, information on Medicaid reim-bursement, the PORRT and referral guidelines, a supply list, parent-education materials in English and Spanish, training guidelines, and a certificate.

North Carolina Early Childhood Oral Health Col-laborative. 2013. Into the Mouths of Babes/Connect-ing the Docs Toolkit. Raleigh, NC: North Carolina Division of Public Health, Oral Health Section. Multiple items. http://www.ncdhhs.gov/dph/oral health/partners/IMB-toolkit.htm.

MARYLAND’S MOUTHS MATTER: FLUORIDE VARNISH AND ORAL HEALTH SCREENING PROGRAMS FOR KIDS—TRAINING FOR EPSDT MEDICAL PROVIDERS IN MARYLAND

This curriculum is designed to provide Early and Periodic Screening, Diagnosis, and Treatment medical providers (i.e., physicians, nurse practi-tioners) and other health professionals in Mary-land with knowledge and skills to reduce the incidence of dental caries among children ages 3 and under and to contribute to the establish-ment of a dental home. The series of four mod-ules provides information on the role of medical providers in children’s oral health. Also included

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PREVENTING DENTAL DISEASE IN PRIMARY CARE MEDICAL SETTINGS

This course is intended for primary care health professionals in practices that have received the Washington Dental Service Foundation’s in-office training, Preventing Dental Disease in Primary Care Medical Settings. Professionals and staff who complete the course and pass an online assess-ment will receive continuing medical education credit and will be certified to provide oral health screenings, oral health education, and fluoride varnish services and to bill the Washington State Medicaid program for these services.

Washington Dental Service Foundation. 2011. Pre-venting Dental Disease in Primary Care Medical Settings. Seattle, WA: Washington Dental Service Foundation. 1 v. http://www.kidsoralhealth.org/? page=pcp-course-introduction.

PROFESSIONAL SERVICES FLUORIDE VARNISH PROGRAM POLICY

This document for physicians, nurse practitioners, and physician assistants describes professional recommendations and the rationale for applying fluoride varnish to the teeth of infants and young children ages 6 months through 5 years as part of the first dental visit. The document also provides information about training and certification pre-requisites and coding for fluoride varnish applica-tion reimbursement in Louisiana.

Louisiana Department of Health and Hospitals. 2016. Professional Services Fluoride Varnish Pro-gram Policy. Baton Rouge, LA: Louisiana Depart-ment of Health and Hospitals. 2 pp. http://new.dhh.louisiana.gov/assets/docs/BayouHealth/Informational_Bulletins/2016/IB16-7.pdf.

PROMOTING HEALTHY SMILES THROUGH EDUCATION AND PREVENTION

This brochure describes a program to assess the oral health status of school-age children and to implement a public health intervention to reduce tooth decay. The fact sheet describes the following program components: surveillance and screening, education, prevention, and referral. Additional topics include community responsibilities, the benefits of fluoride, and fluoride varnish charac-teristics and application. Educational materials,

program flyer, enrollment forms for schools and providers, a parental consent form, and an oral health evaluation results form are also included.

Mississippi State Department of Health. 2012. Miss-issippi Seals Program. Jackson, MS: Mississippi State Department of Health. Multiple items. http://msdh. ms.gov/msdhsite/_static/43,0,151,481.html.

ORAL EVALUATION AND FLUORIDE VARNISH IN THE MEDICAL HOME

This resource describes Oral Evaluation and Fluo-ride Varnish, a program aimed at improving the oral health of infants and young children ages 6–35 months in Texas. Topics include certifica-tion and reimbursement for physicians, physician assistants, and advanced practice registered nurses for performing limited services in conjunction with a Texas Health Steps medical checkup. Program services include oral evaluation, fluoride varnish application, anticipatory guidance, and referral to a dental home. Links to training programs, forms, materials, product resources, online provider lookup, and the Medicaid provider website are also available.

Texas Department of State Health Services, Oral Health Program. 2016. Oral Evaluation and Fluo-ride Varnish in the Medical Home. Austin, TX: Texas Department of State Health Services, Oral Health Program. 1 v. http://www.dshs.state.tx.us/dental/ OEFV.shtm.

A PEDIATRIC GUIDE TO CHILDREN’S ORAL HEALTH FLIP CHART AND REFERENCE GUIDE (REV. ED.)

These resources feature pictures and speakers’ notes to help pediatricians counsel clients about oral health and fluoride varnish. The resources include a flip chart and a reference guide in Eng-lish and Spanish, as well as a presentation. Top-ics include primary teeth, early childhood caries, feeding, nonnutritive sucking, fluoride modalities, toothbrushing, and flossing. [Funded by the Mater-nal and Child Health Bureau]

Oskouian R, Romano-Clarke G. 2013. A Pediatric Guide to Children’s Oral Health Flip Chart and Reference Guide (rev. ed.). Elk Grove Village, IL: American Academy of Pediatrics, Oral Health Ini-tiative. 4 items. $54.95, nonmembers; $43.95 for members; plus shipping and handling.

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SCHOOL-BASED ORAL HEALTH CARE: A CHOICE FOR MICHIGAN CHILDREN

This document describes the role of school-based oral health programs (SBOHPs) in improving access and removing barriers to oral health care for students in Michigan. Contents include infor-mation about the different types of services that can be offered in SBOHPs, including screening and education, fluoride rinse, fluoride varnish, and dental sealants. The document also explains the differences between preventive and comprehen-sive care, discussing services provided, necessary equipment, and services commonly referred out.

Michigan Dental Association. 2013. School-Based Oral Health Care: A Choice for Michigan Chil-dren. Okemos, MI: Michigan Dental Association. 8 pp. https://www.smilemichigan.com/Portals/0/Teaching%20Aides/A%20Choice%20for%20Michigan%20Children.pdf.

SMILES ACROSS AMERICA® PRODUCT DONATION PROJECT

This resource is designed for use by community or school oral health programs in applying for prod-uct donations. Contents include product-donation eligibility requirements; a form for programs to request dental sealant and fluoride varnish prod-ucts as well as toothpaste, toothbrushes, pumice preppies, dental floss, and other products; and a reporting form to describe program results.

Oral Health America. 2004–. Smiles Across Amer-ica® Product Donation Project. Chicago, IL: Oral Health America. Multiple items. https://oralhealth america.org/our-work/smiles-across-america/product-donation.

SMILES FOR LIFE: A NATIONAL ORAL HEALTH CURRICULUM (3RD ED.)—COURSE 6: CARIES RISK ASSESSMENT, FLUORIDE VARNISH & COUNSELING

This course provides a brief review of early child-hood caries and addresses how the use of fluoride is part of a comprehensive approach to a child’s oral health. Topics include the benefits of fluoride, safety precautions, and fluoride dosing, as well as how to apply fluoride varnish and provide follow-up care.

screening forms, oral health supplies, training, and technical assistance are also discussed.

Missouri Department of Health and Senior Services, Oral Health Program. 2013. Promoting Healthy Smiles Through Education and Prevention. Jeffer-son City, MO: Missouri Department of Health and Senior Services, Oral Health Program. 2 pp. http://health.mo.gov/blogs/wp-content/uploads/2013/ 12/PreventiveServicesProgramBrochure.pdf.

RECOMMENDATIONS FOR PREVENTIVE PEDIATRIC HEALTH CARE (UPD.)

These guidelines for pediatricians represent a con-sensus by the American Academy of Pediatrics and Bright Futures about the periodicity of health care services for all children. The guidelines emphasize the importance of continuity of care in compre-hensive health supervision, including oral health supervision, and the need to avoid fragmentation of care.

American Academy of Pediatrics, Bright Futures. 2016. Recommendations for Preventive Pediatric Health Care (upd.). Elk Grove Village, IL: Ameri-can Academy of Pediatrics. 2 pp. https://www.aap.org/en-us/Documents/periodicity_schedule.pdf.

RESOURCE HIGHLIGHTS: FLUORIDE VARNISH

These resources for professionals highlight key facts, materials, and websites on fluoride varnish. Contents include key facts supported by references from the professional literature and resources for providing education and training, developing pol-icies and programs, and staying abreast of new developments. [Funded by the Maternal and Child Health Bureau]

National Maternal and Child Oral Health Resource Center. 2016. Resource Highlights: Fluoride Var-nish. Washington, DC: National Maternal and Child Oral Health Resource Center. Multiple items. http:// mchoralhealth.org/highlights/fluoride-varnish.php.

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marketing materials, a letter of commitment, elec-tronic health record screenshots, new hire train-ing information, follow-up surveys, maintenance of certification guidelines, and an evaluation form.

From the First Tooth. 2015. Starting a State Pedi-atric Oral Health Initiative: Step-by-Step Guide of Lessons Learned in Four New England States. Portland, ME: From the First Tooth. 31 pp. http:// www.fromthefirsttooth.org/wp-content/uploads/ 2015/05/FTFT-How-to-Launch-a-Primary-Care-OH-Initiative-final1.pdf.

TEETHFIRST!

These resources for families, health professionals, and child care professionals provide information about dental visits for young children in Rhode Island. Topics include first dentist appointments, finding a dentist, dental coverage and Medicaid, oral health during pregnancy, clinical guidelines and child-friendly practices, how to include oral health in wellness visits, dental caries risk assess-ment, fluoride varnish application, how to talk to parents about the importance of oral health, and professional training and reimbursement. The Tooth Talk blog is also available on the website.

TeethFirst!. 2014. TeethFirst! Providence, RI: Rhode Island KIDS COUNT; Rhode Island Oral Health Commission. Multiple items. http://www.teethfirstri.org.

TOPICAL FLUORIDE FOR CARIES PREVENTION: FULL REPORT OF THE UPDATED CLINICAL RECOMMENDATIONS AND SUPPORTING SYSTEMATIC REVIEW—A REPORT OF THE COUNCIL ON SCIENTIFIC AFFAIRS

This report provides evidence-based recommen-dations for the use of professionally applied topi-cal fluorides to prevent dental caries. The report addresses the impact of topical fluoride vs. no topical fluoride on new and early carious lesions; which topical fluoride was most effective in pre-venting, arresting, or reversing dental caries; and whether an oral prophylaxis before applica-tion improved fluoride uptake. The report also describes the systematic review of the literature, methodologies used to develop the clinical rec-ommendations, limitations related to the evidence and review, and future research needs.

Clark MB, Douglass AB, Deutchman M, Douglass JM, Gonsalves W, Silk H, Tysinger JW, Wrightson AZ, Quinonez R, Dolce M, Bowser J. 2016. Smiles for Life: A National Oral Health Curriculum (3rd ed.)—Course 6: Caries Risk Assessment, Fluoride Varnish & Counseling. Leawood, KS: Society of Teachers of Family Medicine, Group on Oral Health. 1 v. http://www.smilesforlifeoralhealth.org.

SMILES FOR OHIO: FLUORIDE VARNISH—TRAINING FOR PRIMARY MEDICAL CARE PROVIDERS SERVING CHILDREN ENROLLED IN MEDICAID

This series of four modules is designed to increase knowledge among Medicaid/Healthcheck primary care medical professionals and other health pro-fessionals about reducing the incidence of dental caries in infants and children under age 3 and to contribute to the establishment of a dental home. Topics include the role of primary care medical professionals; the dental caries process; caries risk assessment; and anticipatory guidance, fluoride varnish, and referral.

Ohio Department of Health, Bureau of Oral Health Services. 2011. Smiles for Ohio: Fluoride Varnish—Training for Primary Medical Care Providers Serv-ing Children Enrolled in Medicaid. Washington, DC: National Maternal and Child Oral Health Resource Center; Columbus, OH: Ohio Depart-ment of Health, Bureau of Oral Health Services. 1 v. http://www.ohiodentalclinics.com/curricula/smiles.

STARTING A STATE PEDIATRIC ORAL HEALTH INITIATIVE: STEP-BY-STEP GUIDE OF LESSONS LEARNED IN FOUR NEW ENGLAND STATES

This document provides guidance for states on designing and implementing a program to train private medical practices, community health cen-ters, and health professional schools to incorpo-rate oral health assessments, health education, fluoride varnish application, and referrals into standard pediatric practice. Topics include pro-gram partners, financing, recruitment, training, adoption, sustainability, and measures. Additional topics include the importance of engaging future health professionals, educating consumers, and establishing a dental home. Recommendations are also provided. The appendices contain sample

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WASHINGTON STATE SCHOOL-BASED SEALANT AND FLUORIDE VARNISH PROGRAM GUIDELINES (3RD ED.)

These guidelines aim to facilitate the implemen-tation of school-based-dental-sealant and school-based-fluoride varnish programs in Washington. Topics include the assessment of populations at risk for dental caries, infrastructure, Medicaid cov-erage and reimbursement, staffing, policies and procedures, data collection, scheduling, quality assurance, sealant and fluoride varnish guidelines, student referral, and process and outcome evalu-ation. Information on state laws, memoranda of understanding, checklists, products, and supplies is also provided.

Pyatt J, Spink D, Alves-Dunkerson J. 2012. Wash-ington State School-Based Sealant and Fluoride Varnish Program Guidelines (3rd ed.). Olympia, WA: Washington State Department of Health, Oral Health Program. 63 pp. http://here.doh.wa.gov/materials/sealant-fluoride-varnish-guidelines/15_OHsealguid_E12L.pdf.

WEST VIRGINIA CAVITY FREE BY THREE: FLUORIDE VARNISH MANUAL FOR HEALTH CARE PROVIDERS

This manual is designed to help primary care health professionals and others reduce the rate of dental caries in infants and young children ages 6–36 months in West Virginia. Contents include information about the implementation strategy (training and certification protocol) for caries risk assessment, fluoride varnish application, and facil-itation of the age 1 dental visit; coding and billing; training resources; and parent-education materials.

West Virginia Department of Health and Human Resources, Oral Health Program. 2014. West Vir-ginia Cavity Free by Three: Fluoride Varnish Man-ual for Health Care Providers. Charleston, WV: West Virginia Department of Health and Human Resources, Oral Health Program. 32 pp. https://live well.marshall.edu/OralHealth/Docs/Fluoride VarnishManual.pdf.

ADA Center for Evidence-Based Dentistry. 2013. Topical Fluoride for Caries Prevention: Full Report of the Updated Clinical Recommendations and Sup-porting Systematic Review —A Report of the Coun-cil on Scientific Affairs. Chicago, IL: ADA Center for Evidence-Based Dentistry. 118 pp. http://ebd.ada.org/~/media/EBD/Files/Topical_fluoride_for_caries_prevention_2013_update.ashx.

TRAINING OPPORTUNITIES: DEVELOPMENTAL SCREENING AND FLUORIDE VARNISH

This resource for clinicians explains how to receive training and reimbursement for performing devel-opmental screenings and applying fluoride var-nish in Arizona. Topics include state certification requirements; location, description, schedule, and fees for recommended and other training; how to get paid; and instructions for purchasing supplies.

Arizona Department of Health Services. 2014–. Training Opportunities: Developmental Screening and Fluoride Varnish. Phoenix, AZ: Arizona Depart-ment of Health Services. Multiple items. http:// www.azdhs.gov/audiences/clinicians/index.php #training-developmental-screening-flouride-varnish.

VARNISH VOLUNTEER TRAINING

This video provides instruction on applying fluo-ride varnish to children’s teeth as part of Missouri’s Oral Health Preventive Services Program (PSP). Topics include the course outline and objectives; a description of the PSP methodology (surveil-lance, education, prevention, and referral); a defi-nition of fluoride varnish; and an explanation of how fluoride varnish works and how it is applied. Additional topics include maintaining children’s privacy and self-esteem, infection control, the application process, and post-application instruc-tions. The presentation concludes with a series of self-test questions. A video on applying fluoride varnish to young children’s teeth using the knee-to-knee position is also available.

Missouri Department of Health and Senior Services, Oral Health Program. 2014. Varnish Volunteer Training. Jefferson City, MO: Missouri Department of Health and Senior Services, Oral Health Pro-gram. 1 video (16 min., 6 sec.). http://health.mo. gov/blogs/psp/varnish-volunteer-training.

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Helping Smiles Stay Strong. Sacramento, CA: Cali-fornia Department of Public Health, Maternal, Child and Adolescent Health Oral Health Program. 2 pp. http://www.cdph.ca.gov/programs/MCAHOral Health/Pages/PublicationsandReports.aspx.

FLUORIDE VARNISH: A PART OF A HEALTHY CHILD

This video for parents and other caregivers describes fluoride varnish and how it is used to prevent dental caries in infants and young chil-dren. Topics include what fluoride varnish is, how it works, and why it is important for infants’ and children’s health. Information about the safety and effectiveness of fluoride varnish and the impor-tance of establishing an oral hygiene routine that includes regular oral health visits is included. The video is available in English, French, Hmong, Karen, Oromo, Russian, Somali, and Spanish.

Minnesota Oral Health Coalition. 2016. Fluoride Varnish: A Part of a Healthy Child. Plymouth, MN: Minnesota Oral Health Coalition. 1 video (2 min., 16 sec.). https://www.youtube.com/watch?v=XOS zqfdWbVI.

HEALTHY HABITS FOR HAPPY SMILES: GETTING FLUORIDE FOR YOUR CHILD

This handout for pregnant women and parents of infants and young children provides simple tips on fluoride. Topics include fluoride in water, fluori-dated toothpaste, and fluoride varnish. The hand-out is available in English and Spanish.

National Center on Early Childhood Health and Wellness. 2015. Healthy Habits for Happy Smiles. Elk Grove Village, IL: National Center on Early Child-hood Health and Wellness. 2 pp. http://eclkc.ohs.acf.hhs.gov/hslc/tta-system/health/oral-health/PDFs/getting-flouride.pdf (English) and http:// eclkc.ohs.acf.hhs.gov/hslc/Espanol/salud/Health/docs/getting-flouride-esp.pdf (Spanish).

PUBLIC EDUCATION

ARIZONA FLUORIDE VARNISH PROGRAM (REV.)

This letter to parents describes a free fluoride var-nish program to prevent dental caries in infants and young children from birth through age 5 in Arizona. The letter describes the problem and how fluoride varnish works, why it is recommended, and how it is applied. Tips on how to keep chil-dren’s teeth healthy are also included. The letter is available in English and Spanish.

Arizona Department of Health Services, Office of Oral Health. 2013. Arizona Fluoride Varnish Pro-gram (rev.). Phoenix, AZ: Arizona Department of Health Services, Office of Oral Health. 1 p. http://www.azdhs.gov/documents/prevention/womens-childrens-health/oral-health/dental-programs/fluoride-parent-letter.pdf.

FIRST SMILES

This video for parents and other caregivers pro-vides information about the importance of oral health in infants and young children. Topics include preventing dental caries in primary teeth; early examination, detection, and treatment; and education. The video shows an oral health profes-sional performing a lap-to-lap examination, apply-ing a fluoride varnish treatment, and encouraging a mother to give her child milk and water rather than juice.

Kids Smiles. 2016. First Smiles. Philadelphia, PA: Kids Smiles. 1 video (3 min., 20 sec.). https://www.you tube.com/watch?v=myFGpBw36_c.

FLUORIDE VARNISH: HELPING SMILES STAY STRONG

This pamphlet for parents and other caregivers addresses fluoride varnish and its role in prevent-ing tooth decay in infants and young children. An after-care checklist, a dental appointment reminder, and additional oral health care tips are included. The pamphlet is available in Chinese, English, Hmong, Korean, and Spanish.

California Department of Health Care Services, Child Health and Disability Prevention Program Dental Subcommittee. 2012. Fluoride Varnish:

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caries who are receiving early preventive care, including assessments and fluoride varnish applica-tions; (2) increase the number of children enrolled in the Special Supplemental Nutrition Program for Women, Infants and Children (WIC) who receive a dental visit by age 1; and (3) develop sustainable systems that maximize the use of WIC as an entry point for early oral health services. [Funded by the Maternal and Child Health Bureau]

Center for Oral Health. 2012. TOHSS Final Report Narrative. Oakland, CA: Center for Oral Health. 2 pp. http://www.mchoralhealth.org/pdfs/H47MC08 601.pdf.

UPDATE ON ORAL HEALTH SERVICES

This annual report provides information about oral health services in Tennessee. Topics include the provision of child screenings, referrals, and fluo-ride varnish applications by public health nurses in medical clinics; child screenings, oral exami-nations, health education, and dental sealants in schools; child and adult visits to rural dental clin-ics; adult extractions, cleanings, and emergency dental services; and information dissemination. Data on the number of individuals served and the number of services provided by program are included.

Tennessee Department of Health. 2016. Update on Oral Health Services. Nashville, TN: Tennessee Department of Health. 8 pp. https://tn.gov/assets/ entities/health/attachments/Oral_Health_TN_Dental_Assoc_Annual_Report.pdf.

VARNISH! MICHIGAN BABIES TOO!

This annual report summarizes results from a pro-gram to encourage primary care health profes-sionals to receive oral health training, perform oral health screenings, apply fluoride varnish, and provide guidance to parents during well-child vis-its. Contents include an introduction to oral health and information about training, reimbursement, goals, data collected, lessons learned, evaluation, and next steps.

Deming S. 2015. Varnish! Michigan Babies Too! Lansing, MI: Michigan Department of Health and Human Services, Oral Health. Annual. http://www. michigan.gov/mdhhs/0,5885,7-339-73971_4911_ 4912_6226-145381--,00.html.

STATE AND LOCAL PROGRAM REPORTS

MAKING MILWAUKEE SMILE: A REPORT ON EFFORTS TO IMPROVE THE ORAL HEALTH OF MILWAUKEE CHILDREN 2011

This report describes a 3-year project to reduce the number of children with urgent oral health needs in Milwaukee, Wisconsin; increase participation in school-based oral health programs; and augment the role of primary care health professionals in address-ing oral disease in the city. The project placed oral health care coordinators in schools and trained health professionals to perform oral health risk assess-ments, provide anticipatory guidance, and apply fluoride varnish. Report contents include a summary of the project’s development process, objectives, and evaluation methods; demographics and key findings; and project participants’ success stories.

Children’s Health Alliance of Wisconsin. 2012. Making Milwaukee Smile: A Report on Efforts to Improve the Oral Health of Milwaukee Children 2011. Milwaukee, WI: Children’s Health Alliance of Wisconsin. 32 pp. http://www.chawisconsin.org/ documents/MMSreport12.11.pdf.

PROGRAM NARRATIVE: VIRGINIA TARGETED STATE MATERNAL AND CHILD HEALTH ORAL HEALTH SERVICE SYSTEMS FINAL REPORT

This report describes a project in Virginia to (1) increase age 1 dental visits for children at high risk for dental caries; (2) extend oral health screen-ing, education, and fluoride varnish programs within the Bright Smiles for Babies program; and (3) improve access to care for children with special health care needs through collaborative projects. [Funded by the Maternal and Child Health Bureau]

Day KC. 2012. Program Narrative: Virginia Tar-geted State Maternal and Child Health Oral Health Service Systems Final Report. Richmond, VA: Vir-ginia Department of Health, Dental Health Pro-gram. 21 pp., plus appendices, http://www.mch oralhealth.org/pdfs/H47MC08656.pdf.

TOHSS FINAL REPORT NARRATIVE

This report describes a project to (1) increase the number of young children at high risk for dental

orgAnIzAtIons

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AMERICAN ACADEMY OF PEDIATRIC DENTISTRY211 East Chicago Avenue, Suite 1600Chicago, IL 60611-2637Telephone: (312) 337-2169Fax: (312) 337-6329Website: http://www.aapd.org

The American Academy of Pediatric Dentistry (AAPD) works to achieve optimal oral health for all children and adolescents, including those with special health care needs. AAPD serves primary care and specialty pediatric dentists, as well as general dentists who treat children and adoles-cents in their practices.

AMERICAN ACADEMY OF PEDIATRICS141 Northwest Point BoulevardElk Grove Village, IL 60007-1098Website: http://www.aap.org

Campaign for Dental HealthE-mail: fluoride@aap.orgWebsite: http://ilikemyteeth.org

The American Academy of Pediatrics’ (AAP’s) Campaign for Dental Health (CDH) is a broad network of oral health advocates, health pro-fessionals, child and family organizations, and scientists who are working together to preserve the nation’s oral health gains. CDH shares facts about oral health and strategies, such as commu-nity water fluoridation, to prevent oral disease.

Section on Oral HealthTelephone: (847) 434-4779E-mail: oralhealth@aap.orgWebsite: http://www2.aap.org/oralhealth/

SOPDOH.html

AAP’s Section on Oral Health employs mul-tiple forums to educate pediatricians; pediatric dentists; physician assistants; allied health pro-fessionals including dental hygienists, dental assistants, nurses, and nurse practitioners; pedi-atric residents; and pediatric dental residents. The section also focuses on advocacy for chil-dren’s oral health and on improving relationships

and communication between dental homes and medical homes.

AMERICAN ASSOCIATION FOR COMMUNITY DENTAL PROGRAMS635 West Seventh Street, Suite 309Cincinnati, OH 45203Telephone: (513) 621-0248Fax: (513) 621-0288E-mail: info@aacdp.orgWebsite: http://www.aacdp.com

The American Association for Community Dental Programs supports the efforts of staff working in city-, county-, and community-based programs serv-ing the oral health needs of vulnerable populations.

AMERICAN DENTAL ASSOCIATION211 East Chicago AvenueChicago, IL 60611-2678Telephone: (312) 440-2500Fax: (312) 440-7494E-mail: info@ada.orgWebsite: http://www.ada.org; http://www.

mouthhealthy.org

The American Dental Association provides oral health information to dentists and consumers and works to advance the dental profession at the national, state, and local levels.

AMERICAN DENTAL HYGIENISTS’ASSOCIATION444 North Michigan Avenue, Suite 3400Chicago, IL 60611Telephone: (312) 440-8900Website: http://www.adha.org

The American Dental Hygienists’ Association (ADHA) works to ensure access to high-quality oral health care; promote dental hygiene educa-tion, licensure, practice, and research; and repre-sent the legislative interests of dental hygienists at the local, state, and federal levels. ADHA serves dental hygienists with the goal of helping them achieve their full potential as they seek to improve the public’s oral health.

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with modernizing the nation’s health care system while providing high-quality care at a low cost. CMS strives to ensure a high-quality health care system, improve access to coverage, and contrib-ute to good health for all Americans.

INDIAN HEALTH SERVICE5600 Fishers LaneRockville, MD 20857Website: https://www.ihs.gov/index.cfmDental portal: https://www.ihs.gov/DOH

The Indian Health Service (IHS) is responsible for providing federal health services, including oral health services, to American Indians and Alaska Natives. The IHS dental portal serves as a cen-tralized location where staff who work in Indian health care can locate resources to support the operation of effective clinical and community oral health programs.

MATERNAL AND CHILD HEALTH BUREAUHealth Resources and Services Administration5600 Fishers LaneParklawn BuildingRockville, MD 20857Telephone: (301) 443-2753E-mail: pvodicka@hrsa.govWebsite: http://www.mchb.hrsa.gov

The Maternal and Child Health Bureau provides leadership, in partnership with stakeholders, to improve the physical, mental, and oral health; safety; and well-being of the maternal and child health population, which includes all women, infants, children, and adolescents and their families.

NATIONAL ASSOCIATION OF CHRONIC DISEASE DIRECTORS200 Century Parkway, Suite 250Atlanta, GA 30345Telephone: (770) 458-7400Website: http://www.chronicdisease.org

The National Association of Chronic Disease Directors (NACDD) serves the chronic disease program directors of each state and jurisdic-tion, connecting them to advocate for preventive health policies and programs, encourage knowl-edge sharing, and develop partnerships for health promotion. NACDD works to mobilize efforts to

ASSOCIATION OF STATE AND TERRITORIAL DENTAL DIRECTORS3858 Cashill BoulevardReno, NV 89509Telephone: (775) 626-5008Fax: (775) 626-9268Website: http://www.astdd.org

The Association of State and Territorial Dental Directors promotes the establishment of national dental public health policy, assists state oral health programs in the development and implementa-tion of programs and policies for preventing oral disease, builds awareness and strengthens pub-lic health professionals’ knowledge and skills by developing position papers and policy statements, provides information on oral health to health offi-cials and policymakers, and conducts conferences for the dental public health community.

CENTERS FOR DISEASE CONTROL AND PREVENTION1600 Clifton RoadAtlanta, GA 30329-4027Telephone: (800) 232-4636E-mail: cdcinfo@cdc.govWebsite: http://www.cdc.govDivision of Oral Health: http://www.cdc.gov/

oralhealth

The Centers for Disease Control and Prevention (CDC) works to combat disease and supports com-munities and citizens to do the same. CDC’s Divi-sion of Oral Health works to improve oral health and reduce oral health disparities by helping states improve their oral health programs, extending the use of proven strategies to prevent oral disease, enhancing efforts to monitor oral disease, contrib-uting to the scientific knowledge base related to oral health and oral disease, and guiding infection control in dentistry.

CENTERS FOR MEDICARE & MEDICAID SERVICES7500 Security BoulevardBaltimore, MD 21244Website: https://www.cms.gov

The Centers for Medicare & Medicaid Services (CMS) administers Medicare, Medicaid, the Chil-dren’s Health Insurance Program, and the Health Insurance Marketplace. CMS services are tasked

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NATIONAL NETWORK FOR ORAL HEALTH ACCESS181 East 56th Avenue, Suite 501Denver, CO 80216Telephone: (303) 957-0635Fax: (866) 316-4995E-mail: info@nnoha.orgWebsite: http://www.nnoha.org

The National Network for Oral Health Access pro-vides oral health professionals working in safety net programs with resources, learning opportuni-ties, and advocacy with the goal of improving the oral health and overall health of populations that are underserved.

ORAL HEALTH AMERICA180 North Michigan Avenue, Suite 1150Chicago, IL 60611-4211Telephone: (312) 836-9900Fax: (312) 836-9986E-mail: info@oralhealthamerica.orgWebsite: http://www.oralhealthamerica.org

Oral Health America connects communities with resources to drive access to care, increase health literacy, and advocate for policies that improve overall health through better oral health for all Americans, including those who are most vulnerable.

SOCIETY OF TEACHERS OF FAMILY MEDICINE11400 Tomahawk Creek Parkway, Suite 540Leawood, KS 66211Telephone: (913) 906-6000; (800) 274-7928Fax: (913) 906-6096E-mail: stfmoffice@stfm.orgWebsite: http://www.stfm.org

The Society of Teachers of Family Medicine is a membership-based, academic organization com-mitted to improving and enhancing the quality of family-medicine education. The society provides educational research, faculty-development work-shops, conferences, and management skill training for family medicine educators.

reduce chronic diseases and their associated risk factors through state- and community-based pre-vention strategies.

NATIONAL CENTER ON EARLY CHILDHOOD HEALTH AND WELLNESSAmerican Academy of Pediatrics141 Northwest Point BoulevardElk Grove Village, IL 60007-1098Telephone: (888) 227-5125E-mail: health@ecetta.infoWebsite: http://eclkc.ohs.acf.hhs.gov/hslc/

tta-system/health

The National Center on Early Childhood Health and Wellness (NCECHW) provides resources, train- ing, and technical assistance to the child care and Head Start communities on health-related top-ics (e.g., health literacy, physical health, men-tal health, nutrition, oral health, and injury and tobacco prevention). NCECHW is funded by the Administration for Children and Families’ Office of Head Start and Office of Child Care in partnership with the Health Resources and Services Adminis-tration’s Maternal and Child Health Bureau.

NATIONAL MATERNAL AND CHILD ORAL HEALTH RESOURCE CENTERGeorgetown UniversityBox 571272Washington, DC 20057-1272Telephone: (202) 784-9771E-mail: OHRCinfo@georgetown.eduWebsite: http://www.mchoralhealth.org

The National Maternal and Child Oral Health Resource Center responds to the needs of profes-sionals working in states and communities with the goal of improving oral health services for preg-nant women, infants, children, and adolescents, including those with special health care needs, and their families (MCH population). The resource center collaborates with government agencies, professional associations, foundations, policy and research centers, and voluntary organizations to gather, develop, and share information and mate-rials to promote sustainable oral health services for the MCH population.

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U.S. PREVENTIVE SERVICES TASK FORCE540 Gaither RoadRockville, MD 20850Telephone: (301) 427-1584Website: http://www.uspreventiveservices

taskforce.org

The U.S. Preventive Services Task Force (USPSTF) is an independent panel of nonfederal experts in prevention and evidence-based medicine and is composed of primary care providers. USPSTF conducts scientific evidence reviews of a broad range of clinical preventive health care services and develops recommendations for primary care clinicians and health systems.

Materials Produced by the National Maternal and Child Oral Health Resource Center

n Bright Futures: Oral Health—Pocket Guide (3rd ed.) [practice guide]http://mchoralhealth.org/pocket.php

n Child and Adolescent Oral Health Issues [fact sheet]http://mchoralhealth.org/PDFs/issues.pdf

n Fluoride Varnish: An Effective Tool for Preventing Dental Caries [fact sheet]http://mchoralhealth.org/PDFs/flvarnishfactsheet.pdf

n Getting Fluoride for Your Child [handout]English: https://eclkc.ohs.acf.hhs.gov/hslc/tta-system/health/oral-health/PDFs/getting-flouride.pdfSpanish: https://eclkc.ohs.acf.hhs.gov/hslc/Espanol/salud/Health/docs/getting-flouride-esp.pdf

n Maryland’s Mouths Matter: Fluoride Varnish and Oral Health Screening Programs for Kids—Training for EPSDT Medical Providers in Maryland [curriculum]http://www.mchoralhealth.org/flvarnish

n Resource Highlights: Fluoride Varnish [resource guide]http://mchoralhealth.org/highlights/fluoride-varnish.php

n Smiles for Ohio: Fluoride Varnish—Training for Primary Medical Care Providers Serving Children Enrolled in Medicaid [curriculum]http://www.ohiodentalclinics.com/curricula/smiles