Expanding Oral Health Services to Children

Although preventable, cavities are the most common chronic infectious disease of childhood, of which the burden falls disproportionately on underprivileged, minority, or special needs children.

NYHealth initially awarded the Albany Medical Center Pediatric Group (Albany Medical Center) a grant to expand the Women, Infants, and Children (WIC) Smiles program—a pediatric oral health program that provides preventive services to Medicaid-eligible preschool-age children in areas where access to dental services is limited. Albany Medical Center set out to expand the program at WIC sites in upstate New York, where mothers receiving WIC benefits could also bring their young children to the on-site pediatrician for a basic dental cleaning and fluoride varnish—an important tool in cavity prevention.

During the grant project, however, unexpected national policy changes occurred that Albany Medical Center recognized as an opportunity to move beyond WIC sites and have an even greater impact on children’s oral health in New York State. First, the U.S. Preventive Services Task Force—an authority on prevention and evidence-based medicine—released recommendations that primary care providers apply fluoride varnish to the teeth of all infants and children up to the age of five.

The American Academy of Pediatrics then endorsed these recommendations, releasing guidelines for all pediatricians to perform not only fluoride varnishing but also oral hygiene and dietary counseling as preventive primary care services. As a result, pediatricians across all payers—not just those accepting Medicaid—can provide the varnish and other preventive services to their patients and be reimbursed.Consequently, Albany Medical Center worked with NYHealth to expand the original scope of its grant to make a statewide push for a wider standard of care for children’s oral health and provide professional training to pediatric primary care providers in adopting the new recommendations.

Specifically, Albany Medical Center targeted practices that serve the highest-risk children (although not exclusively); served as an expert and mentor for local health department staff trainings; provided pediatric primary care sites with an implementation toolkit; aligned activities with similar work done by various stakeholders; and conducted outreach to major insurers regarding the impact of the new policy on claims processing.