The Maternal and Child Health Bureau (MCHB) Title V Maternal and Child Health Services Block Grants to States Program has established 15 National Performance Measures for the 2015-2017 grant cycle. Performance Measure 13 is (a) the percent of women who had a dental visit during pregnancy and (b) the percent of infants and children ages 1 to 17 with a past-year preventive dental visit. This evidence brief points to a selection of resources for state MCH programs about oral health, with emphasis on evidence-based information.
The Title V Maternal and Child Health Services Block Grant to States Program guidance1 defines the significance of this goal as follows:
Oral health is a vital component of overall health. Access to oral health care, good oral hygiene, and adequate nutrition are essential component of oral health to help ensure that children, adolescents, and adults achieve and maintain oral health. People with limited access to preventive oral health services are at greater risk for oral diseases.
Oral health care remains the greatest unmet health need for children. Insufficient access to oral health care and effective preventive services affects children's health, education, and ability to prosper. Early dental visits teach children that oral health is important. Children who receive oral health care early in life are more likely to have a good attitude about oral health professionals and dental visits. Pregnant women who receive oral health care are more likely to take their children to get oral health care.
State Title V Maternal Child Health programs have long recognized the importance of improving the availability and quality of services to improve oral health for children and pregnant women. States monitor and guide service delivery to assure that all children have access to preventive oral health services. Strategies for promoting oral health include providing preventive interventions, such as dental sealants and use of fluoride, increasing the capacity of State oral health programs to provide preventive services, evaluating and improving methods of monitoring oral diseases and conditions, and increasing the number of community health centers with an oral health component.
Read More about Performance Measure 13
Performance Measure 13
A) To increase the number of pregnant women who have a dental visit and B) To increase the number of infants and children, ages 1 through 17 years, who had a preventive dental visit in the last year.
Numerator: A) Report of a dental visit during pregnancy and B) Parent report of infant or child, ages 1 through 17 years, who had a preventive dental visit in the last year.
Denominator: A) All live births and B) All infants and children, ages 1 through 17 years.
Healthy People 2020 Objectives
Related to Oral Health (OH) Objective 7. Increase the proportion of children, adolescents, and adults who used the oral health care system in the past year. (Baseline: 44.5%, Target: 49.0%)
Related to Oral Health (OH) Objective 8. Increase the proportion of low-income children and adolescents who receive any preventive dental service during the past year. (Baseline: 30.2%, Target: 33.2%)
Data Sources and Data Issues
This is an integrated measure with two data sources: A) CDC's Pregnancy Risk Assessment Monitoring System (PRAMS) and B) the revised National Survey of Children's Health (NSCH) beginning in 2017. States can use data from the 2011-2012 NSCH as a baseline.
If a state has access to both PRAMS and the NSCH, the state needs to address both parts (A & B) of the measure. If a state does not have access to PRAMS, the state will need to address part B of the measure.
Data and Statistics
National Survey of Children's Health (NSCH). Funded by the Health Resources and Services Administration's (HRSA's) Maternal and Child Health Bureau (MCHB), this survey provides national and state-level data on the physical and emotional health of American children 0 - 17 years old. Information is collected on factors related to the health and well-being of children, including access to and utilization of health care, receipt of care in a medical home, family interactions, parental health, school and after-school experiences, and neighborhood characteristics.
Since 2003, the NSCH has provided both national and state-level prevalence estimates for a variety of child health and health care indicators. MCHB also fielded the National Survey of Children with Special Health Care Needs (NS-CSHCN) in 2001, 2005-2006, and 2009-2010. Its purpose was to assess the prevalence and impact of special health care needs among children and their families in the U.S. The 2016 NSCH underwent significant redesign and administration changes and differs greatly from the prior survey cycles. From 2016 onward, the purpose of the NSCH remains the same, but the two individual surveys were combined into a single survey conducted every year.
National Network for Oral Health Access (NNOHA). Provides advocacy and support for health centers working to improve the oral health status of underserved populations. Promising Practices: Access to Care highlights ways that health centers' safety-net oral health programs have increased access to care in their communities.
Rural Assistance Center. Helps communities and other stakeholders access available programs, funding, and research that can enable them to provide health and human services to people living in rural areas. The Rural Oral Health Toolkit comprises seven modules to help professionals identify and implement an oral health program. Topics include an overview of oral health in rural communities, program models and ways to adapt them to meet community needs, and strategies to ensure program sustainability. The toolkit also includes a framework for evaluation, methods for disseminating results, and examples of programs that have been implemented in rural communities.
American Academy of Pediatric Dentistry. 2014. 2014-15 definitions, oral health policies, and clinical guidelines. Chicago, IL: American Academy of Pediatric Dentistry. Provides guidelines on infant oral health care including caries-risk assessment and management, oral health care for the pregnant adolescent, perinatal oral health care, periodicity of examination, preventive dental services, anticipatory guidance/counseling, and oral treatment for infants, children, and adolescents.
1Health Resources and Services Administration. 2014. Title V Maternal and Child Health Services Block Grant to States Program: Guidance and Forms for the Title V Application/Annual Report, Appendix F, p. 86.