Vermonters have good oral health and 1 more... less...

Vermonters youth have good oral health

% of children in grades K-6 using dental system yearly

Current Value

71%

2023

Definition

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Story Behind the Curve

Last Updated: March 21, 2023

Author: Office of Oral Health, Vermont Department of Health

According to the National Survey of Children's Health, compared to children nationwide, children in Vermont are more likely to have had a preventive dental visit in the past year (2020-2021 National Survey of Children’s Health).

This may be explained by these facts:

Almost all children in Vermont have dental insurance coverage through the Dr. Dynasaur program (Medicaid insurance for children).
There is no annual cap on dental services for children enrolled in the Dr. Dynasaur program.
The 802 Smiles Network serves as an umbrella for and supports all dental health programs in schools across the state.
There is an active state-level school health team made up of representatives from the Health Department and the Agency of Education which helps keep oral health on the radar when it comes to statewide school initiatives designed to integrate health and learning such as Whole School, Whole Community, Whole Child.

Thanks to this combination of consistent dental coverage for children, widespread participation in the 802 Smiles Network, and close connections within the Agency of Education and with other partners, Vermont enjoys relatively high usage of the dental care system for children in grades K-6.

Unfortunately, however, this is not the full story; children in Vermont who are insured by Medicaid are less likely to access dental care than those who are commercially insured (56.27% vs 73.67%) (Nasseh, Vujicic, & Yarbrough, 2014). This is why we focus our efforts towards increasing access to and utilization of dental care for children enrolled in the Medicaid program. These efforts include (among other things): assuring an adequate, flexible, and diverse oral health workforce and working closely with the Department of Vermont Health Access (the organization that administers the Vermont Medicaid program) to increase access to care for beneficiaries (see Strategy section for more details).

Please note, the COVID-19 pandemic resulted in widespread impacts to the education system (e.g., school closures and remote learning) as well as the dental health care system starting in March 2020. Dental services were strictly limited during the state of emergency and many preventive visits were postponed. These factors may account for the decrease in percentage of children using the dental system in 2021 and 2022.

Why Is This Important?

Utilization of dental services during childhood is important for preventing decay, ensuring proper development from primary (baby) to permanent (adult) teeth, and reinforcing the value of good oral health. Oral health is important for eating, speech, self-esteem, ability to learn, employability, and overall health. In other words, you can’t be truly healthy without good oral health.

This particular indicator is also important because the 802 Smiles Network of School Dental Health Programs is a cornerstone of our state oral health program; focusing on usage of the dental care system for children in elementary school for one of our dashboard measures is a way to gauge the success of this program.

Partners

What Works

Thanks to the combination of consistent dental coverage for children, widespread participation by schools and Head Start programs in the 802 Smiles Network of School Dental Health Programs, and support from the Agency of Education and other partners, Vermont enjoys relatively high usage of the dental care system for children in grades K-6. Read more about what works to connect children insured by Medicaid with dental care in this report on Early and Periodic Screening, Diagnostic and Treatment (EPSDT)..

Strategy

Although children in Vermont access dental care at higher rates than other states, we are not immune to oral health disparities; children in Vermont who are insured by Medicaid are less likely to access dental care than those who are commercially insured (56.27% vs 73.67%) (Nasseh, Vujicic, & Yarbrough, 2014). This is why we focus our efforts towards increasing access to and utilization of dental care for children enrolled in the Medicaid program. We have chosen to focus our efforts to increase access to dental care for children in grades K-6 by:

Ensuring that children who are insured by Medicaid have access to preventive (and restorative dental care, when necessary), by improving the effectiveness of our 802 Smiles Network of School Dental Health Programs through rigorous evaluation and quality improvement.
Increasing the capacity, flexibility, and diversity of the dental workforce by promoting the use of Expanded Functions Dental Auxiliary (EFDA), dental therapists, and public health dental hygienists who can provide preventive dental care in public health settings.
Working closely with the Department of Vermont Health Access to achieve shared objectives to increase access to and utilization of dental services for Medicaid beneficiaries (e.g., redesigning the dental benefit to maximize resources, streamlining administrative processes, updating the Medicaid provider portal).
Participating in an active state-level school health team made up of representatives from the Health Department and the Agency of Education which helps keep oral health on the radar when it comes to statewide school initiatives designed to integrate health and learning (e.g., Whole School, Whole Community, Whole Child).

Notes on Methodology

The School Nurse Report includes aggregate self-reported data related to dental exam visits for all Vermont public schools. The data is aggregated from parent’s/caregiver’s responses to questions, such as, “What was the date of your child’s last dental visit?” A child is counted as not visiting the dentist if a form was not returned or if the question was not answered. In general, there is a large number of missing values in this data source, representing about 20-30% of the data depending on student grade. More data is missing for grades 7-12 than for grades K-6. The Vermont Department of Health recommends caution when using the data.

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