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Increase screening and preventive care among children and youth

Increase protective behaviors impacting children

% of Medicaid-enrolled children age 1 to 17 who received a preventive dental service in the calendar year

Current Value




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Story Behind the Curve

Updated: February 2024

Author: Office of Oral Health, Vermont Department of Health

This indicator, or population measure, is part of our Healthy Vermonters 2030 data set. Read more about how this data helps us understand and improve the well-being of people in Vermont on the Healthy Vermonters 2030 webpage.

Because this data is meant to show how the health of our state changes during the decade from 2020-2030, some indicators may have very few data points for now. Keep checking back to see the progress our public health system and partners are making.

By 2030, we want this indicator to increase to 66%. Between 2020 and 2021 there was improvement, but it has leveled off at 58%; the COVID-19 pandemic may have been a factor.

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Increasing the use of oral health care for all people is a Healthy People 2030 Leading Health Indicator. It is a high priority objective to drive action toward improving overall health and well-being.

Why Is This Important?

Data shows that tooth decay is the most common chronic disease for children and adults in the United States. The consequences can be severe. Children with recent dental pain are 3 times more likely to miss school days and 4 times more likely to earn lower grades. This indicator helps inform strategies and activities of the Office of Oral Health and partners.

Equity and Impact

We are focusing on children enrolled in Medicaid because data shows that children from lower income families are more than twice as likely to have untreated cavities (tooth decay). We see this in Vermont’s data: The 2022-2023 Keep Smiling Vermont survey of oral health status showed schools with more low-income children have significantly greater rates of tooth decay experience and untreated tooth decay than high-income children. Per page 11 of the report, “These data suggest that low-income children are not getting the benefit of early preventive services and are less likely to access a dentist for restorative treatment (e.g., fillings).”  There are also significantly more early dental care and urgent dental care needs among low-income children.

Children from lower income families may access preventive dental services at lower rates for a number of reasons including: difficulty getting time off from work for appointments (lost wages), transportation and inability to find a dentist that accepts Medicaid insurance. By focusing on improving access to preventive dental care for children insured by Medicaid we are targeting our efforts to help those most at risk for dental decay to avoid future dental problems.

How We Can Improve

The Community Preventive Services Task Force (CPSTF) recommends school-based programs to deliver dental sealants and prevent dental caries (tooth decay) among children.  

The Vermont Department of Health coordinates the 802 Smiles Network of School Dental Health Programs. Our main strategy to increase the percentage of children who receive preventive dental services is to expand the number of schools that have a higher percentage of children enrolled in the free and reduced-price meal program that participate in the Network and increase the number of 802 Smiles programs that provide preventive dental services like silver diamine fluoride and sealants in school. The 2022-2023 Keep Smiling Vermont survey of oral health status includes additional recommendations to improve oral health for Vermont children.

Notes on Methodology

The target value of 66% was chosen with consideration of the CDC’s Healthy People 2030: Target-setting method selection flowchart. This target of 15% improvement is ambitious, but reasonable. Although there was a marked decline in access to preventive oral health visits during 2020 (COVID-19 pandemic), the Office of Oral Health continues to promote access to oral health care through activities in the Vermont Oral Health Plan. This target value of 66% is slightly above pre-pandemic levels because we anticipate this measure to recover and improve through the decade. Medicaid claims data will be analyzed annually to track progress.

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