Last Updated: September, 2019
Author: Oral Health Program, Vermont Department of Health
Since 2008, medical health care providers have been reimbursed by Medicaid for completing oral health risk assessments and fluoride varnish applications as part of well-child visits (check-ups). Oral health risk assessments involve looking in a child’s mouth as well as asking parents/caregivers questions to assess the child’s risk for dental decay. Fluoride varnish is a clear resin that can be “painted” on teeth to decrease a child’s risk for dental decay. In 2010 the Affordable Care Act began requiring that all medical health insurers reimburse for fluoride varnish applications for children under age 6. This change, combined with our recent collaboration with the University of Vermont’s Office of Primary Care and Area Health Education Centers (AHEC) Program to expand the “From the First Tooth” (fluoride varnish application in primary care) pilot training to medical practices in Vermont, has led to an increased interest among practices in applying fluoride varnish in the primary care medical home. We hope these changes will translate into increased engagement among medical professionals in applying fluoride in the medical home and referring children to local dental practices at age one. We continue to see the curve move in the right direction.
Evidence shows that involving medical health care professionals in delivering oral health messages and services as part of well-child care increases the likelihood that children will have fewer cavities or remain cavity free (Douglass & Clark, 2015). In addition to the decay preventing benefits of fluoride varnish and oral health education provided by medical professionals, ideally, parents/caregivers are also connected with a local dental practice when their child is one year of age, positioning them for regular and preventive dental care and heathy mouths.
We are confident that by working collaboratively with our partners in the medical and human services fields we will be successful in increasing the number of medical professionals that routinely provide fluoride varnish applications to children under age 6 in Vermont.
Data Source: Vermont's Medicaid Claims
Medicaid claims data were used to identify the number of medical providers submitting claims for applying fluoride varnish (CPT=99188, D1206, or D1208) to a child under age 6.