Brush Up on Oral Health

Ensuring Children Are Up to Date on Oral Health Services

Dentist wearing goggles examing a child's mouth and teeth.This Brush Up on Oral Health tip sheet describes one part of the Head Start Program Performance Standard (HSPPS), Ensuring up-to-date child health status, 45 CFR §1302.42(b)(1)(i), and how it relates to oral health. The tip sheet discusses how Head Start programs can find and use the dental periodicity schedule for their state.

Early and Periodic Screening, Diagnostic, and Treatment Benefits

The Ensuring up-to-date child health status standard was set to help keep children healthy and ready to learn. This standard requires that program staff obtain determinations from medical professionals and oral health professionals as to whether the child is up to date on a schedule of age-appropriate preventive and primary medical care and oral health care. These schedules are based on well-child visits and dental periodicity schedules defined by the Early and Periodic Screening, Diagnostic, and Treatment(EPSDT) benefit of each state's Medicaid program. The EPSDT benefit provides comprehensive and preventive health care services for children enrolled in Medicaid. EPSDT includes the following services:

  • Early: Assessing and identifying problems early
  • Periodic: Checking children's health at periodic, age-appropriate intervals
  • Screening: Providing physical, mental, developmental, dental, hearing, vision, and other screening tests to detect potential problems
  • Diagnostic: Performing diagnostic tests to follow up when a risk is identified
  • Treatment: Controlling, correcting, or reducing health problems found

An established schedule based on a child's age determines when EPSDT visits occur and what services are provided. This is known as a periodicity schedule. Each state is required to develop a periodicity schedule for EPSDT well-child services as well as dental services.

Some states use a nationally recognized periodicity schedule for well-child visits, such as the American Academy of Pediatrics' Bright Futures guidelines. Other states have consulted with medical organizations involved in children's health care to develop their own periodicity schedule.

Dental Periodicity Schedule

The dental periodicity schedule that the HSPPS (45 CFR §1302.42(b) (1)) mentions is also set by each state and must meet standards of dental practice. Most states follow the dental periodicity schedule recommended by the American Academy of Pediatric Dentistry (AAPD). Other states have worked with dental organizations involved in children's oral health care to develop their own dental periodicity schedules. At a minimum, oral health services include relief of pain and infections, restoration of teeth, and maintenance of oral health.

AAPD maintains a webpage with a link to each state's dental periodicity schedule. To find your state's dental periodicity schedule, select your state from the list.

Head Start programs can get information on a child's oral health status and care using oral health forms developed by the National Center on Health, Behavioral Health, and Safety The forms are filled out during a child's dental visit. They have information on the child's current oral health status and what oral health services were done during the visit.

The forms can be customized with the Head Start program's name, mailing address, phone and fax numbers, and email address. A sample letter to the child's oral health professional is also available and explains how to complete and submit the form to the Head Start program's health manager.

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