Oral Health Case Management in Head Start

Did You Know?

Head Start staff, directors, and parents report that some of their biggest oral health challenges are:

  • Finding oral health services for children, especially children enrolled in Medicaid
  • Making sure children get the oral health services they need

Brush Up on Oral Health

Case management is a service provided by Head Start program staff. Case management is usually done by health and family service managers, family service workers, and home visitors. As case managers, Head Start staff can help parents find and access oral health care to help children be healthy and ready to learn. Case management is tailored to each family’s strengths and challenges.

This issue of Brush Up on Oral Health defines case management and explains how it can help improve the oral health of children enrolled in Head Start. It also describes how case managers and parents can work together to meet children’s oral health needs. A recipe for a healthy snack to make in the Head Start classroom or at home is also included.

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Case Management Defined

adult hands cradle child's hands holding paper people cut-outsCase management is a process where case managers and parents work together to identify and overcome barriers to accessing and using health and social services. These barriers can include family belief systems and practices, health literacy challenges, and anxieties or phobias. Other barriers can include difficulty locating health and social services, no or insufficient insurance coverage, and lack of reliable transportation.

Head Start case managers can use the process to:

  • Improve parents’ problem-solving and self-management skills
  • Help parents navigate the health care system
  • Establish parents’ role as primary caretakers of their child’s health
  • Build on and use parents’ personal resources to overcome the unique challenges they face in accessing health services
  • Promote evidence-based or evidence-informed care

Using Case Management to Improve Children’s Oral Health

Oral health services can be included in case-management efforts. Some case-management services can include:

  • Asssessment. To decide if case management focusing on oral health is needed, Head Start staff determine the following:
  • A dad holding his daughter in his lap while a dentist examines herEducation and planning. When working with families, the case manager can have a conversation with parents about the importance of oral health, regular dental visits, and follow-up treatment. Together, the case manager and parents can identify barriers that prevent the child from receiving needed oral health services. Then, the case manager and parents can work together to make a plan for ensuring that the child gets those services.
  • Assistance and care coordination. Once parents and the case manager agree on a plan, the case manager can help parents overcome barriers to making the plan work. Assistance and care-coordination services may include helping parents find oral health professionals, arranging dental visits, and enrolling children in dental insurance plans or identifying other resources that can help pay for oral health services. The case manager can also arrange transportation to dental visits and remind parents to go to their child’s visit.
  • Tracking and evaluation. Tracking and evaluation lets the case manager determine whether the plan for ensuring that the child gets the oral health services they need is being followed. This allows the case manager to learn how well the process is working and if the child’s oral health care needs are being met. One tool case managers can use to monitor whether a child’s oral health care needs are being met is the Head Start Oral Health Form, also available in Spanish (español). The form is filled out by the oral health professional and is a record of what oral health services were delivered during a dental visit. It also provides information on what services still need to be completed.

Cook's Corner: Fall Grape Trees

Here is a delicious and healthy snack that children can make in a Head Start classroom or at home with their families.

grapes and pretzels laid out on a plate according to the recipeIngredients

  • 1 bag pretzel sticks
  • 2 cups washed green grapes, cut in half lengthwise
  • 2 cups washed red grapes, cut in half lengthwise


  1. Place pretzel sticks on a plate to form the tree trunk and branches.
  2. Place green and red grape halves around the branches to form leaves.

Makes four to six servings

Safety tip: An adult should slice the ingredients.

Contact Us

The National Center on Early Childhood Health and Wellness welcomes your feedback on this issue, as well as your suggestions for topics for future issues. Please forward your comments to health@ecetta.info or call 866-763-6481.

Subscribe or view all issues of Brush Up on Oral Health on the Early Childhood Learning and Knowledge Center (ECLKC).

Photo credit: Health Trust | Flickr | CC BY-NC-ND (second photo)

Last Updated: November 8, 2019