From The First Tooth An early childhood caries prevention program to improve the oral health of Maine children

1. From The First Tooth An early childhood caries prevention program to improve the oral health of Maine children An initiative of MaineHealth funded by the Sadie and Harry Davis Foundation in partnership with MaineGeneral and EMHS Collaborating with Boston University’s Center for Research to Evaluate and Eliminate Dental Disparities www.fromthefirsttooth.org

2. The purpose is to improve the oral health of Maine’s children by: From The First Tooth • Increasing children’s access to preventive oral health services • Integrating early oral health as the standard of care for children • in medical practices through: • Oral health screening • Fluoride varnish • Parent/caregiver education and counseling

3. From The First Tooth Dental Caries is a Chronic Infectious Disease • Transmissible • Bacterial by-products (acids) • dissolve the enamel of teeth • Loss of tooth structure, pain, • tooth loss, systemic infections

4. From The First Tooth • Dental caries is the single most common chronic disease of childhood • Approximately one thirdor more of Maine children has dental caries • Early childhood caries is the best predictor of lifelong dental caries Source: National Health and Nutrition Examination Survey, 1999 -2002 National Center for Health Statistics, CDC

5. Low-income children who have their first preventive dental visit by age one: Less likely to have subsequent restorative or emergency room visits Average dental related costs are almost 40% lower ($263 compared to $447) over a five year period than children who receive their first preventive visit after age one. From The First Tooth Prevention Reduces Disease and Saves Money

6. From The First Tooth • Provides: • An initial meeting to help assess their readiness in integrating • this service into the practice work flow. • Demonstration and clinical training of fluoride varnish application • during staff meetings or lunch/learn. • Coaching on how to track the fluoride varnish applications • – either manually or electronically. • Instructions on reimbursement procedures. • On-going assistance and support to practices to ensure adoption of the services. • Opportunities to participate with a network of providers via conference calls, • on-line discussions regarding early childhood dental prevention. • Periodic updates on new information on early childhood caries and prevention.

7. From The First Tooth Provides the practices: • All start-up fluoride varnish supplies • From the First Tooth Toolkit consisting of: • Parent/caregiver educational materials and oral health toolkit • Posters, reminders for exam rooms • Templates for postcards to inform parents of this new service • Information on ordering supplies • Information of MaineCare reimbursement

8. Parent/Child Arrives for Well Child Visit (or other visit) Posters, ed materials in waiting room Vitals Signs Taken Medical Assistant tells parent of the FTFT (Parent Counseling) Well Child Exam Medical Provider - Oral Screening, Orders for fluoride based on risk (Parent counseling) No Access to a Dental Home Referral to a Dental Home Immunization Medical Assistant Applies Fluoride Dental Home

9. Oral Health Screening • Incorporate a dental screening during • the child’s physical exam • Takes less that 1 minute per child • Check for the presence of early childhood caries • Urgent treatment needs • Risk assessment

10. Fluoride Varnish • Topical fluoride treatment is professionally • applied to the surfaces of the teeth • Helps enamel become more resistant to decay by about 40% • Helps to remineralize early defects in the enamel • Takes approximately 1 to 2 minutes

11. Infant and Toddler Oral HealthAnticipatory Guidance • Advise parents and caregivers • The importance of healthy teeth, • How to take care of their child’s teeth • The importance of healthy food choices

12. From The First Tooth MaineCare is reimbursing medical providers for the therapeutic application of fluoride varnish for members with moderate to high caries risk. MC will cover 2 applications per calendar year. For members with high caries rates and new decay within 18 months as documented, MC will cover 3 times per year. In Maine, we are currently discussing reimbursement to medical providers by the commercial payers and self-insured organizations.

13. From The First Tooth Endorsed by: • Maine Chapter of the American Academy of Pediatrics • Maine Dental Association • Maine Medical Association • Maine Academy of Family Physicians • Maine Osteopathic Association

14. From The First Tooth We are committed to ensure every child within our organizations and affiliates to have access to early childhood caries prevention program.

15. From the First Tooth For more information: Susan Cote, RDH, MS, Program Manager at 662- 6309 cotes4@mainehealth.org

16. From the First Toothwww.fromthefirsttooth.org MaineHealth is a nationally recognized not-for profit group of leading hospitals, physicians, and health care organizations working together to help make the people of Maine the healthiest in America. Members: Maine Medical Center, Miles Memorial Hospital St. Andrews Hospital, Stephens Memorial Hospital, Spring Harbor Hospital, Waldo County Healthcare Inc, HomeHealth Visiting Nurses, NorDx, and Maine Physician Hospital Organization. Affiliates: MaineGeneral Medical Center, Mid Coast Hospital, Southern Maine Medical Center, St. Mary’s Regional Medical Center and Penobscot Bay Medical Center. Funded by the Sadie and Harry Davis Foundation Administered through MaineHealth