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Preventing Early Childhood Caries: Learning from New York State’s ECC Simulation Model

Escrito por: Melitzi Torres

A new Policy Brief by the Children’s Dental Health Project (CDHP) describes several efforts that New York State has enacted to prevent and manage early childhood caries (or ECC, which is tooth decay in children from birth through age five).

Examining the results of various strategies in practice to reduce ECC among New York State’s Medicaid program recipients can serve as valuable information for policy makers in Rhode Island. Their simulation model provides findings regarding the benefits of individualized plans of action for children at risk or with ECC and the cost-benefits of public health interventions to Medicaid.

Based on data from New York, the CDHP Brief provides several recommendations:

  1. States should require a diagnostic test to measure a child’s level or risk for disease. This assessment, if built-in and required as part of a periodicity schedule, would allow dental providers to tailor a plan of action to best meet the needs of the child.
  2. States should develop a state plan to provide all Affordable Care Act (ACA) preventative services at no cost to beneficiaries. Implementing this plan would result in a 1 percent increase in federal matching funds for the state. 
  3. States should incentivize and encourage the use of oral risk assessments and fluoride varnish by pediatricians.


The Brief also identifies public health interventions that state Medicaid programs could implement to achieve significant savings, including investing in fluoride tooth brushing education, covering the costs of Xylitol gum in adults and pregnant mothers, providing motivational interviewing, and reallocating Medicaid administrative dollars to support efforts in community water fluoridation. Returns on investment in the recommended changes can vary from $1.76 for every dollar spent to $3.21 for every dollar spent.

By tailoring individual plans of action for children at risk of or with ECC, and by restructuring dental services in a more cost-effective manner, the oral health care delivery system can be improved. The data produced by the New York stimulation and the CDHP Brief provide Rhode Island policy makers with specific cost-effective options to reduce ECC among low-income children.

Read the entire Brief here.

Guest post by Melitzi Torres, Intern at Rhode Island KIDS COUNT and Senior at Brown University

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