WHO DELIVERS AND DISSEMINATES THE MYSMILEBUDDY PROGRAM?

Taken together, these Surgeon General’s recommendations point to the MySmileBuddy Program’s use by a wide variety of healthcare and health-supporting professionals and lay health workers:

• Medical providers:  physicians and nurses

• Dental providers: dentists, dental hygienists, dental therapists, and dental assistants

• Health counselors: nutritionists, social workers, health educators

• Lay health workers: community health workers and peer counselors

• Childhood program officials: Head Start, WIC, and Home Visiting Programs (Maternal and Infant Early Childhood Visiting/MIECHV).

 

The MySmileBuddy Program can also be used– or disseminated– by:

• Healthcare & dental insurers to advance quality and outcomes at reduced cost;

• State health departments, especially those that employ community health workers as health counselors;

• Dental Management Organizations (DMOs) and Dental Services Organizations (DSOs) to distinguish their members and enhance care.

 

Medical Professionals

The MySmileBuddy Program addresses the American Academy of Pediatrics’ Bright Future Guidelines call for age-specific oral health promotion through feeding practices, oral hygiene, and diet management. The Program also satisfies national associations of primary care medical professionals – pediatricians, family physicians, and nurse practitioners – all of which support the Oral Health Delivery Framework that calls for an “actionable pathway for delivering preventive oral health care in the primary care setting.” The Program can satisfy all 7 proposed options for medical-dental integration that build on treating caries as a chronic disease amenable (like asthma, diabetes, and obesity) through behavioral interventions. Medical professionals in the full range of delivery sites – from solo private offices to safety net health centers and health systems/accountable care organizations – can utilize the MySmileBuddy Program to advance children’s oral health.

 

Dental providers

The American Dental Association (ADA) calls for caries prevention through oral hygiene and dietary behavioral modifications. The MySmileBuddy Program meets the ADA’s  prevention guidance to reduce the amount and frequency of carbohydrate consumption, limit between meal sugary snacks, and brush twice-daily with fluoride toothpaste. Dentists practicing in solo, group, institutional, and safety-net organizations can utilize the MySmileBuddy Program with families to promote caries prevention and disease management. The American Academy of Pediatric Dentistry caries management guideline similarly incorporates risk-based diet counseling and fluoride use in toothpaste and supplements that the MySmileBuddy Program supports.

 

Health Counselors

A full range of health counselors – medical social workers, certified diabetes educators, certified health education specialists, registered dietitian nutritionists, professionals certified in public health, and community health workers – have the communications skill sets, knowledge of social determinants, and opportunities to provide oral health behavioral counseling using the MySmileBuddy Program.

 

Dental Insurers

Public insurers (Medicaid and the Children’s Health Insurance Program/CHIP) and private dental insurers can provide the MySmileBuddy Program directly to their beneficiaries or can target families of children identified to be at high risk like those slated for dental rehabilitation under general anesthesia.

 

Health Departments

The national group of dental public health officials (the Association of State and Territorial Dental Directors) – has issued a Strategic Framework to Prevent and Control Early Childhood Tooth Decay. The Framework calls for “education and anticipatory guidance for parents and caregivers.” State and local health departments can disseminate the MySmileBuddy Program to families of children at risk of tooth decay and to programs that serve such children. 

 

Early childhood programs

Our 2016 environmental scan of children’s oral health programs identified 15 models of oral healthcare delivery and associated payment approaches that support value-based care by going upstream to prevention. All can use the MySmileBuddy Program to enhance and expand their current interventions.

 

Our survey of 101 early childhood oral health programs found that half are affiliated with Head Start and/or WIC programs. The top two reported interventions -- “educating parents” and “addressing family-level health behaviors” – are key components of the MySmileBuddy Program.

 

Among programs that target high-risk socially-vulnerable families of young children are three that are particularly fruitful venues to deliver the MySmileBuddy Program.

 

• Head Start and Early Head Start (HS/EHS) programs “support children's growth from birth to age 5 through services centered around early learning and development, health, and family well-being” (https://www.acf.hhs.gov/ohs/about/head-start). Oral health requirements include periodically screening children’s dentitions; facilitating, monitoring and tracking dental services; providing healthy snacks and water; and implementing dental hygiene programs.

 

• WIC (formally the Special Supplemental Nutrition Program for Women, Infants, and Children) “aims to safeguard the health of low-income women, infants, and children up to age 5 who are at nutrition risk by providing nutritious foods to supplement diets, information on healthy eating, and referrals to health care” (https://www.fns.usda.gov/wic). WIC dieticians and counselors use a federally approved risk assessment tool that includes an oral health dimension for pregnant women, breast-feeding mothers, non-breastfeeding mothers, and for each child age group. Resulting “risk codes” drive the nutritional education and other interventions offered to that family.

 

• MIECHV (Maternal Infant Early Childhood Home Visiting program) “supports pregnant people and parents with young children who live in communities that face greater risks and barriers to achieving positive maternal and child health outcomes. Families choose to participate in home visiting programs, and partner with health, social service, and child development professionals to set and achieve goals that improve their health and well-being” (https://mchb.hrsa.gov/programs-impact/programs/home-visiting/maternal-infant-early-childhood-home-visiting-miechv-program). MIECHV requires assessment of primary care services and allows states to expand such services to include oral health supervision.  

 

Foundations

Grantmakers committed to promoting oral health have addressed a range of issues that the MySmileBuddy Program advances including access to care, early childhood and school-based programs, Medicaid policy, oral health equity, medical-dental integration, workforce, and value-based care. Non-profit foundations can sponsor a wide range of organizations to utilize the MySmileBuddy Program or can drive its adoption directly through dissemination.