Access to dental care for Head Start enrollees

Objectives: The objectives of this review are to characterize the oral heal th and dental access of Head Start children, describe barriers to their car e, advance strategies to address those barriers, and consider how Head Star t Performance Standards can be utilized to maximize oral health and access to dental care. Methods: Published programmatic, and solicited data describ ing oral health status and dental service utilization are reviewed together with reports of conferences exploring access barriers. Head Start performa nce measures for child health and development services, child health and sa fety, family partnerships, and community partnerships are individually eval uated for their potential to improve oral health. Results: Head Start child ren, like all few-income children, enjoy the highest rates of dental covera ge (because of Medicaid and the State Child Health insurance Program), yet these children also experience the highest rates of tooth decay, the most u nmet dental care needs, the highest rates of dental pain, and the fewest de ntal visits. Getting children the dental care they need is problematic beca use of: multiple barriers associated with public and private dental deliver y systems, Medicaid program funding and administration, dental workforce su fficiency and distribution and issues of culture and communication that sta nd between parents, children, and caregivers. Conclusions: To move beyond s creening and to access necessary dental care requires integration between m edical and dental care, recognition and elimination of barriers to care, an understanding of dental provider types and their capacities a formally str uctured referral process, and regular monitoring to ensure that complete ca re is obtained Action steps are suggested that can maximize the effectivene ss of Head Start Performance Standards, Head Start holds tremendous potenti al to actively develop and implement policies that can markedly improve bot h access to needed dental services and the oral health status of young disa dvantaged children.