Association‌ of‌ State‌ &‌ Territorial‌ Dental‌ Directors
3858‌ Cashill Blvd.,‌ Reno,‌ NV‌ ‌89509
Phone‌ 775-626-5008‌‌

Dental Public Health Activities: Descriptive Summaries

Maryland's Mouths Matter- Fluoride Varnish and Oral Health Screening Program for Kids

Practice Number: 23006
Submitted By: Office of Oral Health, Maryland Dept. of Health and Mental Hygiene
Submission Date: September 2012
Last Reviewed: September 2012
Last Updated: September 2012
Best Practice Approach Example -

The Maryland’s Mouths Matter: Fluoride Varnish and Oral Health Screening Program for Kids was designed to reduce the incidence of tooth decay in children and contribute to the establishment of a dental home.  To achieve this and provide for greater access to dental services for young children, beginning in July 2009, Early and Periodic Screening, Diagnosis and Treatment (EPSDT) Medicaid medical providers (pediatricians, family physicians, and nurse practitioners) certified by the Office of Oral Health (OOH) became eligible to receive Medicaid reimbursement ($24.92) for providing fluoride varnish treatment to children age 9–36 months.

Twelve in-person trainings were held across the state between June 1, 2009 and August 22, 2009. The curriculum was adapted, with permission, from Oral Health Risk Assessment: Training for Pediatricians and Other Child Health Professionals, developed by the American Academy of Pediatrics. Faculty included staff from the University of Maryland School of Dentistry (UMD) and pediatric dentists in private practice. Representatives from DentaQuest, the state’s Medicaid dental administrator, and the Maryland Medicaid Program were in attendance to answer questions and enroll medical providers who were not EPSDT-certified. 

Costs for each in-person training averaged $8,000 to $10,000. To reduce costs, ensure sustainability, and guarantee future training, Maryland’s Mouths Matter was adapted by the National Maternal and Child Oral Health Resource Center (OHRC) at Georgetown University, OOH, and UMD into an online curriculum. The curriculum was released on March 1, 2010. 

OOH and its partners are committed to providing strong customer service at all stages of the training, certification, and post-certification process. Most queries which involve billing and receiving Medicaid reimbursement are received by OOH and addressed within 24 hours of receipt. If needed, OOH contacts DentaQuest, the Maryland Medicaid Program, or OHRC to provide assistance, should the issue fall within their scope of work.

Strong partnerships among stakeholders resulted in a successful statewide program designed to improve children’s oral health. As of June 30, 2012, there were 686 providers who completed the training program, and 385 of these EPSDT medical providers have enrolled with DentaQuest as fluoride varnish providers, which has improved utilization for children aged 9 – 36 months.  As of June 30, 2012, 58,770 fluoride varnish treatments have been provided to children aged 9 – 36 months since the start of this program in July 2009.  The fluoride varnish program has become so successful that it is now serving as the StateStat measure for oral health in Maryland, StateStat being a performance-measurement and management tool that is being monitored by the Governor’s Office.

Lessons Learned:

Identification and involvement of stakeholders early in the process has been instrumental to the success of the program. Maryland’s Mouths Matter could not have been developed or maintained without ongoing communication among partners and stakeholders.

Customer support has been integral to the success of Maryland’s Mouths Matter. Being available to assist customers quickly can make or break a program. This is a strength on which OOH prides itself.

Having a comprehensive understanding of the data involved this program has proven to be instrumental in maintaining, evaluating, and expanding this program.  These data points serve as a continuous input to ongoing evaluation and marketing efforts, two critical components of this program. Ongoing evaluation is essential to ensure the program operates effectively and efficiently, and to ensure that marketing plans evolve and are aligned to evidence-based evaluation findings. The marketing plan details the plan and approach to attract qualified EPSDT medical providers into the program, as well as to sustain those already enrolled.  Additionally, it ensures appropriate plans are in place to address and encourage providers to participate in the program to their maximum potential.  This ongoing program practice management coupled with an attention to strong customer and partnerships is the cornerstone of Maryland’s successful implementation.

 In conclusion, the Office of Oral Health and its partners are committed to this program’s success. Continuous efforts to promote strong partnerships, enhance program participation, improve the existing process and marketing efforts, and provide top-notch customer service have given way to the success of the Maryland’s Mouths Matters: Fluoride Varnish and Oral Health Screening Program for Kids. 

Contact Person(s) for Inquiries:

Stacy Costello, MPH, CHES, Program Coordinator, Office of Oral Health, Maryland Department of Health and Mental Hygiene, 201 W. Preston Street, 3rd Floor, Baltimore, MD 21201, Phone: 410-767-3081, Fax: 410-333-7392, Email:

Harry S. Goodman, DMD, MPH, Director, Office of Oral Health, Maryland Department of Health and Mental Hygiene, 201 W. Preston St, 3rd Floor, Baltimore, MD 21201, Phone: 410-767-5300, Fax: 410-333-7392, Email: