Ohio kids on Medicaid are nearly twice as likely as kids nationwide to go to the emergency department for preventable dental issues, like cavities or tooth decay.
The problem is especially acute in rural and poor parts of the state, where dentist shortages make it harder for children to get regular care.
To address that issue, CareQuest Institute for Oral Health and Oral Health Ohio launched the Medical Oral Expanded Care (or MORE Care) pilot program across six Ohio counties in 2022. The pilot ended in 2024, and a report on its effectiveness was published in July.
Now, the pair of organizations are determining how to scale the model up.
“What do we want to do with that learning? Will that translate into some systems change or policy changes within Ohio?” said Marla Morse, Oral Health Ohio’s executive director.
How did the pilot program work?
Instead of focusing on biennial trips to faraway dentists, the pilot program took another approach: It trained pediatricians to incorporate oral health into kids’ annual checkups.
“So this was a way to really elevate the prevention related services, like fluoride varnish application, that could be provided to a child during the well child visit with their pediatrician,” said Rebekah Mathews, vice president of health transformation with CareQuest Institute for Oral Health.
If a pediatrician noticed something concerning, or if families didn’t have an established relationship with a dentist, pediatricians could refer them to a partnering dental provider.
Mathews said this medical dental integration makes a lot of sense. Poor oral health is linked to chronic illnesses, including heart disease, diabetes, dementia and hypertension.
“Across the lifespan, there is this connection of oral health to systemic health,” Mathews said. “So working to improve the connection for health care delivery is vital to benefiting chronic disease management and resulting in improved health outcomes and cost savings.”
How successful was the pilot?
As a result of the MORE Care Ohio pilot, more than 1,000 kids — from Lucas County in the northwest to Lawrence County in the southeast — got preventive dental care at their annual checkup.
“We’re very excited about that opportunity for more and earlier preventive services being available to Ohio's children."Rebekah Mathews
“We saw that the integration of oral health services that could be incorporated in a well-child visit by a pediatric office increased by an average of 8% across the 20,000 kids that were supported in this project,” Mathews said.
Additionally, pediatric offices referred more than 400 patients to dental partners and surgical interventions dropped by 4%.
“We’re very excited about that opportunity for more and earlier preventive services being available to Ohio's children,” Mathews said.
Still, the pilot program didn’t come without challenges.
Referred dental practices were often up to an hour away, making it difficult for families without reliable transportation to follow up with appointments.
What’s next?
Since the pilot ended last year, many participating providers have adopted medical dental integration as standard practice, Mathews said.
She’s hoping the concept will catch on.
“We feel like the impact report we released that evaluated the program really gives a roadmap for scaling medical dental integration statewide,” she said.
It’ll take a collaborative effort, she said, but she believes it’s worth it to improve care for Ohio kids.
