Program Overview

Into the Mouths of Babes (IMB) - NC Dental Screening and Varnish Project is the collaborative effort of six partners: The NC Academy of Family Physicians, the NC Pediatric Society, the NC Division of Medical Assistance, the NC Oral Health Section, the UNC School of Dentistry, and the UNC School of Public Health.

Initial and continued grant funding has been provided by the Centers for Disease Control, the Center for Medicare and Medicaid Services, the Health Resources and Services Administration and most recently, the State Oral Health Collaborative Systems. The IMB program is now part of the NC Department of Health and Human Services Oral Health Section and continues to collaborate with the five partner agencies.

Objective:

The objective of the IMB program is to train medical providers to deliver preventive oral health services to high-risk children from the time of tooth eruption until the third birthday, including oral screening, parent/caregiver education, and fluoride varnish application.

Goal:

The goal of the IMB program is to reduce the incidence of early childhood caries in North Carolina.

 

The Oral Preventative Procedure:

The oral preventive procedure consists of 3 equally important parts:

1) Oral evaulation	2) Counseling with the primary caregiver	3) Application of topical fluoride varnish.

Application of fluoride varnish can be compared to having a fluoride treatment at the dental office. Toxicity is not an issue with the fluoride varnish because such a small amount is used and it adheres to the teeth until it is brushed off. Medicaid-covered children can have the procedure a maximum of 6 times from tooth eruption until the 3rd birthday, with a 90-day time interval between procedures.

Effectiveness:

IMB data show that Medicaid-covered children receiving the procedure have fewer caries-related treatments in dental offices than enrolled children not having IMB preventive services. Children having 4, 5, or 6 IMB visits before their 3rd birthday have the most benefit.


Training:

Training consists of a standard 1-1/2 hour American Medical Association (AMA) approved continuing medical education (CME) session, which in addition to providing training on oral screening, parent education, and fluoride varnish application, includes information on Medicaid billing, an “oral health toolkit” containing necessary and helpful resources, and a starter kit with supplies for 10 screening and fluoride varnish procedures. Information for ordering subsequent supplies is included as well.

The medical provider conducting the oral screening portion of the procedure must be a certified Healthcheck provider (physician or physician extender). In public health clinics a registered or licensed nurse can perform the procedure with standing physician orders. Oral and written parent/caregiver education is also a required part of the preventive procedure and is individually tailored to the family as determined by risk factor information gathered from the parent. Educational handouts for parents are provided based on the child’s age. Post-operative instructions are on the parent handouts as well and tell parents to wait and brush their child’s teeth the next day and have them eat a soft diet the remainder of the day the varnish is applied. This gives the fluoride varnish more contact time with the tooth surface, strengthening the tooth enamel.
The procedure may be documented on a provided encounter form or directly in the patient chart. Documentation should include the three parts of the procedure, any noted disease or abnormalities, and if the provider referred the child to a dentist.


Reimbursement:

As a partner in the Project, NC Medicaid is reimbursing medical providers for the 3-part procedure. A child can have the procedure a total of six times from tooth eruption until the third birthday.

Medicaid reimbursement is approximately $53 for each of the six visits.

Time involved providing the 3-part service depends on the child’s age and tooth eruption patterns, but the average is 5 minutes.

There are NO other 3rd party insurers covering the procedure at this time.

 

IMB Tools

For Your Convenience:

Below are some links to downloadable tools for all IMB participants. These include English and Spanish versions of our Information for Parents handout, the encounter form, and our quarterly newsletter.

Downloads/Resources:

Toolkit for IMB Participants

IMB Newsletters:

Spring 2007

Fall 2007

 

IMB Contact Information:

Contact Into The Mouths of Babes
Kelly Haupt, Project Coordinator
Phone: (919) 707-5485
Email: kelly.haupt@ncmail.net

NC Oral Health Section
5505 Six Forks Road
1910 Mail Service Center
Raleigh, NC 27699-1910