EPSDT Periodicity Schedules and their Relation to Pediatric Oral Health Standards in Head Start and Early Head Start
Oral health and dental services are important concerns for Head Start and Early Head Start (HS/EHS) programs. From an epidemiological perspective, dental caries (tooth decay) remains the most common chronic disease of childhood, with the highest rates observed in economically disadvantaged and racial and ethnic minority children – conditions that characterize children enrolled in HS/EHS.
Medicaid plays an important role in reducing financial barriers and facilitating access to health care services – including dental services – for low-income children. Accordingly, a close relationship exists between HS/EHS and Medicaid, particularly Medicaid’s Early and Periodic Screening, Diagnostic and Treatment (EPSDT) benefit. Despite the requirement for a distinct periodicity schedule for EPSDT well-child dental services and the availability of model periodicity schedules from entities such as the American Academy of Pediatric Dentistry (AAPD) and Bright Futures, few state Medicaid agencies have published or made available separate periodicity schedules for dental services. This omission has contributed to confusion on the part of many local HS/EHS programs in their efforts to assure that enrolled infants and children are obtaining necessary dental services.
This brief examines the impact of inconsistencies between and failure to publish periodicity schedules on delivery of preventive services to EPSDT and HS/EHS children and makes recommendations for addressing this problem.
Don Schneider, DDS, MPH
James J. Crall, DDS, ScD