Colorado has made significant investments toward improving the oral health of pregnant people and young children over the last 20 years. This timeline is intended to provide an overview of significant oral health system efforts across the state.
Colorado Commission on Children’s Dental Health (CCCDH) made nine recommendations to improve children’s oral health. The results were five legislative initiatives: education loan repayments for providers, tax credits for rural providers, funding for safety net expansion, direct Medicaid reimbursement for dental hygienists, and the addition of dental benefits in Child Health Plan Plus (CHP+).
Supported by Rose Community Foundation, 24 nonprofit dental providers created the Colorado Oral Health Network (COHN) to improve oral health outcomes for underserved populations. The group supports safety net dental providers and oral health data systems. COHN also established the Children’s Oral Health Outcomes Project, which brought together medical and dental providers.
Passage of SB01-164 created the dental loan repayment program, incentivizing dental professionals to serve under-resourced families.
A dental benefit was added to the CHP+, providing preventive and diagnostic services, basic restorative services, oral surgery, and endodontics care for children up to 18 years old.
Oral Health Awareness Colorado (later Oral Health Colorado) was founded to develop and promote positive oral health strategies.
CHP+ was expanded to cover children at or below 200% of the federal poverty level, funded by Amendment 35.
With support from Delta Dental of Colorado Foundation, CU Anschutz School of Dental Medicine established The Frontier Center to promote the connections between oral health and overall health and well-being.
Cavity Free at Three is launched by a collective of six Colorado health foundations. Now managed by CDPHE, this program is set up to provide training to medical and dental professionals to support young children and pregnant women with a focus on serving high-risk populations.
Delta Dental of Colorado Foundation established the Colocation of Dental Hygienists into Medical Settings project. This would later to become the Colorado Medical Dental Integration project.
The Early Childhood Health Integration initiative was funded by the Colorado Trust to offer multi-year support to Colorado’s network of Early Childhood Councils.
The Early Childhood Colorado Framework was published by the Office of the Colorado Lieutenant Governor and includes oral health in patient and parent education. It also encourages collaboration among all providers who serve children.
Colorado Medicaid began reimbursing primary care providers for oral health assessments and application of fluoride varnish during well-child visits for children under age four. To be eligible, those providers must have received training in Cavity Free at Three or Smiles for Life curricula.
The Early Childhood Leadership Commission (ECLC) is created by executive order and legislation and charged to advance a comprehensive and coordinated early childhood system.
Colorado Partnership for Children’s Oral Health (CoPCOH) was created to broaden dental services for hard-to-reach families. This work included educating families about the importance of early preventive care and improving access for low-income families and pregnant people. CoPCOH was also committed to increasing the number of Medicaid dental providers in the state.
Oral Health Colorado developed the Smart Mouths Smart Kids toolkit to help those planning for preventive care in school settings promote equity, assess feasibility, and build sustainable oral health programs.
Colorado Governor John Hickenlooper identified oral health as one of the state’s 10 winnable battles in the next five years.
The Office of Early Childhood was established within the Colorado Department of Human Services (CDHS). The new office consolidated programs and funding streams from CDPHE, the Department of Health Care Policy and Financing, the Department of Education, and the office of the Lieutenant Governor.
CDPHE implemented a model for placing dental hygienists within in rural public health agencies. These regional oral health specialists train health care professionals in Cavity Free at Three, administer school sealant programs, promote community water fluoridation, and provide care coordination and public oral health education.
More families became eligible for Medicaid benefits through Affordable Care Act expansion.
A limited dental benefit was added for adults 21 and older to cover annual dental exams and cleanings, dentures, extractions, and other services. Members could receive up to $1,500 annually toward the cost of needed dental services.
New oral health messaging was added to Bright By Text communications with pregnant people. This content focused on their current health and provided useful information for after their child was born.
Colorado Dental Association’s (CDA) Take Five Bonus Program incentivized dentists to see Medicaid patients by covering the costs of enrollment, training staff, and learning billing systems.
Cavities Get Around, a bilingual public will-building campaign, was created to raise awareness of the importance of baby teeth and having children drink only water between meals and at bedtime.
Passage of House Bill 15-1029 (Health Care Delivery Via Telemedicine Statewide) expanded telehealth services and required insurance carriers to reimburse providers for these services.
When signed into law, House Bill 15-1309 (Protective Restorations by Dental Hygienists) allowed dental hygienists to place interim therapeutic restorations (ITRs) and authorized Medicaid and CHP+ to reimburse for this service delivered via telehealth supervision.
The SMILES Dental Project was a virtual home model pilot created to enable dental hygienists to deliver dental care in rural and under-resourced communities, under the virtual supervision of a dentist.
Healthy Child Care Colorado created the Cavity Free Kids supplemental curriculum to be used in early care and learning settings and home visiting programs that promotes healthy oral habits.
CDPHE was funded by U.S. Health Resources Administration Services (HRSA) to improve oral health care provided to pregnant people. This program quadrupled the number of patients receiving care during their pregnancy.
Colorado Rural Health Center created the Medical ORal Expanded care (MORE) program to support rural health clinics integrate oral health into services offered.
Colorado Child Care Regulations were updated to restrict the consumption of sugar-sweetened beverages.
By passing HB18-1045 (Silver Diamine Fluoride) Colorado’s General Assembly expanded dental hygienists’ services to include application of silver diamine fluoride in collaboration with a dentist.
Colorado’s Basic Screening Survey indicates improvement in children’s oral health over the previous ten years.
The Rocky Mountain Oral Health Network (RoMoNOH) was created to support community health centers across Colorado and neighboring states to integrate oral health services into primary care clinics serving pregnant people, infants, and young children.
Colorado’s Accountable Collaborative Care (ACC) program creates the first key performance indicator (KPI) focused on oral health. It measures the number of members with a dental visit in the prior 12 months. Children receiving a screening and varnish by their primary care provider counts towards this indicator.
Passage of HB19-1038 (Dental Services for Pregnant Women on CHP+) adds oral health coverage for pregnant people with CHP+.
The Colorado Department of Public Health & Environment (CDPHE) launches the Early Childhood Oral Health Advisory Board, made up of stakeholders from across medical and dental fields. The board is charged with improving coordination and integration of preventive oral health strategies across systems, developing a community of practice, and amplifying a collective voice around early childhood oral health issues.
Passage of SB21-102 (Sunset Dental Hygienists Specialized Functions) continues the ability of dental hygienists to place interim therapeutic restorations and apply silver diamine fluoride through September of 2025.
SB21-139 (Coverage for Telehealth Dental Services) was signed into law to allow delivery of dental telehealth services and require dental insurance plans issued, amended, or renewed in Colorado to cover these services.
Governor Polis announces the creation of a new Department of Early Childhood with a mission to create a “comprehensive, community-informed, data-driven, high-quality, and equitable early childhood system.”