ABCD Model 8-02
Iowa Access to Baby and Child Dentistry (ABCD)
The Iowa Access to Baby and Child Dentistry (ABCD) Program is an initiative of the
Bureau of Oral Health at the Iowa Department of Public Health. Iowa ABCD is designed
to improve access to dental services for low-income children age one to twenty-one.
Emphasis of the program is on children from low-income families, children enrolled in
Medicaid, and those without dental insurance. It is an approach that requires
commitment from the child, family, community and local dentists. Modeled after the
Washington State ABCD program, this initiative identifies and eases the barriers to
preventive dental treatment, and promotes life long practices of good oral health.
The program has two major components:
1) The community component increases the capacity of the local community to
2) The direct services component includes education, care coordination,
screenings, fluoride varnish applications, and referrals to dentists.
Map 1: Iowa ABCD Community Component
ABCD Model 8-02
IOWA ABCD COMMUNITY COMPONENT
The community component of Iowa ABCD has three primary areas of focus: community
planning, building partnerships, and infrastructure building.
Community stakeholders such as consumers, Title V child health contractors, community
leaders, health care providers, dentists, dental hygienists and others interested in
improving dental services in the community are involved in the several aspects of Iowa
Community planning is crucial in the implementation of Iowa ABCD. It is through this
planning that a community assessment of dental access needs and assets is completed,
strategies are developed to overcome local barriers to service, and resources are
organized to build a system of care that provides access to dental services for all children
in the community. Careful implementation of those strategies with continuous
monitoring and evaluation of the success of the strategies is crucial to the success of the
Also important to ABCD is building partnerships with area dentists and dental
hygienists, schools, local DHS offices, medical providers and area Head Start programs
to foster community-wide support for the program and allow sharing of resources.
A major focus of the ABCD program is to build the infrastructure of the dental service
delivery system to fit the unique assets and needs of the community. It is this
infrastructure that defines the direct service component of the model.
The expected outcomes of these activities are improved access to dental services,
identification of dental homes, and healthy mouths for all children ages 1 to 21 in the
ABCD Model 8-02
Map 2 Iowa ABCD Direct Services Component
from Dental Homes
Outcomes to Care
IOWA ABCD DIRECT SERVICES COMPONENT
Iowa ABCD direct services are provided as illustrated with variations based on specific
community needs and assets.
Outreach efforts inform families and the community about the Iowa ABCD program,
identify children in need of dental care, and lead families to community educational
activities and/or enrollment in the ABCD program. Outreach activities include media
campaigns, brochures, informational signs in local establishments, and notification to
providers of family services about the purpose of ABCD, referral mechanisms, and
Children may enter the ABCD program in a variety of ways. They may enter by referral
from individuals or agencies in the community. They may receive services from the
ABCD dental hygienist at school dental screenings, WIC clinics, Head Start or the local
ABCD Model 8-02
Title V Child Health Center. Families may also contact Iowa ABCD directly or attend
community educational programs that guide them to dental care.
Community education programs and brochures provide information on practices that
promote healthy mouths and information on services available within the community to
help children receive regular dental care. Equipped with this information, families can
make changes in the way they care for their children’s teeth. Some families may be able
to access regular dental care without additional help, but for those that cannot, enrollment
in the ABCD program will provide assistance. For those families needing additional
help, enrollment into the ABCD program is the next step.
Once enrolled in the program, children are screened for eligibility for Title XIX, hawk-i,
or Title V dental payment plans, and are assisted to enroll in those programs as
appropriate. Children not eligible for the programs receive care coordination regarding
other resources for care.
Care coordination is the primary emphasis of this program. Care coordinators link
children to dental care by assisting families in finding transportation to dental
appointments, determining appropriate payment sources for dental care, educating
families about the importance of keeping appointments, and reminding families of
upcoming appointments. In addition, the care coordinator acts as gatekeeper to refer
children without a dental home equitably among dentists, and assures the child receives
timely and appropriate follow-up dental care.
Dental screenings are provided by a dental hygienist who identifies oral health needs and
educates caregivers and children on the importance of oral health. Dental hygienists also
apply fluoride varnish for children at high risk of developing tooth decay. Referrals are
made to dentists and other community services as needed. The dental hygienist continues
to provide regular and periodic screening and fluoride varnish applications until a dental
home is established for the child.
All these activities improve a child's access to the local dentist for regular dental care.
The goal of the ABCD program is for this dentist to become the "dental home" for this
child, meaning that this is the place where a child receives continuous, comprehensive,
coordinated, family-centered dental care. The dental home works with the family to help
children achieve optimal dental health.
The three major outcomes to measure the effectiveness of direct care services are
improved access to dental services, identification of dental homes, and healthy
mouths for all children ages 1 to 21 in the community.