Start: July 2010

End: December 2011

Funder: California HealthCare Foundation and California's Managed Risk Medical Insurance Board


Tooth decay and dental caries are the most common, yet preventable chronic disease of childhood. Children in low-income families and those in racial and ethnic minority groups are at greatest risk for poor oral health. Key barriers to care include limited access to community dental providers, low awareness about the importance of good oral health, lack of coordination between pediatricians and oral health providers, the hesitation of general dentists to treat young children, a scarcity of pediatric dentists, and the reluctance of dentists to participate in publicly financed programs.

Healthy Smiles – Healthy Families, an 18-month, multi-stakeholder rapid learning initiative was designed to achieve sustainable improvements in oral health care services for young children enrolled in California’s Healthy Families Program (HFP). The initiative sought to identify strategies to address barriers to oral health care in low-income and minority children, and build a more effective system of oral health care for HFP beneficiaries.

Healthy Smiles – Healthy Families worked with the HFP to maximize resources for improving dental care for low-income children. The project focused on: (1) evidence-based clinical quality improvement; and (2) state-level system changes and contract amendments. When implemented together, these two strategies will optimize opportunities for quality improvement and infuse greater value into the state’s dental health care system.

Key Leadership and Stakeholders

The state’s Managed Risk Medical Insurance Board (MRMIB), created in 1990 to ensure the availability of health care to low-income individuals, purchases pediatric oral health services through six contracted dental plans and regularly reports on the quality of these services. MRMIB led the initiative and engaged community, government, and health care stakeholders in the planning and implementation. The California HealthCare Foundation, a leader in advancing oral health care throughout the state, provided ongoing guidance and support.