Evaluation of Colorado's Cavity Free at Three Program--a Preventive Oral Health Training

Background: Colorado's Cavity Free at Three(CF3) program trains medical, dental, and public health providers on preventive dental care (caries risk assessment, screening, fluoride varnish application, education, caregiver goal setting and referral) to children 0-36 months.

Objectives: We aim to evaluate CF3's first year by measuring the adoption of and perceived barriers to the provision of CF3 care.

Methods: Retrospective cohort study. We conducted an online survey of CF3 trainees 7-12 months after their training.

Results: We surveyed 118 trainees(60% response rate) who reported they were medical providers(24%), dental providers(16%), public health nurses(17%), RNs/medical assistants(21%), or other(administrative/other roles)(22%). Prior to the training, 20% reported providing dental care to children 0-36 months. After the training, 46% reported they now provide dental care to these children, 14% are providers but don't provide dental care to these children, and 40% were not care providers. Of those who now provide CF3 care(N=66), 54% provided it to ≥75% of children seen in the past two work weeks. They reported providing the following care components ≥75% of the time: assessing risk(57%), examining teeth(75%), fluoride varnish application(70%) and caregiver goal setting(40%). Reported barriers to providing care were few and included: lack of time(22%), lack of adequate reimbursement(10%), and difficulty obtaining fluoride(10%). Providers reported they are likely to continue providing CF3 care in the future(89%).

Conclusions: After CF3's first year, the program has been successful at training Colorado's providers on the provision of preventive dental care to children 0-36 months. Further training may improve adoption of care components.