Montana meets two of the eight policy benchmarks aimed at addressing children's dental health needs, one less than it met in 2010. The change in grade is due to a clarification of what state law allows dental hygienists to do. Montana hygienists may apply for a Limited Access Permit, which allows them to place dental sealants on children's teeth without a dentist's prior exam. Yet sealant programs can be conducted in only five schools; the hurdle is a state rule requiring the Board of Dentistry to individually approve each participating school or public facility.1 In the vast majority of cases, a dentist's prior exam is required. However, a bill has been introduced (but not yet enacted) to broaden the circumstances in which hygienists can place sealants without this requirement.
The state had one of the lowest rates of utilization of dental services for Medicaid-enrolled children, with fewer than 30 percent using services in 2009. Additionally, the state provides fluoridated water to only 30 percent of its residents on community systems.
1. Administrative Rules of Montana, Department of Labor and Industry, Chapter 138, Board of Dentistry, section 24.138.509 (5). http://bsd.dli.mt.gov/license/bsd_boards/den_board/pdf/den_rules.pdf (accessed April 19, 2011).