State oral health infrastructure and capacity: lessons learned from other states


  • Note: This publication was supported in part by Grant/Cooperative Agreement 5U58DP001695 from the Centers for Disease Control and Prevention (CDC). Its contents are solely the responsibility of the authors and do not necessarily represent the official view of the CDC.

Ms. Beverly A. Isman, Association of State and Territorial Dental Directors, 212 Huerta Place, Davis, CA 95616. Tel.: 530-758-1456; Fax: 530-759-7089; e-mail: Beverly A. Isman, Reginald Louie, Kathy R. Phipps, Betty J. Tatro, Kathleen Mangskau, and Donald W. Marianos are with the Association of State and Territorial Dental Directors.


This paper discusses some preliminary findings from the Infrastructure Enhancement Project conducted by the Association of State and Territorial Dental Directors (ASTDD), which focuses on state oral health programs and their roles in addressing core public health functions and essential public health services. Findings from analysis of state data since 2000, surveys, reports, and key informant interviews substantiate the value of the following: a) state oral health surveillance; b) oral health improvement plans; c) collaborations and coalitions; d) evidence-based practices and evaluation; e) diversified funding; f) placement and authority of the programs and directors; and g) competencies versus staffing formulas. No single program model fits all the unique populations and political and economic variations among states. Each state is encouraged to use the many tools, resources, and best practices/lessons learned available through ASTDD, federal agencies, and national organizations to design effective and sustainable programs.