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States across the nation are redesigning their health care systems to promote higher quality health care services, healthier populations, and lower per capita costs. Medicaid and the Children’s Health Insurance Program (CHIP) are playing key roles in health system redesign for the 31 million children enrolled in these programs.

One aspect of health care that has been recognized as a key contributor to overall health, both in childhood and into adulthood, is children’s oral health care. Redesigning the way Medicaid and CHIP approach the specific problem of early childhood caries (ECC, the disease that causes tooth decay) to focus on preventing and managing it rather than paying high bills for cases that become severe, could produce better care, better health, and lower costs. The strategies required are similar to those already in use to prevent or manage other common chronic diseases.