By Dr. Jonathan Rich
KDA Editor

As the editor of this dental journal, it is my privilege to share an update on the Kentucky Department for Public Health’s ambitious endeavor to craft the 2026-2031 Oral Health Strategic Plan. This initiative marks a pivotal moment in our state’s ongoing commitment to improving oral health outcomes, building on a legacy that began with Kentucky’s first oral health plan in 1928 and the historic introduction of fluoridated water in Maysville in 1951. The forthcoming plan, modeled after the Kentucky State Health Improvement Plan, aims to create a data-informed, equitable, and actionable framework to address the oral health challenges facing Kentuckians over the next five years. On September 15, approximately 100 oral health advocates convened in Frankfort, under the directive of Dr. Julie McKee, to initiate the process.

A Vision for Optimal Oral Health

The 2017-2022 Oral Health Strategic Plan set a bold vision: Optimal Oral Health for a Lifetime of Smiles. Its purpose was to foster oral health equity through collaboration, focusing on access to care, education, workforce readiness, and resource efficiency. That plan established workgroups tackling critical areas such as workforce development, data metrics, inter-professional collaboration, and prevention. Notable achievements included expanding the Public Health Dental Hygiene Program, which now operates 14 teams across 105 schools, delivering 67,892 preventive services to 11,493 patients in 2023. However, challenges persist, as evidenced by a 33% decay prevalence among screened children and caries rates among early learners — particularly in Eastern and South-Central Kentucky — exceeding national averages.

The 2026-2031 plan builds on this foundation, refining the vision and purpose through stakeholder input. Attendees affirmed and revised the purpose and vision, identified three-to-five statewide priority areas, and outlined draft goals. The process will be driven by data, including insights from a 2023 survey of 6,000 early learners and a 2025 oral health survey with 191 responses, which highlighted the urgent need for increased access to care, especially for underserved populations.

Key Priorities and Emerging Goals

The 2026-2031 plan centers on four main categories: Policy, Access, Prevention, and Workforce Development. These priorities reflect the state’s commitment to addressing acute and chronic trends impacting oral health, informed by data and stakeholder feedback. Below are some initial ideas shaping the plan:

Policy: Strengthening Medicaid reimbursement rates, maintaining coverage, and updating provider lists among managed care organizations (MCOs) to ensure accuracy. Policy efforts will also combat fluoride misinformation and advocate for sustainable loan repayment programs to attract and retain dental professionals.

Access: Expanding care for underserved and low-income populations, as well as those with special needs and disabilities. Strategies include increasing access through increasing the number of pediatric dentists, exploring teledentistry and mobile dentistry, and addressing barriers cited in the 2023 survey, such as practices discontinuing Medicaid acceptance.

Prevention: Continuing water fluoridation, expanding silver diamine fluoride (SDF) use, and modernizing prevention models. The plan emphasizes early intervention through oral hygiene instruction starting in childhood and pregnancy, alongside enhanced school-based sealant programs and kindergarten screening reforms to ensure treatment follow-up.

Workforce Development: Incentivizing dentists to serve in underserved areas through income tax reductions, loan repayment programs, and mentorship initiatives. The plan also explores expanding training for dental auxiliaries and mid-level providers to bolster workforce capacity.

Data-Driven Insights

The 2023 and 2025 surveys provide critical insights. The 2023 screening of 6,000 early learners revealed higher-than-average caries rates with Eastern and South-Central Kentucky facing elevated risks. Demographic and socioeconomic disparities further underscore the need for targeted interventions. The 2025 survey identified access to care as the top priority, with respondents advocating for increased fluoridation, better education, and affordable care. These findings will guide the development of measurable goals and metrics, including potential integration of oral health data into the Kentucky Health Information Exchange, despite software challenges.

Collaborative Path Forward

The strategic planning process is collaborative, workgroups were assigned to each priority area. Each group, led by a designated leader, will refine draft statements articulating the need and desired outcomes for their focus area. Initial feedback has highlighted potential overlaps, such as between prevention and access, which will be addressed to avoid duplication. The next steps include setting workgroup meeting dates and finalizing goals that specify the who, what, when, where, and why of implementation.

A Call to Action

During development of the 2026-2031 Oral Health Strategic Plan, we invite the dental community to engage in this transformative process. By addressing disparities, enhancing access, modernizing prevention, and strengthening our workforce, we can achieve a future where every Kentuckian enjoys optimal oral health. Together, we can ensure a lifetime of smiles for all.

Stay tuned as the plan is refined and works toward a healthier Kentucky.