CDC Cooperative Agreement 3022 supports 12 states and 1 territory for capacity building efforts towards implementation of two evidence-based, population-level interventions: community water fluoridation and school-based/school-linked dental sealant programs. One of the activities endorsed by CDC and required of the funded states and territory is the creation and utilization of a state oral health plan, "a roadmap for accomplishing the goals and objectives that have been developed by the state oral health program in collaboration with a range of partners and stakeholders, including the state oral health coalition, members of the public health and dental community, and other relevant groups…Having a state plan will give the state the ability to compete more effectively for resources and opportunities as they arise because they will be able to demonstrate through the plan that they have support mechanisms in place to use the funding for oral health programs."

Children's Dental Health Project recognizes the tremendous value that such a document can do for maintaining and enhancing state priorities, legislative and fiscal, for oral health concerns. As a result, a detailed state oral health plan analysis was conducted to identify both the common themes and unique features of plans for states that currently possess one. 23 states were represented in this analysis: Alaska, Arizona, Arkansas, California, Colorado, Florida, Georgia, Idaho, Illinois, Iowa, Maryland, Michigan, Minnesota, Missouri, Nevada, New Hampshire, New York, North Carolina, Ohio, Pennsylvania, South Carolina, Texas, and Virginia. Most state plans were acquired through the CDC website, though a secondary search was conducted through each individual state's Department of Health website for more current versions. There is no strict definition of a state oral health plan; as a result, some states (Alaska, Arizona, Iowa, Maryland, Minnesota, and Virginia) are represented by 2010 Plans, usually less specific and comprehensive as other oral health plans. 2 other 2010 Plans, from Nebraska and West Virginia, were excluded from the analysis due to their content not fitting in with that of the other 23 plans. Nevertheless, the objectives, recommendations, and strategies compiled from these 23 documents show trends and nuances among states for the primary areas of concern and action regarding oral health improvements.

After acquiring these documents, each plan's strategies, recommendations, or objectives were recorded on an Excel spreadsheet in the specific language used by the creators. Once all of the information was compiled, similar themes were grouped together, such that the categories would be specific enough to be useful to the audience while the total number would be small enough so that quantitative measurements would be possible to determine which areas were viewed as priority areas by the most states. The CDC Oral Health Program Infrastructure Development Tools were included as categories, for their universal relevance to any state seeking to improve its oral health program. Within these 10 activities, Burden Document and Surveillance were combined, Coalitions and Partnerships were combined, and State Oral Health Plan and Policy and Health Systems Strategies were excluded. In addition to the 5 CDC-based categories, other major themes of oral health plans were the raising of awareness of oral health issues, education both in the community and amongst health care professionals, access to care, certain targeted populations, and funding strategies. In total, 20 categories along with 1 miscellaneous grouping comprised the spreadsheet to better understand what priorities and objectives were most often included into the documents, along with unique state-specific recommendations.

Recommendations/Strategies were organized into the following categories:

The most common components included in oral health plans were as follows (# of states out of 23):

State Oral Health Plan Reference Tool