The Smile Alabama! initiative was established to improve access to oral health care in response to decreasing dental provider participation and increasing enrollment of Medicaid-eligible children in Alabama. The initiative has four main components: 1) claims processing, 2) dental reimbursement, 3) provider education and recruitment, and 4) recipient education. The program established a new electronic claims submission system to simplify the process for dental providers and decrease processing time. Through Smile Alabama! dental reimbursement rates were increased to be equivalent with the average regional rates for most procedures. Provider outreach and education includes statewide dental workshops to address policy and billing issues. The program offers provider support materials, including posters, post cards, patient contracts, fee schedules, patient videos, and newsletters. The initiative also uses direct education for consumers to increase awareness among parents and caregivers of eligible children. Statewide education campaigns use radio and television announcements focused on the importance of early care and keeping dental appointments.

The goal of the Smile Alabama! initiative is to improve oral health services for Medicaid-eligible children.

From fiscal year 1999 to fiscal year 2002, enrollment of Medicaid-eligible children increased by 32.7%, with more than 100,000 additional children becoming eligible for dental services. During the same time period, the number of participating dental providers increased by 127 providers, a 38.7% increase. Children receiving dental services increased by 57.1% (from 82,600 to 130,208) , and there was a corresponding 4.8% increase in the annual dental visit rate.