(2) If the child does not have such a source of ongoing care and health insurance coverage or access to care through the Indian Health Service, the program must assist families in accessing a source of care and health insurance that will meet these criteria, as quickly as possible.
(i) Obtain determinations from health care and oral health care professionals as to whether or not the child is up-to-date on a schedule of age appropriate preventive and primary medical and oral health care, based on: the well-child visits and dental periodicity schedules as prescribed by the Early and Periodic Screening, Diagnosis, and Treatment (EPSDT) program of the Medicaid agency of the state in which they operate, immunization recommendations issued by the Centers for Disease Control and Prevention, and any additional recommendations from the local Health Services Advisory Committee that are based on prevalent community health problems;
Health through oral health : guidelines for planning and monitoring for oral health care by C Ross;
(2) A program must implement periodic observations or other appropriate strategies for program staff and parents to identify any new or recurring developmental, medical, oral, or mental health concerns.
(3) A program must facilitate and monitor necessary oral health preventive care, treatment and follow-up, including topical fluoride treatments. In communities where there is a lack of adequate fluoride available through the water supply and for every child with moderate to severe tooth decay, a program must also facilitate fluoride supplements, and other necessary preventive measures, and further oral health treatment as recommended by the oral health professional.
(2) A program must develop a system to track referrals and services provided and monitor the implementation of a follow-up plan to meet any treatment needs associated with a health, oral health, social and emotional, or developmental problem.
(2) A program may use program funds for professional medical and oral health services when no other source of funding is available. When program funds are used for such services, grantee and delegate agencies must have written documentation of their efforts to access other available sources of funding.
A program must promote effective oral health hygiene by ensuring all children with teeth are assisted by appropriate staff, or volunteers, if available, in brushing their teeth with toothpaste containing fluoride once daily
(i) Learn about preventive medical and oral health care, emergency first aid, environmental hazards, and health and safety practices for the home including health and developmental consequences of tobacco products use and exposure to lead, and safe sleep;
(i) Health care providers, including child and adult mental health professionals, Medicaid managed care networks, dentists, other health professionals, nutritional service providers, providers of prenatal and postnatal support, and substance abuse treatment providers;
(c) A program must facilitate the ability of all enrolled pregnant women to access comprehensive services through referrals that, at a minimum, include nutritional counseling, food assistance, oral health care, mental health services, substance abuse prevention and treatment, and emergency shelter or transitional housing in cases of domestic violence.
Emphasis for cleaning and disinfection should be placed on surfaces that are most likely to become contaminated with pathogens, including clinical contact surfaces (e.g., frequently touched surfaces such as light handles, bracket trays, switches on dental units, computer equipment) in the patient-care area. When these surfaces are touched, microorganisms can be transferred to other surfaces, instruments or to the nose, mouth, or eyes of DHCP or patients. Although hand hygiene is the key to minimizing the spread of microorganisms, clinical contact surfaces should be barrier protected or cleaned and disinfected between patients. EPA-registered hospital disinfectants or detergents / disinfectants with label claims for use in health care settings should be used for disinfection. Disinfectant products should not be used as cleaners unless the label indicates the product is suitable for such use. DHCP should follow manufacturer recommendations for use of products selected for cleaning and disinfection (e.g., amount, dilution, contact time, safe use, and disposal). Facility policies and procedures should also address prompt and appropriate cleaning and decontamination of spills of blood or other potentially infectious materials. Housekeeping surfaces, (e.g., floors, walls, sinks) carry less risk of disease transmission than clinical contact surfaces and can be cleaned with soap and water or cleaned and disinfected if visibly contaminated with blood.
Blue Cross and Blue Shield of North Carolina does not discriminate on the basis of race, color, national origin, sex, age or disability in its health programs and activities. Learn more about our non-discrimination policy and no-cost services available to you.
The U.S. Public Health Service Oral Health Coordinating Committee authored the Framework to provide the context for leveraging current and planned oral health priorities and actions across HHS and partner agencies. The Framework aligns key activities with five major goals and associated strategies in response to recommendations from two 2011 Institute of Medicine reports, Advancing Oral Health in America and Improving Access to Oral Health Care for Vulnerable and Underserved Populations,1,2 and reflects discussions with external stakeholders. Although the Framework does not attempt to inventory all oral health initiatives supported by HHS and other federal partners, it provides a roadmap to prevent oral disease, increase access to services, develop and disseminate oral health information, advance public policy and research and translate it into practice, strengthen the oral health workforce, and eliminate oral health disparities.
This separation of services results in a lack of integration between medical and dental records, a lack of use and acceptance of dental diagnostic codes, and separate insurance coverage and payment systems, treatment delivery, and health-care systems. Greater interprofessional education and collaborative practice could help integrate oral and primary health care and improve patient-centered care. Although community and clinical approaches have been shown to reduce oral diseases, lessen dental care costs, and improve the quality of individuals' lives, these approaches are not being used to the greatest extent possible.1,16
The cost of dental care and lack of dental coverage are often cited as reasons individuals do not seek needed dental care.17 Publicly financed reimbursement programs covering the provision of oral health services are often limited in scope or are nonexistent for adults. For example, Medicare provides 22 preventive screenings for eligible individuals but does not include oral health services. Medicare is limited in its scope of coverage for dental care and, typically, dental care must be related to a covered medical procedure provided in a hospital setting. Although most state Medicaid programs cover emergency dental procedures for low-income adults, only 28 U.S. states provide dental benefits to Medicaid-enrolled adults beyond medically necessary care in emergency circumstances.18 Emergency room treatment for preventable dental conditions, estimated at 830,000 visits in 2009, is expensive and continues to increase.19 In addition, the geographic distribution of dentists varies substantially. In 2011, the number of dentists per 10,000 population ranged from 4.2 (in Arkansas and Mississippi) to 10.8 (in the District of Columbia).20
HRSA will develop a set of oral health core clinical competencies for primary care clinicians, delineate the elements that influence the implementation and adoption of competencies, and outline the basis for implementation strategies and translation into primary care practices in safety-net settings. HRSA will also promote oral health education and training among primary care providers by developing and implementing a human immunodeficiency virus (HIV)/acquired immunodeficiency syndrome (AIDS) oral health curriculum targeting primary care providers. (Strategy 1-B)
Americans are healthier because of preventive efforts such as community water fluoridation and dental sealants, which reduce both the prevalence and severity of tooth decay. Children receiving dental sealants in school programs have 60% fewer cavities on treated surfaces after placement of a sealant.43,44 Community water fluoridation is a cost-saving measure; it is estimated that every $1 invested in fluoridation yields about $38 in savings from fewer cavities treated.45 As a result of preventive efforts and improved oral health care, baby boomers will be the first generation to largely maintain their natural teeth during an entire lifetime.46
Multiagency efforts by CDC, CMS, and HRSA also encourage states to incorporate oral health innovations in their efforts to redesign their health-care delivery systems, support payers and funders to design and implement payment and funding approaches that favor prevention and better health outcomes, and encourage cooperation between payers and funders to magnify the effects of available dollars. (Strategy 2-B)
CDC and HRSA coordinate program oversight and monitoring of related oral health programs, increase communication and knowledge sharing between project officers, and hold regularly scheduled discussions across agencies. CDC, HRSA, and SAMHSA build and/or maintain effective public health capacity for implementation, evaluation, and dissemination of best practices for preventing and improving oral health, and deliver joint webinars and coordinate technical assistance to state grantees. (Strategy 2-C)
Identifying dental providers who accept Medicaid and other public dental insurance can be difficult.53 Transportation and finding participating providers are significant barriers for low-income or rural populations.54 According to the recent Pew report, data from several states revealed that only 10% to 20% of dentists accept patients who are covered through Medicaid. The major reason for this low participation in Medicaid was inadequate reimbursement rates.53 In addition, lack of understanding and emphasis on the importance of oral health and oral health care by individuals and health professionals can be a significant barrier to accessing such care.55 Supporting individuals to navigate the existing oral health-care system for timely and affordable care is critical. 2ff7e9595c
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