VolUME 1 • IssUE 2 - oNlINE

P.O. BOX 659010

Sacramento, CA 95865-9010

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ProviderRelations@premierlife.com

www.PremierLife.com

Fall-Winter 2011oNlINE

IN THIS ISSUE:

Periodicity Schedule for Children . . . . . . . . . . . . . . . . . . . . . . . pg. 1

Premier Access Outreach . . . . . . . . . . . . . . . . . . . . . . . pg. 1

Tweet. Yelp. Squawk. . . . . . . . . . . . . . . . . . . . . . . pg. 2

Dental Home by Age 1 Year . . . . . . . . . . . . . . . . . . . . . . pg. 3

New Infection Control Regulations . . . . . . . . . . . . . . . . . . . . . . pg. 4

Oral Health Ad Campaign . . . . . . . . . . . . . . . . . . . . . . pg. 4

Peptide As Early Intervention . . . . . . . . . . . . . . . . . . . . . . pg. 5

New Diabetes Screening Process . . . . . . . . . . . . . . . . . . . . . . pg. 5

Transmitting X-rays . . . . . . . . . . . . . . . . . . . . . . pg. 6

Faster Claims Turn-Around: . . . . . . . . . . . . . . . . . . . . . . pg. 6

Save Time: Go Online . . . . . . . . . . . . . . . . . . . . . . pg. 7

Periodicity Recommendations . . . . . . . . . . . . . . . . . . . . . . pg. 8

Periodicity schedule for Children

“Federal law governing the provision of dental services to children under Medicaid’s Early and Periodic Screening, Diagnosis and Treatment (EPSDT) program requires that dental services be provided in accordance with a dental periodicity schedule. This schedule must recommend treatment intervals that meet reasonable standards of dental practice. The dental periodicity schedule reflects the ages and intervals at which a child should receive specified dental services.”

The AAPD periodicity schedule outlines best practices recommended by the Association and addresses periodicity and general principles for

• Examination• Preventivedentalservices• Anticipatoryguidance/counseling• Oral treatment for children who have

no contributory medical conditions The periodicity of professional oral health inter-

vention and services is based on a patient’s individual needs and risk level. Each age group has specific de-velopmental needs and a specific interval as part of comprehensive evaluation. Combined with caries risk assessment level, the periodicity schedule is part of a basic caries management treatment strategy. Any program providing dental benefits for children will benefit from these processes: Medicaid, CHIP, and the developing essential pediatric benefits package within the Health Care Reform.

Note:Recommendedtreatmentsand/orfrequen-cies may not be covered benefits in all Programs. The AAPD Periodicity Schedule can be found at the end of this newsletter.

Source: Guidelines on Periodicity of Examination, Preventive Dental Services, Anticipatory Guidance/Counseling, and Oral Treatment for Infants, Children, and Adolescents. American Academy of Pediatric Dentistry. Clinical Guidelines; revised 2009.

The complete document is available at http://www.aapd.org/media/Policies_Guidelines/G_Periodicity.pdft

Further sources for this article appear on Page 8.

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PrEMIEr PIPElINEN e w s & I N f o r m a t I o N f o r P r o v I d e r s

Premier Access/Access Dental Plan has reviewed the periodicity schedule of the American Academy of Pediatric Dentistry (AAPD) (which is adopted by California Medi-Cal Dental Program) and recommends that the network providers follow these guidelines when planning treatment for covered children.

YoUr CoMMUNICatIoN CoNNECtIoN

D e n t a l a n d V i s i o n

Premier access outreach support

Seeing that the underserved in our communities receive necessary dental care is a high priority for Premier Access. We work with several organizations such as Healthy Families and Healthy Kids to ensure that the children who need these types of services get the support they require. One of the ways we provide thishelp is through our team of Certified Application Assistors (CAA), who are available to help potential members through the sometimes-com-plicated process of enrolling in a state-sponsored health program.

OurCAAsworkwithapplicantstohelpensurethat all of the submitted information is complete and correct so that the application will have a better chance of being accepted the first time, reducing rejection and the need for re-filing. These individuals have been given the training needed to ensure things are done right – the first time. And they each have the people skills necessary to create an environment of comfort and trust with the potential member.

There is a network of CAAs who keep in touch with one-another through regular conferences, sponsored by health organizations and companies that are involved in this type of outreach. At these conferences,speakersprovidecontextforthejobsthe CAAs do…giving them an idea of how much impact they can have within the community. To ensure that the speakers provide relevant information, a “pre-survey” is conducted and workshops and lectures are designed based on the needs of the attendees.

Santa Barbara Healthy Kids held a conference recently in Buellton, California. Representatives of Premier Access attended and were available to answer questions and provide information. The sharing of information is key to building a strong CAA network and Premier Access will continue to provide this type of support, building on our commitment to the underserved.

How can you avoid negative noise? Social media is a new phenomenon and there are no real guidelines…but here are a few things you can do to help avoid the negative noise:

1. accept that this form of communication is here to stay and that it is not just “the kids” who are active participants. Anyone with Internet access can let the world know what’s on his or her mind.

2. Monitor social media regularly to ensure you are aware of any comments about you, your staff or your practice. You probably won’t be able to have a negative review removed, but you need to know it’s there.

3. Give your patients options (when possible); allow them to be a part of the decision-making process. The number one patient complaint is a feeling of being manipulated into purchasing services that are more expensivethantheyfeelisnecessary.

4. Make sure you provide complete information about anytreatment.Explainwhatyou’redoingandwhy.Aninformed patient usually will be a more satisfied patient.

5. anticipate the patient’s need to be heard. Create a short survey asking for opinions on how they were treated and what you can do to make their visits better. Remember, it’s important that you take positive action afterward so that the patient knows you’re listening.

6. let your patients know you care about their comfort and well-being. It’s an old-fashioned solution in a new-fangled world.

Also, don’t forget you can use social media as a marketing tool. In the same way your patients are using this form of communication to give their opinions, you can use it to create interest in you and your practice. It’s a new world. Instant communication can be a blessing or a curse – it all depends on how you look at it.

Provider surveys. Premier Access gives you the opportunity to communicate your opinions through our email Provider Surveys. We appreciate your comments and use them to enhance the services we provide you. It’s easy to participate – just make sure our Provider Services Department has your most current email address and you will be included. And when you receive the survey, be sure to respond … your input is important to us.

1. http://www.silicon.com/technology/mobile/2011/04/01/social-network-accounts-outnumber-people-on-earth-39747241/

2. N. Heaivilin, B. Gerbert, J. E. Page, J. L. Gibbs. Public Health Surveillance of Dental Pain via

tweet. Yelp. squawk. What all this noise means to you

If you have not already been impacted by some aspect of social media, there’s a good chance you will be in the future. Market analyst group In-Stat announced in April this year that there are now more social-networking accounts than there are people in the world.

Social media has given people a platform to communicate whatever and whenever they choose. Facebook, Twitter, Yelp, Amy’s List and other similar services are set up to allow people to share information, ideas and opinions. Yelp alone reported more than 53 million unique visitors in June 2011.1

These avenues of communication are used every day formyriadreasons.Asanexample,theJournalofDentalResearch (the official publication of the International and AmericanAssociationsforDentalResearch(IADR/AADR)published a study titled “Public Health Surveillance of Dental Pain via Twitter.” Researchers demonstrated that Twitterusersareextensivelysharingtheirexperiencesoftoothache and seeking advice from other users.2

In California recently, an angry father created a Facebook page with the sole purpose of closing down the office of a dentist he felt had mistreated his son. While most issues do not go this far, one bad “review” on Yelp or Amy’s List can reach hundreds of current or potential patients in your area.

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Premier PIPELINE

From the Yelp website...

“Yelpers have written more than 20 million local reviews, making Yelp the leading local guide for real word-of-mouth on everything from boutiques and mechanics to restaurants and dentists.”

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Fall-Winter 2011

• Referring to dental specialists when care cannot directly beprovided by the dental home.

The AAPD advocates interaction with early intervention programs, schools, early childhood education and childcare programs, members of the medical and dental communities, and other public and private community agencies to ensure awareness of age-specific oral health issues.

The Medi-Cal Dental Services Division (MDSD) strongly encourages all Dental Plans to follow the AAPD guidelines and educate their providers on the importance of establishing the dental home and providing dental care for children by age 1 year.

Source: http://www.aapd.org/media/Policies_Guidelines/P_DentalHome.pdf

Premier access/ access Dental Plan recognizes the aaPD policy of establishing the dental home by age 1 year and recommends that providers follow the policy and guidelines set by the AAPD for providing dental care to children by the age of 1 year. In addition, the AAPD guidelines suggest that health care professionals be supportive of the selection of dental home for all infants at 1 year of age.

Pilot Initiative.PremierAccess/AccessDentalincollaborationwith the Healthy Families Program (MRMIB), the Center for Health Care Strategies, and participating Healthy Families Dental Plans has started a dental home pilot initiative for the California Healthy Families children by age 24 months in target counties of Los Angeles, San Diego, Santa Barbara, and Ventura. The collaboration’s goal is to increase awareness of the importance of oral health and secure comprehensive, ongoing dental care from a consistent provider (a dental home) for Healthy Families children with the specific target to increase the percentage of young children who have established a dental home by age 24 months.

There are two primary challenges to improving dental health among Healthy Families children:

• Many parents, caregivers and educators are unaware of theimportant role early dental visits and an established dental home play in preventing dental problems.

• There are unique challenges to providing dental care toyoung children. Many general dentists and hygienists are not comfortable welcoming the youngest children into the office.

We will be working with the collaboration on family education and outreach materials, as well as strategies to increase the number of participating dentists providing successful dental homes for these youngest members.

Complete guidelines on infant oral health care available on the AAPD website. http://www.aapd.org/media/Policies_Guidelines/G_InfantOralHealthCare.pdf

Dental Home by age 1 Year The Centers for Disease Control and Prevention reports that the

most prevalent infectious disease for our nation’s children is dental caries. More than 40 percent of children have caries by the time they reach kindergarten. Although dental caries prevalence has declined significantly among school-aged children since the early 1970’s, caries rates in children aged 2-5 years has increased.

Source: Guideline on Infant Oral Health Care. CLINICAL GUIDELINES AMERICAN ACADEMY OF PEDIATRIC DENTISTRY http://www.aapd.org/media/Policies_Guidelines/G_InfantOralHealthCare.pdf Reference: Dye BA, Arevalo O, Vargas CM, Trends in paediatric dental caries by poverty status in the United States, 1988- 1997 and 1994-2004. Int J Paediatric Dent 20(2):132-43. 2010.

oral Health Care For Infants. The American Academy of Pediatric Dentistry (AAPD) led the way in 1986 by releasing guidelines on infant oral health care that recommended infants have an oral evaluation within 6 months of the eruption of the first primary tooth or by 12 months of age.

The American Dental Association (ADA) issued a statement emphasizing children’s susceptibility to decay as soon as their teeth erupt. The ADA also joined the AAPD in recommending dental care for infants by 12 months of age along with education for parents and caregivers on ECC prevention. The American Academy of Pediatrics (AAP) subsequently issued a policy statement in 2003 recommending oral health assessments by trained health professionals beginning at 6 months of age and establishment of “dental homes” for high-risk infants by age 1.

Source: Preventing Early Childhood Caries: Lessons from the Field. Amy Brown, MPH1 Elizabeth Lowe, RDH, MPH2 Beth Zimmerman, MHS3 James Crall, DDS, ScD4 Mary Foley, RDH, MPH5 Mark Nehring, DMD, MPH

Establishment of a dental home should begin no later than 12 months of age and includes referral to dental specialists when appropriate. The dental home provides time-critical opportunities to implement early preventive health practices and reduces the child’sriskofpreventabledental/oraldisease.

Source: http://www.aapd.org/media/Policies_Guidelines/D_DentalHome.pdf

The AAPD encourages parents and other care providers to help every child establish a dental home by twelve months of age.

According to the AAPD, a dental home should provide comprehensive oral health care including

• Acutecare• Preventive services in accordancewith theAAPDperiodicity

schedules• Comprehensiveassessmentoforaldiseasesandconditions• Individualizedpreventiveproceduresbaseduponperiodontal

and caries risk-assessment • Anticipatory guidance about growth and development issues

(i.e., teething, digit or pacifier habits) • Dentaltrauma• Informationonchildteethandgingivae• Dietarycounseling

The AAPD defines the dental home as “the ongoing relationship between the dentist and the patient, inclusive

of all aspects of dental health care delivered in a comprehensive, continuously accessible, coordinated, and

family-centered way.”

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Premier PIPELINE

New Infection-Control in California

OnAugust20,2011newinfection-controlregulationstookeffect in California. These changes will impact your practice; it’s important that you are aware of the new rules to ensure you are in full compliance.

The Dental Board of California does not contact dental licensees to inform them of new regulations. They expectdentists to check the dental board website to stay informed of any changes.

The California Dental Association (CDA) has made an effort to inform members through CDA’s monthly news magazine, online resources, email, and local dental society newsletters, according to an association spokesperson.

the ChangesThere are a number of changes, some of which we have

noted below.

• Utility gloves that are chemical and puncture-resistant must now be worn by anyone working with germicides or hazardous chemicals and when processing contaminated instruments.

• Instrument pouches, packages and wraps must be labeled with the date of sterilization and sterilizer used (if an office has more than one sterilizer).

• Instruments, items and devices processed by high-level disinfection (cold sterile) must be packaged or wrapped and dated upon completion of the disinfection process.

• Hand-washing with soap and water must be performed at the start and end of each workday. Alcohol-based hand rubs may still be used in-between glove changes as long as hands are not visibly soiled or contaminated.

• Protective eyewear and face shields must be cleaned and disinfected after each patient treatment.

There are also changes to help clarify who the rules apply to. “Dental workers” is now “Dental Healthcare Personnel,” which broadens the scope of who might be exposed toinfectious materials while working in a dental office.

For complete information about this important regulation revision, logon to the Dental Board website. (http://www.dbc.ca.gov/lawsregs/index.shtml)

Premier Access protocols require compliance with all infection control policies.

The Ad Council is set to create a series of public service ads focusing on oral health literacy, backed with more than $3 million in funding from a coalition of U.S. dental organizations.Expecttostartseeingoral health “PSAs” early next year;the campaign will continue into 2015.

The concept for this campaign began with the Partnership for Healthy Mouths, Healthy Lives dental coalition, which is led by the Dental Trade Alliance Foundation and includes a broad range of oral health professional, trade, and advocacy organizations.

These PSAs are set to target national, state, and local officials, healthcare providers, and members of underserved communities. They will also reach out to those impacted by the recession who might be tempted to skip a dental appointment.

The goal is to increase the number of people in a dental home by an additional 5 percent.

$3M U.s. ad Campaign targets oral Health awareness

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Fall-Winter 2011

New Diabetes screening Process

Most recent data from the American Diabetes Associa-tion® indicates that there are currently 7 million people who have diabetes – and don’t know it. In addition, there are 79 million who are pre-diabetic. Early diagnosis is essential to help ensure that people suffering from this chronic disease receive the treatment they need to avoid serious health con-sequences, one of which can be periodontal disease.

Researchers at Columbia University College of Dental Medicine conducted a study based on the supported assumption that dental visits represented a chance to intervene in the diabetes epidemic by identifying individu-als with diabetes or pre-diabetes who are unaware of their condition.

Recruiting individuals identified as part of an at-risk dental population, a simple algorithm composed of only two dental parameters (number of missing teeth and percentage of deep periodontal pockets) was effective in identifying patients with unrecognized pre-diabetes or diabetes. The addition of the point-of-care A1c test was of significant value, further improving the performance of this algorithm.

“Early recognition of diabetes has been the focus of efforts from medical and public health colleagues for years, as early treatment of affected individuals can limit the development of many serious complications,” says Dr. Evanthia Lalla, an associate professor at the College of Dental Medicine, and the lead author on the paper. “Relatively simple lifestyle changes in pre-diabetic individuals can prevent progression to frank diabetes, so identifying this group of individuals is alsoimportant,”sheadds.“Ourfindingsprovideasimpleapproach that can be easily used in all dental-care settings.”

Columbia University Medical Center (2011, July 15). Dentists Can Identify People With Undiagnosed Diabetes. Medical News Today. Retrieved September 7, 2011 from http://www.medical-newstoday.com/releases/231124.php

American Diabetes Association Statistic http://www.diabetes.org/diabetes-basics/diabetes-statistics/

Introducing…Premier access Provider servicesProvider Services is a department dedicated solely to the support of

dental care professionals within the Premier Access and Access Dental networks. Staffed by knowledgeable and friendly individuals, these representatives are available to assist with questions regarding our plan policies and procedures; claims research and contract processing.

Each Provider Services Representative is paired with a Provider Relations Field Representative to assist in recruiting and maintaining our provider networks throughout the United States.

To ensure we are meeting the needs of both our contracted dentists and our members, the team monitors member accessibility to our network providers, gathers and reports data for network disruptions and competitor comparisons.

The Provider Services Department is an integral part of the service and care we provide to our networks of dentists. The Representatives look forward to assisting our member dentists … call us at 800.646.4466 if we can help you.

Peptide as Early Intervention

Researchers at the University of Leeds (United Kingdom) have developed what may be an innovative way to treat the firstsignsoftoothdecay.Theyhavebeenexperimentingwith a peptide-based fluid which is painted on the tooth’s surface, stimulating regeneration of the tooth defect.

“This may sound too good to be true, but we are essentially helping acid-damaged teeth to regenerate themselves. It is a totally natural non-surgical repair process and is entirely pain-free too,” said Professor Jennifer Kirkham, from the University of Leeds Dental Institute, who has led development of the new technique.

The peptide solution was created by researchers in the University of Leeds’ School of Chemistry, led by Dr. Amalia Aggeli. It contains a peptide known as P 11-4 that - under certain conditions - will assemble together into fibers. In practice, this means that when applied to the tooth, the fluid seeps into the micro-pores caused by acid attack and then spontaneously forms a gel. This gel then provides a framework that attracts calcium and regenerates the tooth’s mineral from within, providing a natural and pain-free repair.

The technique has been tested on a small group of adults whose teeth showed initial signs of tooth decay. The result from this small trial has been positive and shows there is good possibility that P 11-4 can reverse tooth damage and regenerate the tissue.

Paula Gould (2011, August 24). Pain-Free Repair Of Teeth With New Peptide Fluid. Medical News Today. Retrieved September 7, 2011 from http://www.medicalnewstoday.com/releases/233254.php

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Premier PIPELINE

New Website … new look … new features … new functionality!

Check it out today!www.Premierlife.com

Faster Claims turn-around: ePayment

InOctober2011PremierAccesspartneredwithEmdeontobringEFT (Electronic Funds Transfer) to our contracted dentists. EFT is safer – a more secure and efficient method of payment.

Payment is deposited directly into your designated bank account.

There are several reasons you will want to take advantage of this new service:

•Fasterclaimsturnaroundtime–helpscashflow

•“Handling”timeeliminated–nomail,nobankdeposits,etc.

•Simplifiesreconciliation–real-timeclaimsstatusandtracking

•Nocosttoyou!

Enroll today: online, by fax, by phone or by mail.Online: emdeondental.comFax: 615.340.6107Phone: 888.255.7293 Mail: EmdeonAttn: Dental Provider Enrollment 220 Burnham St. S. Windsor, CT 06074-4128

For fax or mail, print the EFT enrollment form found onemdeondental.com.

For more information, you can contact Premier Access Provider Services at 800.646.4466, go online to emdeondental.com or call Emdeon directly at 877.363.3666.

transmitting X-rays and other attachments

For several years, Premier Access and National Electronic Attachment, Inc. (NEA) have worked together to offer the FastAttach system to expedite the transmission andreview of important documentation such as x-rays, EOBs,perio-charting, etc., in support of electronic claims processing. For a monthly flat fee you will get unlimited attachment transmissions to Premier Access and over 500 other payors (no “per attachment fee”).

But you should know that FastAttach is more than just an electronic attachment transmission service. It is a way to manage your attachments. Instead of spending time sending unnecessary attachments, you can use a unique feature of FastAttach called FastLook. This feature provides you with the attachment requirements for all procedure codes for each payor. The attachments transmitted using FastAttach will automatically create a tracking number, which provides confirmation of receipt and a tracking mechanism for those attachments. All transmitted attachments can be viewed online in the patient attachment history. You can even securely share attachments with other dental offices and be within HIPAA regulations. NEA provides unlimited customer service and training for those capabilities and more at no additional charge.

To learn more about NEA’s Dental Services, go to www.nea-fast.com. From there, you can browse the NEA website for additional information, view videos by clicking “Learn More”, and register online by clicking the “FastAttach Registration” button. If you prefer to talk to a NEA Representative, call 800-782-5150 opt 2.

NEA is offering Premier Access providers a special promotion for FastAttach. Register by December 31, 2011 and your office will not have to pay the $200 Registration fee. When registering, use the promotion code PREMLZ. The FastAttach service plan is only $25/mo per office location.

save time: Go online Did you know you can access your claims information on

the Premier Access website (www.premierlife.com) Click on “Provider” and register for a user name and password.

Onceyou’veregistered,youwillbeableto...

• View and print your claims information includingacknowledgement of receipt and payment information

• Viewmembereligibilityinformationforyourpatients• Viewandprintmemberbenefitsinformation• Viewandprintyourmonthlyroster• Checkpre-authorizationstatus• Getup-to-dateReferralGuidelinesinformation• Downloadorprintproviderformssuchas o Provider Manuals/Dentist Handbook/Reference

Guides o Provider Agreements o W-9 Forms o Provider Dispute Resolution Mechanism Form o Referral and Claim forms

More online services are currently in the works ... along with a new website look and improved functionality. We continue to work to provide you with tools to make your office administration easier.

EDI services

To facilitate your claims submissions, Premier Access works with three different clearinghouses: Emdeon, Tesia and EHG.ThePayorIDforPremierAccessPPO,DHMOandPremier Healthy Families is CX078. Utah CHIP, claims can be submitted through Emdeon with Payor ID CX110.

New GroupsPremier Access continues to add new groups, which means more members are being marketed to your practice. The groups listed below

are those with more than 100 members.

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Bridgewater Healthcare, Inc.

CBA Site Services

Cels Enterprises, Inc.

Check Agencies of California

CMG Mortgage, Inc.

CommuniCare Health Centers

Community Housing Works

Cork Supply USA, Inc.

Crimson Midstream LLC

EdeniQ, Inc.

FCE Benefit Administrators, Inc.

First Alarm

Goodwill Industries of the Redwood Empire

Harvest Christian Fellowship

HELP of Southern Nevada

Kagome, Inc.

Koinonia Foster Homes, Inc.

L.A. Gauge Company

Labels Unlimited, LLC

Lakeview Professional Services

Lincoln Training Center

M. Caratan, Inc.

Meraki, Inc.

Monterey Bay Oncology

Monterey City Disposal Service, Inc..

Nor-Cal Beverage Company, Inc.

Outsource Fleet Services, Inc.

Planet Bingo, LLC

Polycomp Administrative Services, Inc.

Presentation Products, Inc.

Richard Iest Dairy, Inc.

San Francisco Federal Credit Union

Simonich Corp.

Sun City Summerlin Community Association

Sun Valley Growers

Taurus Roof Services, Inc.

The Lagunitas Brewing Company

Traffic Control & Safety Corporation

Training and Research Foundation

UGS America Sales, Inc.

Universal Site Services

Valley Administrators - Northern California Plasterers Health & Welfare Trust Fund

Valley Business Bank

Venbrook Insurance Services

Your comments and suggestions are always welcome. Please contact us at ProviderRelations@PremierLife.com

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Premier Pipeline is published by Premier Access Insurance Company and Access Dental Company, for the sole use of their contracted providers.

Board of Directors

Reza Abbaszadeh, DDS, Director, Secretary, Chairman of the Board & CEO Emery Dowell, Director, Retired Senior Vice President and Director of Blue Cross of California Arulkannan Kothandaraman, Director; CEO of Data Telesis John Ramey, Director; Executive Director of the Local Health Plans of California Richard Fulton, Director; Chief Marketing Officer of Premier Access Debra Abbaszadeh, Director; Owner of Simple Wishes Jeffery Elder, Director; Consultant, Self-employed

Senior Staff

Reza Abbaszadeh, DDS, President and CEO Robin Muck, Chief Operating Officer Richard Fulton, Chief Marketing Officer Tyrette Hamilton, Senior Vice President of Product Development & Management Lorri Badten, Chief Operating Officer of Clinic Operations

Dental Director

Dr. Laila Baker, DDS, MSD

Provider Relations Team

Lynn Thompson, Director Cathy Mack –Riverside, San Bernardino counties, Nevada, Arizona Kathy Butler – Los Angeles County, Virginia Jessica Mirabella, Northern California, Utah Joseph Canas – Ventura, Santa Barbara counties, New Jersey, Central Valley , Pennsylvania Amanda Yoakam – Orange, San Diego counties, Ohio, Texas

Periodicity Copyright © 2010-2011 by the American Academy of Pediatric Dentistry and reproduced with their permission.

Recommendations for Pediatric Oral Health Assessment, Preventive Services, and Anticipatory Guidance/Counseling

Since each child is unique, these recommendations are designed for the care of children who have no contributing medical conditions and are developing normally. These recommendations will need to be modified for children with special health care needs or if disease or trauma manifests variations from normal. The American Academy of Pediatric Dentistry (AAPD) emphasizes the importance of very early professional intervention and the continuity of care based on the individualized needs of the child. Refer to the text of this guideline for supporting information and references.

1 First examination at the eruption of the first tooth and no later than 12 months. Repeat every 6 months or as indicated by child’s risk status/susceptibility to disease. Includes assessment of pathology and injuries.

2 By clinical examination. 3 Must be repeated regularly and frequently to maximize effectiveness. 4 Timing, selection, and frequency determined by child’s history, clinical findings, and susceptibility to oral disease. 5 Consider when systemic fluoride exposure is suboptimal. Up to at least 16 years. 6 Appropriate discussion and counseling should be an integral part of each visit for care. 7 Initially, responsibility of parent; as child matures, jointly with parent; then, when indicated, only child.

8 At every appointment; initially discuss appropriate feeding practices, then the role of refined carbohydrates and frequency of snacking in caries development and childhood obesity.

9 Initially play objects, pacifiers, car seats; when learning to walk; then with sports and routine playing, including the importance of mouthguards.

10 At first, discuss the need for additional sucking: digits vs pacifiers; then the need to wean from the habit before malocclusion or skeletal dysplasia occurs. For school-aged children and adolescent patients, counsel regarding any existing habits such as fingernail biting, clenching, or bruxism.

11 For caries-susceptible primary molars, permanent molars, premolars, and anterior teeth with deep pits and fissures; placed as soon as possible after eruption.

Premier PIPELINE

Federal law governing the provision of dental services to children under Medicaid’s Early and Periodic Screening, Diagnosis and Treatment (EPSDT) program requires that dental services be provided in accordance with a dental periodicity schedule. This schedule must recommend treatment intervals that meet reasonable standards of dental practice. The dental periodicity schedule reflects the ages and intervals at which a child should receive specified dental services.

http://www.denti-cal.ca.gov/provsrvcs/bulletins/Volume_26_Number_7.pdf