Tuesday, August 14, 2018: 12N-1 PM

Transcription

1 QC for Kids & From the First Tooth Importance of Age One Dental Visits, How Pediatricians and Dental Providers Can Work Together! Speakers: Rachel King, D.D.S and Jeffrey Stone, DO Hosted by Amy Belisle, MD, Maine Quality Counts Tuesday, August 14, 2018: 12N-1 PM Maine Quality Counts is partnering with From the First Tooth (FTFT) to offer this webinar. Audio is available through your computer speakers. For audio by phone, call (408) and enter webinar code

2 Mission Maine Quality Counts is a nonprofit organization located in Manchester, Maine. We are working to improve the health of all Maine people (and beyond) by transforming the way healthcare is delivered. 2

3 Priorities QC Brings Together the People Who Give, Get and Pay for Healthcare to Address Shared Priorities: Improve the alignment of heath care systems to transform health for all Maine people Provide quality improvement assistance to practices Engage consumers in healthcare Promote the integration of physical and behavioral health 3

4 Maine Child Health Improvement Partnership (ME CHIP) Mission To optimize the health of Maine children by initiating and supporting measurement-based efforts to enhance child health care by fostering public/private partnerships. Vision All practices providing health care to children will have the skills, support, and opportunities for collaborative learning needed to deliver high quality health care. ME CHIP is part of the National Improvement Partnership Network (NIPN) 4

5 CME Disclosure: Today s speakers do not have any relevant financial relationships with the manufacturers(s) of any commercial products(s) and/or provider of commercial services discussed in this CME activity. CME will be available for participants who have signed into the live webinar. If there are multiple people at one computer, please type their names and addresses into the chat box for our attendance records. We do not have separate nursing CEUs- but you can get a CME certificate. A CME evaluation survey will be sent after the webinar via . Please complete the survey via Survey Monkey within 1 week. A CME certificate will be ed within 1 month of completion of the survey. Please Jackie Tiner (jtiner@mainequalitycounts.org) with questions. 5

6 Connect With Us Join our list mainequalitycounts.org Engage and be social. 6

7 Important Webinar Notes You are in listen-only mode. Please use the Q&A function to ask questions or make comments. Video screen size and location is adjustable. In two days you will receive an with links to slides and recordings and CME survey. 7

8 Today s Speakers Dr. Rachel King, DDS, MPH After graduating from Stony Brook University School of Dental Medicine in 2009, Dr. King continued her training as a pediatric dental resident at the University of Medicine and Dentistry of New Jersey. Following residency, she entered the U.S. Air Force, where she had the opportunity to practice for two years in Japan as a pediatric clinical provider on Misawa Air Base, and for one year as an AEGD residency faculty member at Eglin Air Force Base in Florida. Dr. King received her Master of Public Health degree in 2015 from the University of Massachusetts Amherst and began a residency in Dental Public Health through NYU Lutheran soon thereafter. Working in Providence, Rhode Island, with both the Rhode Island Department of Health and St. Joseph Pediatric and Family Dental Center, Dr. King received her second specialty certificate in 2016, prior to joining the UNE College of Dental Medicine. 8

9 Today s Speakers Dr. Jeffrey A. Stone, DO, FAAP Dr. Stone is a pediatrician at Waterville Pediatrics and a member of MaineGeneral Medical Center s active staff. He joined Waterville Pediatrics medical staff in He completed his internship at Waterville Osteopathic Hospital. In 1988 Dr. Stone completed his medical school training at the University of New England College of Osteopathic Medicine in Biddeford, Maine. His residency was done in Pediatrics at Janet Weis Children s Hospital at Geisinger Medical Center in Danville, PA, received his Bachelor s at the University of Maine, Orono, Maine in

10 Importance of Age One Dental Visits, How Pediatricians and Dental Providers Can Work Together! Rachel King, DDS, MPH and Jeffrey Stone, DO, FAAP August 14 th, 2018 Webinar hosted by Maine Quality Counts for Kids & From the First Tooth

11 Learning Objectives o Explain the From The First Tooth Age One Campaign o Review data and information on importance of the age one dental visit o Provide examples on how to integrate age one messaging into pediatric and family medicine practices

12 Age 1 Campaign Before the First Tooth and From the First Tooth are initiatives to improve the oral health of Maine s pregnant women, infants and children. The Before the First Tooth initiative has developed the Age 1 Campaign to increase the number of children accessing dental care before age 1. The Campaign aims to achieve this goal by: Educating parents and community members regarding the importance of the Age 1 dental visit Recognizing the efforts of dentists in Maine who welcome children for early dental visits, specifically at the age of one or younger Facilitating connections and fostering relationships between potential patients, pediatricians, and local dental offices

13 Why Age 1? From the First Tooth The American Academy of Pediatric Dentistry (AAPD), the American Dental Association (ADA), and the American Academy of Pediatrics (AAP) all recommend that children have their first dental visit by Age 1. At this early visit, dentists perform a brief oral examination, deliver preventive information regarding oral health and development, discuss and demonstrate home care techniques, and provide anticipatory guidance for the child s caregiver.

14 Why is an Age 1 Dental Visit Important? Primary teeth are important The health of primary teeth can affect the health of permanent teeth Cavities in baby teeth can lead to problems with growth, development, learning & self-esteem Treatment of cavities can be painful & may require treatment under general anesthesia for young children This disease is almost 100% PREVENTABLE

15 Why is an Age 1 Dental Visit Important? Dental caries is the most common chronic disease in children 5 times more common than asthma 7 times more common than hay fever 27.9% of children aged 3 to 5 have experienced at least one cavity >20% of children aged 2 to 5 have untreated tooth decay The burden of disease is greatest among lower socioeconomic minority populations

16 Why is an Age 1 Dental Visit Important? 2011 Maine Integrated Youth Health Survey 22% of K and 33% of 3 rd graders with caries experience 13% of K and 15% of 3 rd graders with untreated caries Increased instance in those who receive free or reduced meals 27% vs 18% (caries experience) 17% vs 12% (untreated caries) Oral Health in Maine (2013)

17 Goals of the Age 1 Visit Provide education to caregivers on how to create good lifelong oral health habits (brushing, flossing) Discuss diet and nutritional decisions that can cause cavities and how to alter them for better oral health Review current habits, such as pacifier use or thumbsucking and discuss cessation Inform caregivers about trauma prevention, tooth development, and fluoride use Prevent disease before it starts!

18 Standard of Care

19 Incorporation and Clinical Workflow

20 Components of the First Dental Visit Discussion with Caregiver Medical History Birth, previous conditions, hospitalizations, medications, allergies (type of reaction) Hygiene Practices Who, What, Where, When, How? Fluoride? Difficulties? Diet Bottle to bed? Juice all day? Gummy snacks? Habits Thumb, fingers, pacifier Vertical Transmission

21 Components of the First Dental Visit Knee-to-Knee

22 Components of the First Dental Visit Oral Hygiene Instruction Demonstrate to parent quantity of toothpaste 2 and under: smear, rice grain 3 +: pea sized Brushing Positioning child Keeping child open Reaching areas inside lower lip and under upper lip Flossing Handled flossers Bedtime Rules Nothing in mouth but water after nighttime brushing

23 Components of the First Dental Visit Dietary Counseling Juice and milk limited to meal times (regular cup) Water between meals and in sippy or travel cups Avoid sticky and gummy fruit snacks Brush after treats Just say no to SODA It is a four-letter word in pediatric dentistry Ensure, Pediasure For children on nutritional supplement drinks, advise parent to brush afterwards due to quantity of carbs

24 Components of the First Dental Visit Anticipatory Guidance Habits Trauma Dental Development Dietary Changes

25 Components of the First Dental Visit Fluoride Varnish Application

26 Tips and Tricks for a Successful Age 1 Dental Visit Best appt times: Mornings/after naps/slow time in GP office Avoid late afternoon and evenings 30 minutes appointment slots Do NOT need to complete in an operatory Tools ready and within reach 2x2 gauze, mirror, toothbrush, fluoride varnish, flossers, napkin for lap Limit crying to exam time by doing all talking upfront and avoiding bringing child up and down for lap exam more than once Crying is NORMAL!!! Reassure caregiver that it is normal and allows you to see everything better! Remember Identify those at risk Communicate with caregivers Don t be afraid of a few tears Explore alternatives

27 Billing: Procedure Codes Code Nomenclature CDT Descriptor D0145 Oral evaluation for a patient under three years of age and counseling with primary caregiver Diagnostic services performed for a child under the age of three, preferably within the first six months of the eruption of the first primary tooth, including recording the oral and physical health history, evaluation of caries susceptibility, development of an appropriate preventive oral health regimen, and communication with and counseling of the child s parent, legal guardian and/or primary caregiver. D1120 Prophylaxis-child Removal of plaque, calculus and stains from the tooth structures in the primary and transitional detention. D1206 Topical Fluoride Varnish Application Prescription strength fluoride product designed solely for use in the dental office, delivered to the dentition under the direct supervision of a dental professional. Fluoride must be applied separately from the prophylaxis paste.

28 Age 1 Dental Champions All Smiles Dental 2 Wellspring Rd. Biddeford, ME David C. Olvias, DDS 7 Hatnkness Brook Ln. Rockport, ME Caring Hands of Maine Dental Center 72 Beechland Rd. Ellsworth, ME Wendy L. Aplaugh, DMD 356 Airport Rd. Stonington, ME Disclaimer: FTFT does not endorse any specific dental provider or dental office, only that they will accept patients for an age one dental visit. All dentists are licensed with the state of Maine and have volunteered to be an Age One Champion.

29 Clinical Champions Dr. Rachel King, DDS, MPH University of New England College of Dental Medicine, Dr. Jeffrey Stone, DO, FAAP Waterville Pediatrics, Dr. Jennifer Dubail, MD - Maine Medical Partners, DubailJ2@mmc.org

30 Resources and Materials for Your Practice

31 Patient Education Materials

32 Resources for Your Practice

33 Quality Improvement Quality improvement is an effective way to improve patient care. In the primary care setting, there are multiple opportunities to develop, test and optimize processes. Quality improvement should be a continual and integral process. Four general areas for consideration: Defining an Aim Statement Identify Measures and Targets Creating a Measurement Plan/Data Collection Demonstrating Impact/Reporting

34 Ready, Set, Go!! We are here to help and support your practice! (207)

35 Questions and Thank You! Contact Information: Before and From The First Tooth - Maine Laura Robbins, CHES - Director, Before and From the First Tooth, lhrobbins@mainehealth.org Audrey Patin, RDH, CHES - Program Manager, From The First Tooth, APatin@mainehealth.org Cori Holt, MBA - Program Manager, Before The First Tooth, cholt@mainehealth.org Wendie Lagasse, MCHES - Central Maine Region Wendie.Lagasse@MaineGeneral.org Julie Carvelli - Program Coordinator, Before and From The First Tooth, JCarvelli@mainehealth.org

36 Acknowledgements

37 Contact Information Amy Belisle, MD, Dir. Child Health Quality Improvement, Phone: , x Kayla Cole, Project Manager, QC for Kids Phone: x Jackie Tiner, QC for Kids Admin. Coordinator, Phone: x QC for Kids Website: 37