Same-Day Dental Sealant Workflow Same-Day Sealant Workflow Why - PowerPoint PPT Presentation

Same-Day Dental Sealant Workflow

Same-Day Sealant Workflow Why implement? • Prevention of chronic oral health disease First visit intake/ assessments • Increased sealant measure Molars Schedule identified for • Staff performing top of licensure scope next visit sealants • Avoiding no-show appointments How to incorporate? If no time remains: make Discuss new with parent/ • Ready-to-go sealant kits appointment caregiver for prophy, Fl2, restorative • Establishing protocol and workflow • Daily huddles to enhance communication If time Implement What outcomes expected? remains: using ready-to- prophy/fl2 go sealant kit • Increased productivity Document sealant codes • Enhanced patient concept of prevention AmeriHealth Caritas District of Columbia 2

Dental Caries Most common chronic disease in children ages 6 – 11 and adolescents ages 12 – 19 Five times more common than asthma in adolescents ages 14 – 17 Four times more common than early childhood obesity A primary health-related cause of school absenteeism AmeriHealth Caritas District of Columbia 3

Strategies for Same-Day Sealants • Ready-to-go sealant trays • Glass ionomer or wet bond sealant material • An assistant/isolation system/ dry shield, Isolite • Quick curing light • Identifying patients eligible for sealants before the appointment (daily huddles) • Establishing a sealants-first workflow • Regular patient education on sealants • Provider buy-in AmeriHealth Caritas District of Columbia 4

International Caries Detection and Assessment System (ICDAS) Code Description Sound tooth surface: No evidence 0 of caries after 5 seconds of air drying First visual change in enamel: Opacity or discoloration (white or brown) is 1 visible at the entrance to the pit or fissure seen after prolonged air drying Distinct visual change in enamel 2 visible when wet, lesion must be visible when dry Localized enamel breakdown (no clinical visual signs of dentinal 3 involvement) when wet and after prolonged drying 4 Underlying dark shadow from dentin 5 Distinct cavity with visible dentin Extensive (more than half the surface) 6 distinct cavity with visible dentin https://www.ncbi.nlm.nih.gov/pmc/articles?PMC5030492 http://www.nnoha.org/resources/hrsa-sealant-measure-faqs/ https://www.dchealthcheck.net/documents/DC_Medicaid_HealthCheck_DENTAL_Periodicity.pdf https://jada.ada.org/article/S0002-8177(16)30475-5/fulltext AmeriHealth Caritas District of Columbia 5

Same-Day Sealant Workflow Why implement? Patient 6 – 14 years old presents for comprehensive • Dental caries is the most common or periodic exam with RDH chronic disease in children • Dental caries is five times more RDH identifies one RDH identifies RDH completes or more molars no molars are eligible common than asthma assessments/radiographs eligible for sealant for sealants • Dental caries is four times more common than early childhood obesity RDH discusses RDH enters sealant exclusion code with parent sealant • Dental caries is a primary health-related (DZ1361) to be prioritized cause for school absenteeism How to incorporate? RDH/EFDA utilize RDH continues sealant set up to with visit and complete sealants completes prophy fl2 • Staff performing to top of licensure scope • Ready-to-go sealant kits/Isolite RDH/EFDA enters Document next visit • Established protocol and workflow D1361 sealant code • Daily huddles to enhance communication If sufficient time What outcomes expected? remains, complete prophy/fl2; otherwise, make new • Increased productivity appointment for prophy • Fewer no-shows for sealants • Increased sealant measure Document next visit • Enhanced patient concept of prevention AmeriHealth Caritas District of Columbia 6

References • https://www.ada.org/en/publications/ada-news/2015-archive/march/cdc- disparities-in-caries-continue • http://www.nationaloralhealthconference.com/docs/presentations/2007/0430/ Margherita%20Fontana%20%20Updating%20Recommendations%20for%20School% 20Sealant%20Programs.pdf • National Access to Oral Health Network webinar 2018: https://www.nnoha.org/events/presentation-archives/2018-nnoha-annual- conference/ • https://jada.ada.org/article/S0002-8177(16)30475-5/fulltext • Evid Based Dent, 2010;11(3):79 – 80 • https://jada.ada.org/article/S0002-8177(14)64748-6/pdf • https://www.dryshield.com/ • https://www.zyris.com AmeriHealth Caritas District of Columbia 7

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