Carolina Dental Home (CDH) Pilot project in Craven, Pamlico, and Jones Counties Partnership of pediatricians and dentists PORRT developed to refer youngest high risk children to dental home
CDH lessons learned Physicians found PORRT easy to use Children evaluated were found to be: 80% low risk 15% moderate risk 5% high risk Large increase in identification of white spot lesions: from 20% at baseline to 58% at follow-up
Infant/Child Oral Evaluation Expect a fussy and noisy patient!!!
Needed for the oral evaluation… Good source of directed light 2 x 2 gauze sponges for drying the teeth Disposable dental mirror PORRT (priority oral health risk assessment and referral tool)
Positioning for the oral evaluation Use the knee-to-knee position with the child in the parent’s lap, facing them (great for babies/small children) Place the child on an exam table (good for larger, older children) In either position, evaluate looking over the top of the child’s head Parent holds child’s hands (or gives permission to staff), child’s legs around parent’s waist
Screening/evaluation Every three months starting at first tooth eruption (maximum 6 procedures) Any visit We pay a small bonus to our nurses for each eligible patient identified and screened using the PORRT form. Form identifies both nurse and physician.
Education Doctor or midlevel Screen for sugar exposure and appropriate drinking and brushing habits. Pathology and dental risks identified on oral exam (may need dental mirror). Risks stratified and referral to general or pediatric dentist made in manner of any other specialist referral. Follow-up is tracked by our AccessCare nurse.
Application Nurse applies at end of visit. Brush on dry teeth (easier if crying) No meals for 30 minutes Sugar free lollipop at checkout (if age appropriate)
Goal for Project: Connect the Docs! Increase these aspects of referrals Quantity Quality Effectiveness Appropriateness Work in progress
Next month’s webinar October 14 th Dental varnish update Questions?