the practitioner is again responsible to make a renewed referral attempt to a dentist and should again apply topical fluoride varnish . Ideally , once a dental home is established for the child , the dental staff should assume responsibility for preventive oral health services including fluoride treatments . The physician should continue to perform an oral assessment and reinforce the importance of regular visits to the dental home , but should defer application of topical fluoride in favor of the dental home going forward .
Where do we go from here ? In order for the program to be successful there must be better communication and understanding on the part of all stakeholders involved . Parents / caregivers must be better educated as to the importance of maintaining oral health of the primary dentition , need for early evaluation , preventive interventions , and appropriate treatment when needed . As noted previously , primary care physicians and CRNPs can and should play an expanded role in this education process and facilitate the establishment of a dental home for young patients in their care by developing meaningful communication with dental professional colleagues in their communities . The American Academy of Pediatrics has established its own Oral Health Initiative and offers a wealth of information to physicians and other medical professionals through its association website and sponsored events ( http :// www . aap . org / ORALHEALTH ). Pedodontists and general practice dentists who are already comfortable treating young children could outreach to their community primary care medical colleagues to assist in development of referral networks . The PDA participated in the development of OMAP ’ s fluoride varnish program and has repeatedly stated its support for the program in its recent publications . Enthusiastic support at the district and local society levels will factor heavily in the success of the program by maintaining and hopefully expanding the referral base for dental homes capable and committed to preventing what is still the most common chronic disease among children . OMAP remains focused on oral health as part of overall physical health and will continue to partner with our MCOs in HealthChoices and case management vendor in ACCESS Plus to improve our programs targeting oral health issues . We face complex issues in our search for solutions . Combined and collaborative efforts offer our best chance for success .
To review or download any of the MA Bulletins referenced in this article , use the following web link and type the appropriate number listed below in the box for Bulletin Number under Search Option A :
http :// www . dpw . state . pa . us / PubsFormsReports / Newsletter sBulletins / 003673169 . aspx
Enter 99-08-13 for the Bulletin issued in September 2008 on Updates to the Early and Periodic Screening , Diagnosis and Treatment ( EPSDT ) Program Periodicity Schedule
Enter 27-09-02 for the Bulletin issued in April 2009 on Implementation of the Pediatric Dental Periodicity Schedule
Enter 09-10-08 for the Bulletin issued in March 2010 on application of Topical Fluoride Varnish by Physicians and CRNPs
1 Dye , B . A ., Tan , S ., et al . “ Trends in oral health status : United States , 1988-1994 and 1999-2004 .” National Center for Health Statistics . Vital Health Stat 11 , 2007 .
2 U . S . Department of Health and Human Services . Oral Health in America : A report of the Surgeon General . Rockville , MD : U . S . Department of Health and Human Services , National Institute of Dental and Craniofacial Research , National Institutes of Health , 2000 .
3 US Census Bureau Data , Annual Estimates of the Resident Population by Sex and Age for States and for Puerto Rico : April 1 , 2000 to July 1 , 2009 . Available at : http :// www . census . gov / popest / states / asrh / SC-EST2009-02 . html , Accessed July 29 , 2010 .
4 Internal Data , Pennsylvania Department of Public Welfare , Office of Medical Assistance Programs , June 2010 .
5 American Academy of Pediatrics , Policy Statement : Preventive Oral Health Intervention for Pediatricians , Pediatrics 2008 Dec : 122 ( 6 ).
Paul R . Westerberg , DDS , MBA Dr . Westerberg is a graduate of Temple University School of Dentistry and began his professional career in private practice in the Philadelphia area , serving patient populations in both inner city and suburban locations . After earning an MBA from the University of Delaware , he transitioned to the corporate environment as a program dental consultant and then as Dental Director administering managed care Medicaid , Medicare , and CHIP healthcare services in southeastern Pennsylvania . Moving to public service in state government , Dr . Westerberg originally joined the Office of the Medical Director in the Office of Medical Assistance Programs of the Pennsylvania Department of Public Welfare as the Executive Dental Consultant . He has served as the Chief Dental Officer for the Department since 2002 .
34 September / October 2010 • Pennsylvania Dental Journal