Children’s Dental Disease Prevention Program (cddpp) California Department of Health Services



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DENTAL SCREENING

GUIDELINES

Children’s Dental Disease Prevention Program (CDDPP)




California Department of Health Services

Chronic Disease Control Branch

Office of Oral Health

PO Box 997413/MS 7210

Sacramento, CA 95899-7413

www.dhs.ca.gov/oralhealth
In Collaboration with
The University of California San Francisco

School of Dentistry

707 Parnassus Ave.

San Francisco, CA 94143-0758

Updated 8/2006

Table of Contents



Objectives 1
Screening Procedure 1
Optional Screening Procedure 2
Referral Procedure 3
Coordination with Dental Health Professionals 3
Funding 3
Information To Be Reported To The Office of Oral Health 3
Exhibit I Reporting Form 4
Exhibit II Standard Dental Screening Form 5

STATE OF CALIFORNIA


DEPARTMENT OF HEALTH SERVICES

OFFICE OF ORAL HEALTH


CHILDREN’S DENTAL DISEASE PREVENTION PROGRAM



Guidelines for Dental Screening

These dental screening guidelines were written to answer the basic questions about dental screening programs. The guidedelines are recommended for use by dentists, registered dental hygienists and others who wish to participate in screenings as part of the Children’s Dental Disease Prevention Program (CDDPP).


NOTE: A SCREENING DOES NOT REPLACE A DENTAL EXAM WITH X-RAYS
I. OBJECTIVES:


  • To facilitate early detection and treatment of dental disease

  • To reduce the incidence and impact of dental disease

  • To inform parents/guardians of their children’s dental problems

  • To encourage the establishment of effective oral health practices early in life, including regular professional care

  • To promote a positive image of oral health professionals

  • To increase the oral health awareness of the public

  • Contribute to meeting the Healthy People 2010 Oral Health Objectives


II. SCREENING PROCEDURE:


  1. At a minimum, the screening procedure should include a visual examination for:

    1. Caries free dentition

    2. Evidence of caries (including Early Childhood Caries (ECC) in preschool and kindergarten children)

    3. Presence of, or recommendation for, pit and fissure sealants

    4. Prophylaxis recommendation

    5. Other conditions which need professional care




  1. Screenings may only be performed for CDDPP children who have parental/guardian permission.

  • Passive consent is an acceptable form of permission

  • Check local guidelines (County, School Board, etc) to ensure compliance with their regulations




  1. The screening should classify individuals as follows:


Ethnicity (optional)

W=White, B=Black/African American, H=Hispanic/Latino, O=Other

A=Asian/Pacific Islander, AI=American Indian

Caries Free


If the child has no untreated decay nor any restorations in primary or permanent teeth.

  1. A tooth with a dental sealant is considered sound when coding for caries

  2. Crowns that are in place because of injuries are NOT considered restored teeth due to caries

Filled Teeth

If the child has any fillings, crown or any other sign of dental work indicating that they have seen a dentist.



Untreated Decay

If the child has any obvious signs of untreated decay, mark (Y) for yes.



Sealants:

HAS: If at least one occlusal surface of a permanent molar has a complete or partial sealant


NEEDS: If the screener recommends that the child have sealants placed on

permanent molars, even if they are already present on some teeth


Treatment Urgency (Class I, Class II, Class III)
Class I: Individuals who have no apparent need for restorative treatment. The teeth and gums appear healthy. Such individuals should still be advised to have regular dental examinations.
Class II: Early Dental Care Needed. Small carious lesions, temporary or broken fillings or gingivitis and the patient is asymptomatic. The condition is not urgent, yet requires a dental referral.
Class III: Urgent Care Needed. Extensive decay, injury, abscess’, extensive gingivitis, moderate to severe ECC or a history of pain. The need for dental care is urgent. Refer for treatment immediately.

Recommend Orthodontics:


Check box when you suspect that a child needs orthodontics to treat severe

malocclusion.


Early Childhood Caries (ECC):


If the child is 6 years old or younger, ECC will be defined as a minimum of two

primary maxillary incisors that have decay, crowns, or are missing.




III. OPTIONAL SCREENING PROCEDURES:


  1. The screening may include a visual examination for:

    1. Gingivitis (red and/or bleeding gums)

    2. Oral hygiene status (adequate or inadequate)

    3. Oral injury (soft tissue laceration, anterior tooth: avulsion, extrusion, fracture, dark discoloration of entire crown)




  1. Second screening information:

A second screening is optional, but encouraged, to determine and record if treatment recommendations

were followed.


IV. REFERRAL PROCEDURE:


  1. Screenings should not be conducted without first making arrangements for follow-up of any dental problems that are detected. Prior to conducting the screening, it is vital to have made referral arrangements with appropriate school personnel (particularly with all conditions deemed “emergency dental treatment required”). Effective follow-up must be assured if the screening is to be of value.

  2. The local dental society may be contacted to obtain the names of dentists for referrals.

  3. A report should be sent home with each child who has been screened. The report should note that the visual screening did not include radiographs and does not constitute, or take the place of, a complete dental examination.

  4. Dentists may not send home their business cards or in any other way solicit patients, according to the State Dental Practices Act.



V. COORDINATION WITH DENTAL HEALTH PROFESSIONALS:

CDDPP programs should attempt to obtain volunteers from the local dental society and dental hygienists’ association to assist with screenings, and should coordinate screening activities with these organizations whenever possible.


VI. FUNDING:
Dental screenings are an optional component of the CDDPP. Although the CDDPP encourages local projects to conduct dental screenings, funding is not available to reimburse local projects for screening. However, it should be noted that the information sought in a dental screening could easily be obtained during a SEALANT SCREENING. Therefore, projects are encouraged to use that opportunity to obtain dental screening information whenever possible.
VII. INFORMATION TO BE REPORTED TO THE OFFICE OF ORAL HEALTH:
At a minimum, each dental screening program should report the following information:


  1. Total number of children screened (1st screening)

  2. Number of students in which screening results are available

  3. % of schools in rural areas (see guidelines)

  4. % of schools in urban areas (see guidelines)

  5. Number and % of students:

  1. in the stated ethnic categories (optional)

  2. who are caries free

  3. classified as Class I, Class II, Class III

  4. who have pit and fissure sealants

  5. who had sealants recommended

  6. with evidence of Early Childhood Caries

  7. who have been rescreened (2nd screening)

  8. who received treatment (restoration, prophylaxis, sealant, etc.) NOTE: The same child is seen a second time.

LOCAL CDDPP PROJECTS ARE REQUIRED TO REPORT SUMMARY INFORMATION FROM DENTAL SCREENINGS TO THE STATE DEPARTMENT OF HEALTH SERVICES, OFFICE OF ORAL HEALTH. SEE EXHIBIT 1 AN EXAMPLE OF CDDPP REPORTING FORM #6 FILLED OUT CORRECLTY.


DENTAL SCREENING DATA

(
Exhibit 1

Report 6
If screening is provided)

PRESCHOOL THROUGH SIXTH GRADE


  1. Number of students who have had a dental screening 1,000




  1. Number of students you have screening results on (if results are different from #1, please 1,000

explain on separate piece of paper)


  1. Number and % of children in the following ethnic categories: (optional)

No. %


White 150 15%

Black/African American 159 16%

Hispanic/Latino 571 57%

Asian/Pacific Islander 109 11%

American Indian 5 0.5%

Other 6 0.6%


  1. Number and % of schools in rural areas 500 50%

Number of schools in urban areas 500 50%

(See “Guidelines for Dental Assessment Screening Form”)




  1. Number and % who are caries free (No filled teeth and no

visual decay in primary or permanent teeth) 400 40%


  1. Number and % of students in each classification

(See “Guidelines for Dental Assessment Screening Form”

for detailed classification descriptions):

No. %


  1. Class I – No obvious problem 502 50%

  2. Class II – Requires early dental care 88 9%

  3. Class III – Requires urgent care 10 10%


NOTE: A-C SHOULD ADD UP TO THE TOTAL NUMBER OF STUDENTS THAT YOU HAVE SCREENING RESULTS ON (#2 ABOVE)


  1. Number and % with dental sealant(s) 488 49%

  2. Number and % where dental sealants are recommended 394 39%

  3. Number and % with evidence of Early Childhood Caries 5 0.5%

(ECC = children ≤ 6 yrs who have a minimum of 2 primary

maxillary incisors with decay, crowns or are missing)



  1. Number and % with an oral injury (if available) 2 0.2






County Logo

Local Program Logo


California Department of Health Services


Office of Oral Health

Children’s Dental Disease Prevention Program

Dental Screening Form



School: Grade: Room:

Teacher: Screener: Date:


Student Name

Age

Sex

M F


Ethnic

W B H A O AI



Caries Free

Filled Teeth

Y N


Untreated Decay

Y N


Sealants

Has / Rec



Treatment Urgency

1, 2, 3


Rec Ortho

ECC

Comments or

Describe Injury




























































































































































































































































































































































































































































































































































































































































































































































































































W=White B=Black H=Hispanic A=Asian O=Other AI =American Indian

  1. List student’s name

  2. Age

  3. Sex – Male or Female

  4. Mark Ethnicity, if known W=White B=Black H=Hispanic A=Asian O=Other AI =American Indian

  5. Caries Free? Mark Yes (Y) ONLY if child has NEVER had a filling, crown or other dental work and has NO obvious decay. Children considered caries free are also considered Class I, but not all Class I children are caries free.

  6. Filled Teeth: Mark Yes (Y) if child has any fillings, crowns or any other sign of dental work indicating that they have seen a Dentist.

  7. Untreated Decay: Mark Yes (Y) if the child has any obvious signs of untreated decay.

  8. Sealants: Mark (H) if the child has one or more sealants including partially retained sealants. Mark (R) recommend, if you see teeth eligible to receive dental sealants – permanent molars with no obvious decay and no fillings present on the occlusal (biting) surface.

  9. Treatment Urgency: Dental classifications according to the Association of State and Territorial Dental Directors:

Class I = no obvious problem – teeth and gums appear healthy, refer for routine dental care.

Class II = early dental care needed – suspected decay, temporary or broken fillings.

Class III = urgent care needed - extensive decay, injury, ECC, abscess. If a child needs IMMEDIATE dental attention,

mark them class III and place an asterick ( * ) by the classification to make follow-up easier.

10. Recommend Ortho: Check box when you suspect that a child needs orthodontics to treat severe malocclusion.

11. ECC: Early Childhood Caries - defined as a child 6 years or younger that has a minimum of 2 primary maxillary incisors

(upper front teeth) that have decay, crowns or are missing. Mark Yes if present.

12. Comments or Describe Injury: Write any comments or notes in this column. Please note if child has obvious trauma to the



head, neck, face, teeth, gums, mouth, etc. describe injury.






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