Measuring sealant placement in children at the dental practice level

Abstract

Background. Although sealants are an established and recommended caries-preventive treatment, many children still fail to receive them. In addition, research has shown that existing measures underestimate care by overlooking the sealable potential of teeth before evaluating care. To address this, the authors designed and evaluated 3 novel dental electronic health recordebased clinical quality measures that evaluate sealant care only after assessing the sealable potential of teeth. Methods. Measure I recorded the proportion of patients with sealable teeth who received sealants. Measure II recorded the proportion of patients who had at least 1 of their sealable teeth sealed. Measure III recorded the proportion of patients who received sealant on all of their sealable teeth. Results. On average, 48.1% of 6-through 9-year-old children received 1 or more sealants compared with 32.4% of 10-through 14-year-olds (measure I). The average measure score decreased for patients who received sealants for at least 1 of their sealable teeth (measure II) (43.2% for 6through 9-year-olds and 28.4% for 10-through 14-year-olds). Fewer children received sealants on all eligible teeth (measure III) (35.5% of 6-through 9-year-olds and 21% of 10-through 14-yearolds received sealant on all eligible teeth). Among the 48.5% who were at elevated caries risk, the sealant rates were higher across all 3 measures. Conclusions. A valid and actionable practice-based sealant electronic measure that evaluates sealant treatment among the eligible population, both at the patient level and the tooth level, has been developed. Practical Implications. The measure developed in this work provides practices with patientcentered and actionable sealant quality measures that aim to improve oral health outcomes.

Caries Risk Documentation And Prevention: eMeasures For Dental Electronic Health Records

“…We stratified our data in four age groups as follows: 0 to 5 (primary dentition), 6 to 12 (mixed dentition), 13 to 18 (permanent dentition), and 18þ (permanent dentition including wisdom teeth, 3rd molars; ►Table 2). Across all sites, the majority of our denominator patient population were adults aged 18 corresponded to 57.2% of the total denominator population. The measure scores were statistically significant by race with the highest proportion of Native Americans (98.8%) received a CRA and 82.5% of patients in the "Other" race category.…”

“…14 The literature reports on the development and implementation of process of care clinical quality measures seeking to improve fluoride applications, oral evaluations for patients with diabetes, 15 tobacco use and cessation, 16 and placement of dental sealants. 17,18 In 2020, the Dental Quality Alliance released technical specifications of a process of care measure to evaluate caries risk documentation using program/plan administrative enrollment and claims data in children aged 21 years and younger, 19 combining primary, mixed, and permanent dentitions. Our study builds on the Dental Quality Alliance measure, utilizing EHR derived data.…”

An Evaluation of Methods for Monitoring Annual Quality Measures by Month to Predict Year-End Values

“…We applied each monitoring method to the specifications for the annual diabetic oral exam[2] and the annual caries risk assessment[3] measures. Since each site in this study used the same Electronic Dental Record (EDR) system, we developed and validated SQL scripts for each method at one site.…”

“…We applied each monitoring method to the specifications for the annual diabetic oral exam[2] and the annual caries risk assessment[3] measures separately to data from three US dental schools and one large dental accountable care organization (Sites A to D in the results) for 2016 and 2017. Since each site in this study used the same Electronic Dental Record (EDR) system, we developed and validated SQL scripts for each method at one site.…”

“…In this paper, we focus on two measures: an annual diabetic oral exam[1,2] and an annual caries risk assessment. [3] Other similar measures in the overall health arena include annual falls screening for elderly patients[4] and annual flu vaccination. [5]…”