Welcome to the training on First Dental Home provided by the Texas Health and Human Services Commission (HHSC) and the University of Texas Health Science Center at San Antonio.
The goal of this module is to train general and pediatric dentists enrolled in Texas Health Steps to provide dental homes for children 6 through 35 months. Completing this course is a prerequisite to applying for certification as a First Dental Home dentist.
Texas Health Steps providers and other interested health-care professionals.
Specific Learning Objectives
After completing the activities of this module, you will be able to:
- Summarize the challenges that young Texans face in accessing oral health care and the importance of the First Dental Home model.
- Specify the required components of a First Dental Home checkup.
- Determine the recommended dental checkup frequency for a child with moderate to high risk for the development of early childhood caries.
NOTE: In this module, the term “parents” also refers to guardians and other caregivers.
Please note this module expires on 8/31/2021.
This module was released on 7/27/2018.
Continuing Dental Education
The University of Texas Health Science Center at San Antonio has approved this course for continuing education from the Office of Continuing Dental Education.
The mission of the Office of Continuing Dental Education at The University of Texas Health Science Center at San Antonio is to provide professional growth opportunities and quality continuing education programs as the needs of the profession demand.
It is our firm belief that Continuing Dental Education courses should present the newest developments in patient evaluation, treatment, techniques, products, materials, and equipment even though some of them may be controversial. The Dental School does not endorse the content and philosophy of any Continuing Education course but offers various viewpoints to better serve the practicing dental professional.
One of the requirements of continuing education is disclosure of the following information to the learner:
- Notice of requirements for successful completion of continuing education activity. To receive continuing education credit the learner must successfully complete the following activities:
- Create a Texas Health Steps account.
- Complete on-line registration process.
- Thoroughly read the content of the module.
- Complete the on-line examination.
- Complete the evaluation.
- Commercial Support.
The THSTEPS Web-based Continuing Education Series has received no commercial support.
- Disclosure of Relevant Financial Relationships.
The THSTEPS Continuing Education Planning Committee and the authors of these modules have no relevant financial relationships to disclose.
- Non-Endorsement Statement.
Accredited status does not imply endorsement of any commercial products or services by the Department of State Health Services, Continuing Education Service; Texas Medical Association; or American Nurse Credentialing Center.
- Off-Label Use.
Using a disclosure review process, the THSTEPS Continuing Education Planning Committee has examined documents and has concluded that the authors of these modules have not included content that discusses off-label use (use of products for a purpose other than that for which they were approved by the Food and Drug Administration).
The following are policies and definitions of terms related to continuing education disclosure:
The intent of disclosure is to allow Department of State Health Services (DSHS) Continuing Education Service the opportunity to resolve any potential conflicts of interest to assure balance, independence, objectivity and scientific rigor in all of its Continuing Education activities.
All faculty, planners, speakers and authors of Department of State Health Services (DSHS) Continuing Education Service sponsored activities are expected to disclose to the Department of State Health Services (DSHS) Continuing Education Service any relevant financial, relationships with any commercial or personal interest that produces health care goods or services concerned with the content of an educational presentation. Faculty, planners, speakers and authors must also disclose where there are any other potentially biasing relationships of a professional or personal nature.
Glossary of Terms
Conflict of Interest: Circumstances create a conflict of interest when an individual has an opportunity to affect Continuing Education content about products or services of a commercial interest with which she/he has a financial relationship or where there are any other potentially biasing relationships of a professional or personal nature.
Commercial Interest: Any entity producing, marketing, re-selling, or distributing health care goods or services consumed by, or used on, patients.
Financial Relationships: Those relationships in which the individual benefits by receiving a salary, royalty, intellectual property rights, consulting fee, honoraria, ownership interest (e.g., stocks, stock options or other ownership interest, excluding diversified mutual funds), or other financial benefit. Financial benefits are usually associated with roles such as employment, management position, independent contractor (including contracted research), consulting, teaching, membership on advisory committees or review panels, board membership, and other activities for which remuneration is received or expected. Relevant financial relationships would include those within the past 12 months of the person involved in the activity and a spouse or partner. Relevant financial relationships of your spouse or partner are those of which you are aware at the time of this disclosure.
Off Label: Using products for a purpose other that that for which it was approved by the Food and Drug Administration (FDA).
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American Academy of Pediatrics, Medical Home Initiatives for Children with Special Needs Project Advisory Committee. (2002). The medical home.
American Academy of Pediatrics, Campaign for Dental Health. I Like My Teeth (ilikemyteeth.org), a bilingual website for health-care providers that focuses on fluoridation and other key issues.
American Dental Association. Caries risk assessments are documented and billed under the codes listed in the current Code on Dental Procedures and Nomenclature (CDT) Dental Procedure code book published by the ADA.
Centers for Disease Control, National Center for Chronic Disease Prevention and Health Promotion, Division of Oral Health. (2012). National oral health surveillance system: State oral health profile, Texas.
Texas Department of State Health Services. First Dental Home web page.
Texas Department of State Health Services. Visit the DSHS First Dental Home Materials web page to download a PDF of the Caries Risk
Texas Department of State Health Services. Texas Primary Care Office (TPCO).
Texas Department of State Health Services, Texas Health Steps Provider Information. (2017). Texas Health Steps Periodicity Schedule.
Texas Department of State Health Services. (2015). Oral Health in Texas 2008 Report.
To find a dental provider: Providers can call Texas Health Steps toll-free at 877-847-8377 (877-THSTEPS) Monday through Friday from 8 a.m. to 6 p.m. Central Time, or log on to the TMHP online provider lookup (OPL). Providers can also contact the Medicaid dental managed care organizations (DMOs) to locate Texas Health Steps First Dental Home providers in a specific geographic area. Likewise, First Dental Home providers can look up Oral Evaluation and Fluoride Varnish (OEFV) providers in their area on the TMHP web page.
Texas Health Steps Resource Catalog.ll of the DSHS resource materials — Keep Your Child Smiling pamphlet, The Benefits of Fluoride Varnish poster, Stages of Tooth Decay poster, and Sealants and Fluoride Varnishes poster — free of charge.
Texas Oral Health Coalition. (2018). Texas Oral Health Report Card.
Texas State Legislature. Texas Occupations Code § 258.001.
Texas State Legislature. Texas Occupations Code § 258.002.
Think Teeth. Provides free customizable outreach materials in both English and Spanish that can help health professionals improve access to dental services for eligible children through enrollment in Medicaid and CHIP.
National Health Service Corps. A health-care provider education loan repayment program offered by the U.S. Department of Health and Human Services, Health Resources and Services Administration (HRSA).
U.S. Department of Health and Human Services. (2015). Healthy People 2020, Oral Health.
American Academy of Pediatric Dentistry. Frequently Asked Questions (for parents and caregivers).
American Academy of Pediatric Dentistry. Mychildrensteeth.orgwebsite for families.
American Academy of Pediatrics, Campaign for Dental Health. I Like My Teeth, a bilingual website.
American Academy of Pediatrics. Brush, Book, Bed, a website with resources to help families structure their child’s nighttime routine, including tooth brushing. The website is available in Spanish.
American Dental Association. How to Care for Your Child’s Teeth.
American Dental Association. Find Dental Care for Your Kids, which helps families search for dental clinics using their home address.
CavityFreeKids.org. Sponsored by the Washington Dental Service Foundation, this website offers a wealth of resources about oral health care for young children and their families.
Texas Department of State Health Services. Early Childhood Caries.
Texas Department of State Health Services. Brush-Up on Healthy Teeth.
Texas Department of State Health Services. Healthy Mouths: What You Need to Know About Your Teeth.
American Academy of Pediatric Dentistry. (2018). Definitions, oral health policies, and recommendations.
American Academy of Pediatric Dentistry. (2017). Policy on Social Determinants of Children’s Oral Health and Health Disparities.
American Academy of Pediatric Dentistry, Council on Clinical Affairs. (2015). Policy on the dental home.
American Academy of Pediatric Dentistry. (2014). Guideline on Fluoride Therapy.
American Academy of Pediatric Dentistry. (2013). Guideline on Periodicity of Examination, Preventive Dental Services, Anticipatory Guidance/Counseling, and Oral Treatment for Infants, Children, and Adolescents.
American Dental Association. (2017). Context for the Alabama Early Preventive Care Study
American Dental Association, Health Policy Institute. (2015). Geographic Access to Dental Care: Texas.
Blackburn, J., Morrissey, M., & Sen, B. (2017). Outcomes Associated With Early Preventive Dental Care Among Medicaid-Enrolled Children in Alabama. JAMA Pediatrics, 171(4):335-341.
Child and Adolescent Health Measurement Initiative. (2012). Data Resource Center for Child & Adolescent Health.
Dye, B. A., Thornton-Evans, G, Li, X., & Iafolla, T. J. (2015). Dental caries and sealant prevalence in children and adolescents in the United States, 2011-2012. (Centers for Disease Control and Prevention, National Center for Health Statistics [NCHS] Data Brief No. 191).
Dye, B. A., Li, X., & Thornton-Evans, G. (2012). Oral health disparities as determined by selected healthy people 2020 oral health objectives for the United States, 2009–2010. (Centers for Disease Control and Prevention, National Center for Health Statistics [NCHS] Data Brief No. 104).
Garish Babu, K. L. & Doddamani, G. M. (2012). Dental home: Patient centered dentistry.
Savage, M. F., Lee, J. Y., Kotch, J. B., & Vann, W. F., Jr. (2004). Early preventive dental visits: Effects on subsequent utilization and costs. Pediatrics, 114(4), e418-e423.
Sohn, W., Burt, B. A., & Sowers, M. R. (2006). Carbonated soft drinks and dental caries in the primary dentition. Journal of Dental Research, 85(3), 262-266.
Steele, J. S., & Buchi, K. F. (2008). Medical and mental health of children entering the Utah foster care system Pediatrics, 122(3), e703-e709.
Texas Department of State Health Services. (2018). First dental home materials.
Texas Department of State Health Services. (2018). First dental home training and certification request form.
Texas Department of State Health Services. (n.d.). First dental home.
Texas Department of State Health Services, Texas Health Steps. (2015). Texas Health Steps dental health checkups materials. Texas Health Steps Resource Catalog.
Texas Department of State Health Services, Oral Health Program. First Dental Home Benchmarks video. Texas Health Steps Video Library, Oral health.
Texas Medicaid & Healthcare Partnership. (2018). Texas Medicaid Provider Procedures Manual.
Texas Medicaid & Healthcare Partnership, Texas Medicaid Provider Procedures Manual. (2018). First dental home.
Texas Oral Health Coalition. (2018). Texas Oral Health Report Card
Texas Tribune. (2012). Interactive: Mapping Access to Health Care in Texas.
U.S. Department of Health and Human Services. (2015). Healthy People 2020, Oral Health.
U.S. Department of Health and Human Services, Agency for Healthcare Research and Quality. (2015). Health Literacy Universal Precautions Toolkit, 2nd Edition.
U.S. Department of Health and Human Services, Centers for Medicare & Medicaid Services. (2013). Keep Kids Smiling: Promoting Oral Health Through the Medicaid Benefit for Children & Adolescents.
Building a Comprehensive and Effective Medical Home
Learn how and why to create and sustain a medical home in your primary care practice.
Oral Evaluation and Fluoride Varnish
Implement practices required for physicians, advanced practice nurses and physician assistants to perform Oral Evaluation and Fluoride Varnish services in Texas. Completion of this course and additional certification are required to bill Medicaid for the service.