This section includes:
The federally-mandated Medicaid service known in Texas as Texas Health Steps covers emergency dental care, routine preventive dental checkups, and follow-up dental care for children from birth through 20 years of age. This service includes but is not limited to routine diagnostic, preventive, therapeutic, and emergency dental care, as well as medically necessary orthodontic dental care for children ages 6 months through 20 years of age who are enrolled in Medicaid.
Texas Health Steps is committed to improving health-care standards and services for all infants, children, and adolescents. Participating dental providers not only help eligible children receive dental services but also help to instill the importance of good oral health throughout the community.
The June 2000 Surgeon General's Report points out the prevalence of oral disease and the unmet need in oral health. “Tooth decay (dental caries) is the most common chronic childhood disease,” and is “five times more common than asthma and seven times more common than hay fever,” the report states.
The report also found that oral disease is more prevalent among children in minority and low-income families who see dentists infrequently. Fluoridated water that helps improve the oral health of many children is unavailable in some Texas communities.
Because of the many serious effects and consequences of untreated dental caries, it is imperative that Texas dental professionals have the information and resources they need to address this growing problem.
Texas Health Steps follows standards adopted by the American Academy of Pediatric Dentistry (AAPD), the American Dental Association (ADA), and the American Academy of Pediatrics (AAP), which are designed to improve and maintain the oral health of infants, children, and adolescents. Preventive dental care is fundamental in stopping or slowing the progression of oral health problems that may otherwise become chronic or irreversible. Provider participation in the program is an essential component of providing dental care for children who would otherwise go without dental services.
The Medicaid and CSHCN populations have a potentially higher risk of dental disease than the general population. This condition stems in part from a lack of access to dental care.
The 2009 US Government Accountability (GAO) Report, “Medicaid: State and Federal Actions Have Been Taken to Improve Children’s Access to Dental Services but Gaps Remain” (GAO-09-723) states, “Although dental services are a mandatory benefit for the 30 million children served by Medicaid, these children often experience elevated levels of dental problems and have difficulty finding dentists to treat them. Attention to this subject became more acute after the widely publicized case of a 12-year-old boy who died in 2007 as a result of an untreated infected tooth, even though he was entitled to dental coverage under Medicaid. …Children in Medicaid were almost twice as likely to have untreated cavities as children with private insurance.”
Click the following link to see the 2009 GAO report.
Many children’s government and privately-funded health insurance plans include dental benefits that cover pediatric dental care delivered by dental professionals. Texas Health Steps (Medicaid) is an example of a government-funded health insurance plan.
Another example of a health insurance plan is the Children’s Health Insurance Program (CHIP). Click the following link to find out more information about CHIP. Providers who serve children who are covered by other plans should consult those plans for the specific details about their dental care coverage and policies.
Maria brings her one-year-old son to your dental practice for his Texas Health Steps Checkup. Looking at his teeth, you notice white spots on his teeth that indicate nursing decay. What advice do you give Maria to promote optimum oral heath care for her son?
Do not let the child walk around with the bottle or put the child to bed with fruit juice in the bottle.
Replace the bottle with a sippy cup, and schedule feeding times. Provide recommendations for cleaning the teeth after meals, and check for white spots and cavities. All of the above.Your answer is correct!
To prevent developing oral disease, dental diagnoses and treatment plans need to encompass two important interventions:
Your answer is incorrect.
To prevent developing oral disease, dental diagnoses and treatment plans need to encompass two important interventions:
Dental anticipatory guidance includes a range of key information that a dentist or health-care professional provides to the parent or caregiver of the child or to older children and adolescents about current oral health conditions and what to expect during the next developmental stage. Many oral health issues can be prevented if parents or caregivers take an active role in the daily care of their child’s gums and teeth. Dentists and health-care providers should include topics such as guidance about:
Anticipatory guidance should also address the specific risk assessment responses that the patient or the patient's parent has provided. The content of the anticipatory guidance should always address age-appropriate information because oral environment and risk factors change dramatically from infancy to late adolescence.
Dental Anticipatory Guidance Charts are available in English and Spanish through Texas Health Steps. Click this link to the DSHS Resource Catalog webpage for more information and to order charts.
The use of early and periodic dental examinations and dental anticipatory guidance, in combination with appropriate dental treatment that conforms to professional standards, helps assure that dental and health professionals meet the Texas Health Steps goals of quality services and good oral health care.
Texas Health Steps patients through 20 years of age can self-refer for dental services.