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Debbie Seidel-Bittke, RDH, BS is known as a top dental consultant by Dentistry Today.

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Dental Practice Solutions - Debbie Bittke

Caries Risk Assessment: Saving Dollars for Your Dental Patient Adds Profits to Your Dental Practice

By: Debbie

July 9, 2013

Tooth Decay

I get excited when a dental office contacts me to be their Dental Practice Management Consultant and recently I had a few offices contact me who were located outside of the United States.

Their reason to call was to have a US Dental Practice Management Consultant implement preventive services for their practice and bring preventive protocols to their practice.

One of the most overlooked areas in a dental practice today is the Caries Risk Assessment. (CAMBRA) It happens a lot that offices do not have a protocol in place to assess and prevent caries. CAMBRA is not new. The California Dental Journal produced two journals dedicated to this topic in October and November 2007 and again in October 2011.

It is very rewarding to be a part of the shift in other countries who have millions upon millions of their population without preventive care services! There are dentists in these countries looking to make a change in their country. Congratulations to these dentists for leading CHANGE!

Caries Risk assessment is one of the areas we can see a huge shift in the underserved populations. With the guidance of a Consultant you will have a turn-key value added system in place to prevent disease and create one more profit center.

(Read below and add your own numbers to see what this means for your practice and profitability.)

What is CAMBRA?

  • CAMBRA assists providers to systematically evaluate caries risk in an individualized manner; children as well as adults.
  • Tailors a specific preventive therapeutic management plan or “care path”;
  • Customizes a restorative plan in conjunction with preventive care; and
  • Supports the dental professional to plan a timely, specific, and appropriate periodicity schedule based on the patients’ caries risk.

To effectively prevent and management the disease of caries, care should begin early, ideally during at age 1 a comprehensive oral exam visit is completed.

Yes, assessment begins very early. Do you tell parents that a child’s first visit is at age 3? NO? Think again.

Here are steps to prevent caries risk:

  1. A caries risk assessment is the first of these critical steps,
  2. Give the provider more information to help them consider the risk and health status of each patient before beginning the exam.
  3. Caries risk assessment provides information pertaining to three specific overarching domains: white spot lesions, decalcification enamel.  defects or other obvious decay in the child.

The information obtained from a caries risk assessment allows the care provider to formulate a caries risk profile for the child, and also an adult. This is an essential first step to determining the prevention and treatment plan, as well as the periodicity of patient follow-up/continuing care visit. (one month, three months, six months, or one year).

The CAMBRA-based dental practice will increase the usage of current preventive products. (Another profit center for your dental hygien department)  The dental practice needs to have these products available to the patient so they can easily improve self-efficacy and begin using these preventive care products immediately.

CAMBRA-based prevention and nonsurgical caries management should lead to a shift away from restorative procedures to procedures focused on prevention and early intervention; cost analysis and development of financial models should show the economic value change the psychology of the dental professional’s messaging style.

Include attractive literature for patients to read in your reception areas and take home with them to learn more about Caries Prevention.

The new CDT codes for CAMBRA will assist in reimbursement for the patient.

In January 2013 the CDT codes were revised and D 1204 and D1203 are no longer used. For the patient who receives a fluoride varnish the insurance billing code will be: D1206.

For adults and children who receive a fluoride other than a varnish the code for billing used will be: D1208.

What does this mean for the profits to your practice?

For patients who are assessed moderate to extremely high risk they will return every 1-3 months for a short appointment to assess biofilm, review home care and diet, provide a fluoride varnish and if the patient will always use a 1.1% Sodium Fluoride each night.

Here is a breakdown of what this may mean for your dental practice and the patient:

 RISK ASSESSED         Interval of Service                          Services                                                                               CDT Code                Fee                 

Mod – Extremely High            1- 3mos                      Biofilm eval, F2 Varnish, eval home-care, 1.1% NaF                D1206, D09999          $  65

Low                                                  6 mos                        Prophy, F2 Varnish                                                                                 D1110, D1206             $135

 

Most offices will enroll at least 100 patients annually into CAMBRA. This above chart can be used to assess your profit potential. (Average practice is approximately 1500 patients)

CAMBRA strategies are implemented with a focus toward prevention and early intervention. Studies should also determine if there is significant practice growth and case acceptance once the patient oral health is improved.

CAMBRA represents best practices and should become the standard of care in disease prevention and treatment.

Debbie Oct 2012
ABOUT DEBBIE SEIDEL-BITTKE, RDH, BS

Are you looking to improve profits in your dental hygiene department? Debbie has an innovative and successful way to consistently increase profits in your dental practice.

Many dentists today only need a 1 or 2 day workshop in-office to create the best solutions. Some offices find it valuable to participate in one of our online membership programs. This investment will be your highest ROI .

Check our services section on the website to find one that meets your needs. Consider getting your team involved in our 12 week Case Acceptance Program. You won’t need to stop your day of work at the office or pay for a dental consultant to travel to your office. The program is at your fingertips 24/7 indefinitely.

Debbie writes for many of the major dental conferences in the world. She is recognized for the past 8 years as “One of Dentistry Today’s Top Consultants.”

Many of her clients span from not only the United States but Brazil, Australia, India and the UK, just to mention a few. She has unique and one-of-a-kind learning systems for offices all over the world to participate in as well as in-office workshops and dental hygiene consulting.