National Quality Forum #: None
Description: Percentage of oral health patients1 with a diagnosis of HIV who had a dental treatment plan2 developed and/or updated at least once in the measurement year.
Numerator: Number of oral health patients with a diagnosis of HIV who had a dental treatment plan2 developed and/or updated at least once in the measurement year
Denominator: Number of oral health patients with a diagnosis of HIV who received a clinical oral evaluation3 at least once in the measurement year
Patient Exclusions:
- Patients who had only an evaluation or treatment for a dental emergency in the measurement year4
- Patients who were < 12 months of age
Data Elements:
- Does the patient have a diagnosis of HIV? (Y/N)
National goals, targets, or benchmarks for comparison
The HIV Quality Measures (HIVQM) Module is a tool within the Ryan White HIV/AIDS Services Report portal. It allows recipients to enter aggregate data specific to HRSA HAB Performance Measures. The HIVQM Module allows recipients to conduct point-in-time benchmarking across Ryan White HIV/AIDS Programs that use the module.
Outcome measures for consideration
Rate of emergency dental visits in the practice population
Basis for selection
A comprehensive dental treatment plan that includes preventive care, maintenance, and elimination of oral pathology should be developed and discussed with the patient. Various treatment options should be discussed and developed in collaboration with the patient. As with all patients, a treatment plan appropriate for the patient's health status and individual preference should be chosen.
Medications may interfere with dental treatment and cause adverse effects: such as decreased salivary flow, altered liver function, bone marrow suppression, resulting in anemia, thrombocytopenia, and neutropenia. There is no evidence to support modifications in oral health care based solely on the presence of HIV infection. However, such modifications may be indicated on the basis of certain medical problems that occur as a result of HIV infection. Severely or terminally ill patients, for example, will require alterations in care similar to those of patients suffering from other conditions that cause debilitating illness, such as cancer or mental health impairment.5,6
Dental providers should follow American Dental Association (ADA) Dental Practice Parameters to address processes related to diagnosis and treatment planning for patients with HIV.7
Department of Health and Human Services Clinical Practice Guidelines
None
References/notes
1 "Patient" includes all patients aged 12 months or older.
2 Treatment plan: The sequential guide for the patient's care as determined by the dentist's diagnosis and is used by the dentist for the restoration to and/or maintenance of optimal oral health. ADA.org. Accessed January 2022.
3 Clinical oral evaluations include evaluation, diagnosis, and treatment planning. Pertinent ADA CDT codes may include the following: D0120-Periodic Oral Evaluation-established patient; D0150-Comprehensive oral evaluation, new or established patient; D0160-Detailed and Extensive Oral Evaluation; D0170-Re-evaluation, limited, problem focused (established patient; not post-operative visit); and D0180-Comprehensive Periodontal Evaluation-new or established patient.
4 Pertinent ADA CDT codes for patient exclusion may include the following: D9110-Palliative (emergency) treatment of dental pain-minor procedure; and D0140-Limited Oral Evaluation-Problem Focused. However, the diagnostic and treatment procedures associated with emergency evaluation and treatment encounters (including those using these or other ADA CDT codes, as well as other procedures which may not be coded) should be considered when identifying patients for exclusion.
5 Glick M, Abel SN, Muzyka BC, DeLorenzo M. "Dental complications after treating patients with AIDS." J Am Dent Assoc. 1994;125:296-301.
6 "Dental management of the HIV-infected patient." J Am Dent Assoc. 1995;(Suppl):1-40.
7 Department of Scientific Information, Evidence Synthesis & Translation Research, ADA Science & Research Institute, LLC. Human Immunodeficiency Virus (HIV). 2021. Available online. Accessed August 2023.