National Quality Forum #: None
Numerator: Number of oral health patients with a diagnosis of HIV who received oral health education2 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
- Patients who had only an evaluation or treatment for a dental emergency in the measurement year4
- Patients who were <12 months of age
- Does the patient have a diagnosis of HIV? (Y/N)
- Data reports required by HRSA/HAB, such as the Ryan White HIV/AIDS Program Services Report (RSR)
- Electronic Health Record/Electronic Medical Record
- Sample of oral health services, patient records
- Provider billing systems (Note: This will be dependent on the completeness and accuracy of coding of the procedures of interest.)
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 dental disease and oral pathology in the practice population
- Rate of tobacco cessation in the practice population
Basis for selection
A higher risk of dental caries in patients with HIV may be caused by decreased salivary flow, which may occur as a result of salivary gland disease or as a side effect of a number of medications. Also, some topical antifungal medications have high sugar content, possibly resulting in increased caries susceptibility.
The adverse effects of using tobacco should be discussed with the patients. If patient is a tobacco user, cessation should also be discussed. For in-office consumer and provider materials on tobacco cessation programs, dentists can access HHS.gov: The Surgeon General's Priorities.
The American Dental Association (ADA) provides a number of resources providers can use regarding tobacco and oral health.
Department of Health and Human Services Clinical Practice Guidelines
1 "Patient" includes patients aged 12 months or older.
2 Oral health education should include oral hygiene instructions (ADA CDT code D1330) and tobacco counseling for the control and prevention of oral disease (ADA CDT code D1320) as indicated. Oral health education may be provided and documented by a licensed dentist, dental hygienist, dental assistant, and/or dental case manager. For pediatric patients, age-appropriate oral health education should be provided to parents and caregivers.
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 excluded patients.
5 New York State Department of Health. Oral health care for people with HIV New York (NY): New York State Department of Health; 2001 Dec: 4.