Action for Provider
Prevention education and early detection of oral health problems are pivotal to preventing diseases. Oral health assessment is a mandatory component of the Texas Health Steps exam for Medicaid eligible members from birth through 20 years of age. THSteps policy requires referral to a dentist at six months of age and every six months thereafter until a dental home has been established and until patient is being seen regularly for dental care.
As a provider of services for children on Medicaid, you can contribute by following the Texas Health Steps Periodicity Schedule1 to incorporate all necessary components, including assisting patients with accessing dental health care and dental care coverage, making successful dental referrals, and educating patients on the importance of daily dental hygiene.
Oral Health Facts
- Tooth decay is the most common chronic childhood disease in the United States. Untreated cavities can cause pain and infections that may lead to problems with eating, speaking, playing, and learning.
- About 1 of 5 children ages 5 to 11 years old and 1 of 7 adolescents ages 12 to 19 years old had at least one untreated decayed tooth.2
- Over 67% of Texas 3rd graders have experienced tooth decay.2
- Children ages 5 to 19 years from low-income families are twice as likely to have cavities, compared with children from higher-income households. 3 This disparity may be related to issues of access to care, payment, and lifestyle behaviors.
Resources
For Texas Medicaid Provider Quality Improvement, review the following resources ranging from quality measures data to current vaccine schedules:
- Clinical Practice Guidelines
- Preventive Care Guidelines
- ImmTrac2 Texas Immunization Registry
- Quality Improvement Toolkit and Tip Sheets for Medicaid providers
- Texas Health Steps for Medicaid providers
References:
1 Texas Health and Human Services. (2018). Texas Health Steps medical checkup periodicity schedule for infants, children and adolescents. Retrieved Nov. 1, 2019, from https://hhs.texas.gov/sites/default/files/documents/doing-business-with-hhs/provider-portal/health-services-providers/thsteps/ths-med-checkup-periodicity-sched.pdf
2 Texas Department of State Health Services. (2019, Oct 24). Smiles in Schools. Retrieved from: https://www.dshs.state.tx.us/dental/School-based-clinics.aspx
3 Centers for Disease Control and Prevention. (2019, May 14). Children’s Oral Health. Retrieved from: https://www.cdc.gov/oral-health/prevention/oral-health-tips-for-children.html
The above material is for informational purposes only and is not a substitute for the independent medical judgment of a physician or other health care provider. Physicians and other health care providers are encouraged to use their own medical judgment based upon all available information and the condition of the patient in determining the appropriate course of treatment. References to other third-party sources or organizations are not a representation, warranty or endorsement of such organization. The fact that a service or treatment is described in this material, is not a guarantee that the service or treatment is a covered benefit and members should refer to their certificate of coverage for more details, including benefits, limitations and exclusions. Regardless of benefits, the final decision about any service or treatment is between the member and their health care provider.