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Identifying high risk adults for more preventive care

Partners In Prevention 1A new review of dental studies found that traditional risk factors for caries in adults are wanting in terms of accuracy. The best conventional predictors are recent experience with this disease and salivary concentrations of Streptococcus mutans; but even these, when used singularly are not robust.

Because major payers of dental services are starting to ration their payment according to risk (so that the high risk get more attention), the validity of risk factors becomes paramount. Payers such as the UK National Health Service need to ensure that high risk adults who consume the majority of services in any group, are indeed high risk.

Let me weigh-in with 3 comments:

  • traditional dental risk factors (such as a recent experience with cavities or crowns)need supplementing with disease indicators such as diabetes and arthritis. It is clear that diabetics and those with other chronic conditions experience more decay.
  • Risk assessment needs to rely on more than one indicator. A composite of traditional and disease indicators will enhance the accuracy of predicting who will have poor oral health.
  • The plethora of controlled studies on shared diagnosis in chronic diseases show thatinvolving the patient in predicting oral health, greatly enhances both accuracy and adherence. Moreover, it is what the patient wants.

Payment for dental services according to the risk of poor oral health, is the future of dental reimbursement. The status quo of un-differentiated access to care has led to over-treatment, under-treatment and an inexorable growth in costs. So, we better get the risk assessment process right.

For more, please visit: http://partnersinprevention.ca/identifying-high-risk-adults-for-more-preventive-care/.

By: Ross Perry
SOURCED: Partners In Prevention – www.partnersinprevention.ca

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