As an oral health care provider, you’re an essential member in the fight against the opioid epidemic. Many adolescents who abuse opioids have their first encounter with medically prescribed painkillers (such as those prescribed for wisdom tooth removal), according to the National Institutes of Health. The overall percentage of opioids prescribed by dentists increased by 12.9% from 2010 through 2015, so being aware of how to combat overprescribing is more important than ever.
making continuing education on prescribing opioids and other controlled substances mandatory
implementing statutory limits on opioid dosage and prescription duration
improving the quality, integrity and interoperability of state drug monitoring programs
Another important aspect of helping to combat opioid addiction is having open and honest discussions with your patients. The ADA has put together resources to help you educate your patients about the addictive qualities of narcotic painkillers. You can find a comprehensive collection of webinars about opioid prevention for dentists. For example, the ADA offers advice on selecting strategies for pain management that are appropriate for the estimated severity of different procedures.
Studies have also found that a combination of ibuprofen and acetaminophen can be a more effective pain management tool than simply prescribing opioids, as well. As Dr. Daniel Croley, our Vice President of Network Development, says, “We ask that all dentists consider non-addictive pain management as their first choice. When narcotics are needed, only prescribe the lowest dosage and quantity needed to effectively manage your patients’ pain.”
The opioid epidemic may be too big for any one person to solve, but to quote Dr. Croley, “Together, we can stop the overprescription and abuse of opioids.”
It’s back-to-school season. In the spirit of ongoing education, we’re announcing a series of webinars in September that will show you how to make the most of Provider Tools. The webinars will also show you how you can talk to your patients about returning to your practice safely and how you can help fight the opioid epidemic that continues to afflict the United States.
Attend a Provider Tools and National Recovery Month webinar to learn:
How to use Provider Tools to manage your patients
How to talk to your patients about teledentistry and safe in-office visits
How to help your patients manage pain without narcotics
How you can do your part to fight the opioid epidemic
Have you already opened up your practice, but you’re seeing fewer patients than before? Want to learn more about the latest tools to help you run your business more easily and more efficiently?
Not only will our webinar series show you all the tips and tricks you need to get the most out of Provider Tools, it will also offer insight into running a reopened practice. Whether you’re a Provider Tools expert or a first-time user, whether reopening has gone more smoothly than you imagined or has been a bumpy ride, we’re here for you.
Attend a Provider Tools and Return to Care webinar to learn:
How to use Provider Tools to manage your patients
How to communicate with patients about coming back for dental visits
How to protect yourself, your staff and your patients against COVID-19
On-site quality assessment (QA) reviews are part of our quality assessment program for dentists in California, mandated by the California Department of Managed Health Care.
A QA review gives
you a look at how the many components of your practice compare to the
expectations of dental professionals, regulatory agencies, dental educators and
QA reviews are
conducted in two parts:
Structural (about 20 minutes): Review of your facility and equipment, as well as emergency, sterilization and infection control protocols.
Records (about 1 hour and 45 minutes): Review of patient treatment documentation for relevance and acceptability under current standards of patient care.
The following list highlights just some of the aspects of a QA review. It can serve as a useful tool to help you review your practice through the eyes of the QA examiner. Together with your staff, you can evaluate your office policies and procedures and be even better prepared for a future on-site QA review.
Facility and equipment
Facility is clean and well maintained, dentist name and office hours are posted.
Procedure manual includes written protocols for new and recall appointments, documenting complaints, broken appointments, specialty referral.
Accessibility/reasonable accommodations exist for patients with disabilities, such as wheelchair access and a grab bar in the restroom.
Waterlines have anti-retraction valves installed and maintained, handpieces and waterlines are properly flushed.
Certificates are current and equipment inspection dates are posted.
Lead (or lead-equivalent) apron with thyroid collar is used.
Sterilization and infection control
Staff is trained in infection control standards and logs are kept of procedures followed.
Gloves, masks, protective attire and eyewear are used appropriately.
Weekly biologic monitoring is conducted and records are kept.
Instruments and handpieces are properly sterilized, stored and labeled.
Safety and emergency
Drugs, syringes and needles are properly stored; a log is kept of drugs dispensed on site.
Required certifications are up-to-date.
A modern evacuation system exists for nitrous oxide.
Written office protocol includes staff responsibilities for assisting/evacuating patients in emergencies or natural disasters, evacuation plan is posted and exits marked.
An active contact system can reach the dentist 24/7.
Portable emergency oxygen is available, tank is full and there is a positive pressure valve and/or Ambu bag; staff are trained in use.
Mercury hygiene and safety requirements are observed.
Medical emergency kit is up-to-date.
Medical and dental history
Medical history forms include yes/no questions, identify patient’s existing conditions and contain comprehensive health information.
Dental history includes baseline information, TMJ/occlusion status, appliances, periodontal condition and results of soft tissue/oral cancer exam.
Progress/treatment notes are legible and in ink
Included, as appropriate, are:
Referrals to specialists
Records forwarded or received
Anesthetic used (type, amount and concentration of any vasoconstrictor)
Quality of care
Professionally acceptable standards of care are observed for:
X-rays — adequate number, appropriate frequency, of diagnostic value, mounted and labeled
Treatment plan — in ink, consistent with diagnosis and exam findings, alternative and elective treatment documented with the patient’s choice and reason
Treatment sequence — in order of need
Informed consent — documentation that treatment plan was reviewed and patient understands risks, benefits, alternatives and costs; any refusal of recommended care is documented
Outcomes of care
Patient records demonstrate effectiveness of preventive care
Overall comprehensive documentation demonstrates that treatment was provided as appropriate, including:
Ensuring that patients understand their financial responsibility for treatment, including treatment that is not covered under their dental benefits plan, can help safeguard their overall satisfaction with your practice.
A good way to accomplish “informed consent” (as required under your Delta Dental participation agreement) is with a thorough discussion about treatment, alternatives and costs, along with a form or other documentation that includes the same information and the patient’s written acknowledgement of the discussion. Points to discuss and document include:
The agreed-upon course of treatment and specific non-covered services
The patient’s acknowledgement of non-covered services and personal responsibility for the cost
Risks and advantages of proposed and alternative treatment
Costs for necessary subsequent treatment, such as a crown after endodontic therapy
In addition, we strongly recommend that you submit a pre-treatment estimate before providing any non-covered services (or any expensive and/or extensive services). Though not usually required, a pre-treatment estimate has several advantages, including further helping patients understand their benefits and financial obligations.
Much of this information is covered in your Dentist Handbook, which is updated periodically. Be sure to review it regularly by logging in and using the Reference Library.