This spring, DentaQual ratings were added to dentist directory listings. The program introduction was positively received and we are sharing a national announcement to broaden the understanding of the system as it is rolled out to more listings. In preparation for these changes, you can learn more about how DentaQual works, how it can help your practice and how ratings are developed.
Do you know how many of your patients plan to become pregnant or adopt a child in the next year? Unlike physicians, you probably see most of your patients every six months. In the space between cleanings, a woman could be almost 2/3 of the way through a pregnancy or an average adoption could be nearly finalized.
Since visits can be far apart, communication is key. When your patients tell you about plans to have a child, tell them how important it is to consider dental health and visits to the dentist as an important part of a child’s overall health. Less than half of parents receive professional advice on when to start taking their child to the dentist, which can lead to early oral health problems and dental disease.
The pandemic’s effect on pediatric oral health
Even before the COVID-19 pandemic, dental disease among children was rampant:
- Tooth decay is the most common non-communicable disease in the world.
- More than 40% of American children have decay before the time they reach kindergarten.
- About 20% of children aged 5 to 11 years have at least one untreated decayed tooth.
The pandemic made these problems worse by stressing the financial systems that deliver dental care with job loss that led to lack of coverage and loss in income. As a result of the pandemic, households were three times more likely to indicate that dental care was an unmet health need of theirs rather than medical care, according to a JADA study. The authors found a significant association between the probability of unmet child dental care and pandemic-related household income or job loss.
About 40% of families reported the loss of a job or decrease in income due to the pandemic. Before the pandemic, children from families with lower incomes or on Medicaid were twice as likely to have cavities than children from higher-income households. Whether due to lost or decreased income, fear of contracting COVID-19 or mixed communication from health organizations, dental care visits dropped in 2020.
Luckily, households were unlikely to completely lose health insurance during the pandemic. Robust signups for Medicare and Medicaid kept many people insured. But cost remains the major barrier to receiving dental care. Although access to pediatric dental care has grown for families with public insurance since the early 2000s, inequitable access continues to be linked to socioeconomic status. Additional barriers include difficulty finding a dentist, transportation and geographic proximity to available dentists.
What you can do to address unmet needs
As a dentist or a hygienist, you’ve got a lot to do in a day. You can still find ways to address children’s health that fit into your office’s workflow. Here are some examples you can use to start the conversation with your co-workers and with patients:
- Talk about timelines. Be sure to inform any new parents, guardians or caretakers about recommended timelines for pediatric care to guarantee they get the information they need from a trusted source.
- Get innovative. Did you know that 75% of pediatric dentists offer virtual services, compared to only a third of general dentists? If you haven’t explored teledentistry services, consider adding them to your repertoire.
- Share materials. Explore Delta Dental’s wellness resources and share a selection of helpful articles and flyers in your office or on your website. You can even highlight assets that are made for kids, like MySmileKids and Grin! for Kids.
- Collaborate instead of criticizing. Making a patient feel guilty, ashamed or afraid for their health rarely works to inspire improvement. Focus on behaviors that they can change and empower them with knowledge.
- Gather information. Your patients may feel uncomfortable if you ask them directly about their plans to conceive or adopt in the next year. If your practice already does pre-screenings, consider adding a question to capture that information and add it to the patient’s file.
How Delta Dental invests in communities
The best way to treat the pediatric oral health dilemma is large investment in public dental health, something dentists can’t really do on their own. The COVID-19 pandemic stressed the financial system that supports the delivery of dental care services, revealing that changes are required to support access to dental care during times of changing financial situations.
To help dentists make investments in their communities, the Delta Dental Community Care Foundation awards several million dollars in grants each year to increase access to care. These awards enable underserved individuals, including children, to get preventive and restorative treatments in accessible locations. More than 250 organizations received funding from the Delta Dental Community Care Foundation during the COVID-19 pandemic, totaling $11 million to provide relief. Many of these clinics support and serve children.
These Access to Care grants fund activities designed to remove barriers to seeking care such as distance, cost and even fear. The grants can be used to set up mobile or pop-up clinics in a local community, provide dental care in underserved clinical settings, fund outreach programs or offset costs for clinics that routinely provide care to underserved populations.
What comes next
The U.S. economy seems to be recovering. The national unemployment rate is projected to fall to 5.3% by the end of the year. But the problems highlighted by the pandemic shouldn’t be ignored.
As a dentist or dental hygienist, you can’t be expected to fix all of the problems in the American economy or health care industry. Still, by making active efforts to be accessible and communicative with your patients, you can make a difference in their lives and the lives of their children.
In addition to your exam findings, do you evaluate your patient’s blood pressure readings? May is National High Blood Pressure Education Month, when you can renew focus on the importance of heart health in oral health and total wellness care.
The time you take for a blood pressure reading gives you vital information for your patient’s gum treatment, which may reduce hypertension risk.
The causal link between gum disease and hypertension
A March 2021 research study showed that patients with periodontitis and no other health issues are twice as likely to have elevated blood pressure as those with healthy gums. This may suggest that periodontal bacteria can trigger an inflammatory response that affects blood vessel function and lead to the development of hypertension.
When does blood pressure signal health risks?
A normal blood pressure reading is less than 120 mm Hg systolic and less than 80 mm Hg diastolic, according to Centers for Disease Control and Prevention (CDC) guidelines. You should be concerned if the systolic/diastolic reading falls into one of these categories:
- Elevated: 120-129 mm Hg and less than 80 mm Hg
- Stage 1 Hypertension: 130-139 mm Hg or 80-89 mm Hg
- Stage 2 Hypertension: >140 mm Hg or > 90 mm Hg
Hypertension puts your patients at risk for heart disease and stroke, the leading causes of death in the U.S. Nearly half (45%) the adults in the U.S. have hypertension or are taking medication to control it, according to the CDC, and only 24% of them have it under control.
The dangers of gum disease
Gum disease triggers inflammation that thickens the lining of blood vessels. The thickening plaques decrease blood flow, which increases the risk of heart disease and stroke.
Patients with healthier gums had lower blood pressure and responded better to medications, compared to those with periodontitis, according to an analysis, published in Hypertension, based on review of medical and dental exam records of more than 3,600 people with high blood pressure.
What’s more, periodontal therapy can make a difference. Intensive periodontal treatment lowered blood pressure levels (12.67 mm Hg/9.65 mm Hg) in patients over six months, after a four-week intervention, according to a clinical study published in 2017 in the Journal of Periodontology.
How you can educate your patients about high blood pressure
With this in mind, use your blood pressure check as an opportunity to educate your patients. If you notice an elevated reading, discuss the importance of getting blood pressure under control.
And you can explain how keeping gums healthy can contribute to better circulation and heart function through lowering blood pressure.
Your periodontal treatment and advice on daily flossing and brushing regimens take on added value for your patient, in reducing risks from hypertension.
Delta Dental Insurance Company’s NCQA Credentialing Accreditation has been renewed through March 2024.
“Achieving NCQA Credentialing Accreditation demonstrates that Delta Dental Insurance Company has the systems, process and personnel in place to conduct credentialing in accordance with the strictest quality standards,” said Margaret E. O’Kane, president of the National Committee for Quality Assurance (NCQA).
NCQA is a private, nonprofit organization dedicated to improving health care quality. NCQA’s Credentialing Accreditation is a quality assessment program that focuses on consumer protection and customer service improvement.
NCQA has reviewed and accredited Delta Dental Insurance Company’s Credentialing functions only. For complete details on the scope of this review, visit www.ncqa.org.
Beginning April 2, you can find a new quality rating system in the dentist directory: DentaQual. Here are a few points to help you understand how your DentaQual score helps new patients find you by objectively quantifying what makes you a great dentist.
What is DentaQual?
DentaQual is a ratings system developed by P&R Dental Strategies that showcases the quality of the care you provide to your patients. By providing a comprehensive, uniform metric, DentaQual boosts patients’ trust in your care and confidence in their outcomes. Your DentaQual score appears on your dentist directory listing and is updated monthly.
What makes DentaQual scoring objective?
P&R Dental Strategies is a neutral third-party dental informatics company that is not owned by any insurance carriers. DentaQual ratings are determined using treatment data only. Instead of relying on subjective patient testimonials, DentaQual is based on a statistical analysis of de-identified and aggregated claims data. The metrics that are scored are:
- Treatment outcomes
- Commitment to best practices
- Patient retention
- Treatment recommendations
All scoring is based on standard deviation from the norm, with the “the norm” representing the average level of quality in the dentist’s three-digit ZIP code region and specialty. DentaQual’s data comes from DentaBase, P&R Dental Strategies’ multi-payer, de-identified and aggregated claims database. DentaQual ratings do not include Medicaid claims data.
How can DentaQual help my practice?
Your DentaQual score serves as another resource to attract new patients. Unlike an online review you might find on social media, DentaQual’s objectivity means that the quality of your work as a dentist will be able to speak for itself. When it comes to online reviews, patients often review dentists like they would a restaurant, prioritizing personality and speed of service over quality of care.
Will every dentist in the Delta Dental network have a DentaQual rating?
Ratings will be applied to Delta Dental PPO™ and Delta Dental Premier® dentists in our 15 enterprise states and the District of Columbia. DeltaCare® USA dentists within those geographic areas who also participate in the PPO and Premier networks will also be rated. At this time, DentaQual scores will only be shown on the directory pages for dentists with enough available data to be rated. The data will be refreshed on a monthly basis, so if you don’t currently have a score, you may in the future as more data becomes available.
I’m in a group practice with other dentists and we all share the same patients. Will we have different ratings?
DentaQual scoring is based on claims data from the dentist who performs the treatment through his or her NPI. Because of this, your rating may differ from those of other dentists at the same practice.
If you have more questions about DentaQual or your score, please reach out to P&R Dental Strategies at DentaQual@pandrdental.com. You can also request a copy of your rating summary for reference.
When he was receiving a dental cleaning many years ago, Dr. Daniel Croley had a conversation that changed the course of his life and career. At the time, he was a college student with a pre-med major headed toward medical school, but a serious talk with his dentist opened his eyes to a new path.
After shadowing the dentist for a few weeks to learn about his practice, Dr. Croley realized that the profession would be a great fit.
“Throughout my life, I’ve been interested in helping people, and making a meaningful impact,” he said. “I liked the patient interaction, and dentistry’s focus on prevention spoke to me.”
While earning a B.S. degree in zoology and a DMD degree at the University of Kentucky, he gained practical experience working in hospitals, where he “fell in love with patient care” while assisting patients with disabilities or medical conditions requiring stronger oversight.
Today, Dr. Croley serves as Delta Dental’s chief dental officer. In his new role, he builds on his years in private practice to inform his work overseeing Delta Dental’s dentist networks.
From private practice to dental insurance
After earning his DMD, Dr. Croley moved to Chicago and managed two dental practices for eight years. Although he loved the work, he suffered a severe shoulder injury, related to repetitive strain, that caused him to seek care from several specialists.
The risk to his health was too great, and it was an emotional decision to leave practice. He began looking for a new position that would allow him to use his knowledge and skill “in a meaningful way to help people get healthy.”
Dr. Croley worked for seven years for a third-party administration company, which eventually became Humana. He then received a call from PMI, an HMO subsidiary of Delta Dental of California, and he accepted a position to manage its dental networks.
“I found my way to the dental benefit world and it was a fit for sure,” he said. “When I was in practice, I helped one person at a time, and now I could influence many more people through my work overseeing quality delivery of care across many providers.”
Shaping Delta Dental’s care and vision
After a brief period working for the American Dental Association, Dr. Croley began his role as vice president of network development at Delta Dental.
“Having worked for other insurance companies, I knew Delta Dental to be the best in class,” he said, “and this is continually confirmed. This is a great, caring compassionate company.”
As vice president of network development, he emphasized the goal Delta Dental shares with dentists: bringing health to our communities. He described a partnership of trust that supports dentists as business owners, healers and community members.
Improving the quality of dental care
Now, as chief dental officer, Dr. Croley has another goal: improving the quality oral health care that patients receive.
“When you think about what patients want,” he said, “it’s access, affordability and quality.”
While he was serving as director of informatics at the ADA, Dr. Croley made two significant observations: (1) the value of data and using data to inform decision-making, and (2) the shared focus of dentists and dental plans — the patient.
Combining these ideas fits into Dr. Croley’s plans as chief dental officer. Defining quality is the first step in the process, he said, and then identifying objective measurements against expected outcomes.
”We will be building transparency around the quality of care that dentists deliver to patients,” he emphasized.
To do this, Delta Dental will be helping to facilitate dentists’ understanding of what quality is and empower them to achieve it in their interactions with, and services to, patients.
Today’s practice challenges for dentists
The COVID-19 pandemic has taken a toll on dental practices. As dentists face ever-changing conditions in 2021, Dr. Croley sees planning as a key to the return to pre-COVID-19 patient volumes and practice revenue.
“COVID has been hard on dentists, and it’s been harder in some states, like California and New York,” he pointed out. “Patient traffic is down in dental offices, both because some people are afraid of catching the virus and so many have lost their jobs.”
However, patient volumes nationally have increased to an estimated 78% of their pre-COVID-19 level, according to an ADA poll taken Dec. 14, 2020. Dentists have applied infection control, sanitization and sterilization measures in their practices all along, Dr. Croley observed. The key, he said, is to “just make sure their patients feel safe to come back into care. People cannot put off their preventive and restorative dental care.”
While the pandemic has increased costs for personal protective equipment (PPE) and caused difficulty with staging and scheduling, Dr. Croley advises dental offices to adjust their business practices to the new conditions, such as changing their hours of operation.
“Dentistry is both a business and a clinical profession,” he said. “We want to help practices remain stable in the market.”
A shared purpose
Through participation in Delta Dental’s networks, which are the largest in the nation, dentists can attract patients, and patients covered under Delta Dental plans can access quality care.
Ultimately, Dr. Croley said, “Delta Dental and dentists share a fundamental purpose: improving health through affordable, quality care.”