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CSPD Members Play Critical Role: School Entrance Oral Assessments Up and Running
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Under legislation long sought by CSPD and effective January 1 of this year, children enrolled in their first year of public school in either kindergarten or first grade are now required to obtain an assessment of their oral health as part of school readiness preparation. For children who already see a dentist and have established a dental home, compliance will be as simple as calling the office and requesting that the dentist fill-out and return the data collection form sent home by the school. Any dental examination conducted in the 12 months prior to the beginning of the school year will meet the assessment requirement, although dentists may wish to recommend a more recent examination when indicated in the best interests of the child. Parents have until May 31st to return the State’s data collection form to the school. While many schools districts are placing school information at the top of the form, dentists and parents may download and use the form available from the California Department of Education. A link to the California Department of Education website and a direct link to downloadable English and Spanish versions of the form are now available on the CSPD website (www.cspd).

For children who have not received a dental examination in the twelve months prior to school entrance, parents have several options. They may schedule a dental examination with a licensed dentist, they may arrange an oral assessment or screening evaluation by any licensed dental professional (a dentist, dental hygienist, or registered dental assistant under the direct supervision of the dentist), or they may request a waiver of the requirement. CSPD members have the opportunity to play a critical role in which decision is made by the parent.

The best decision for the child, and a significant intent of the legislation, is the establishment of a dental home through the scheduling of a comprehensive dental examination. When this is not possible or feasible, CSPD urges its members to consider providing a screening assessment in their office as a public service. It is important for both dentists and parents to understand the difference between a dental examination, which is a billable service and establishes the dental home, and a screening assessment which is not considered a billable service and only (1) collects the data required by the state concerning the incidence of treated and untreated dental caries and (2) identifies obvious or suspected conditions which require, or might require, examination and treatment by a dentist.

If a screening evaluation is conducted in the dental office it does not establish a dentist-patient relationship. Patients receiving such assessments do not become a patient-of-record and should not be expected to complete health histories or other office forms. To assist members providing these assessments, CSPD and CDA have developed a Consent and Recommendation Form for use in the dental office. The form provides for the consent of the parent or caregiver, explains the limitations and differences between an oral assessment and a comprehensive oral/dental examination, and provides a section in which the dentist can make recommendations concerning the child’s oral health. The form, in multiple languages, is downloadable from the CSPD website (www.cspd). It should be given to the parent or caregiver, along with the State data collection form, and a copy kept in the office for a period of one year. Oral evaluations performed in the dental office help parents meet the school requirement and serve as an introduction to the dental delivery system.

CSPD anticipates may school districts, especially those most impacted by oral health disparities, will work with local dentists and local component dental societies to establish school-based and school-linked oral health screenings to ensure pupils receive these assessments. Such screenings will provide an additional opportunity to create effective systems of triage and referral of children whose families experience barriers to dental care and the establishment of a dental home. CSPD encourages the participation of its members in these activities as well as in providing in-office assessments.

Ultimately, the success and survival of school-entrance oral health examinations and assessments will be judged by public compliance with the legislation. Parents may receive a waiver of the requirement by indicating the assessment poses an undue financial burden, cannot be completed because they are unable to locate a dental professional to perform the assessment, or by simply withholding consent. By facilitating the examination and assessment process, CSPD members make it less likely a parent will choose to use the waiver.

Paul Reggiardo, DDS
Public Policy Advocate
California Society of Pediatric Dentistry
February, 2007

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