Is There A Better Win/Win Situation Out There?

According to the American Dental Association,  two or more applications of fluoride varnish per year are effective in preventing caries in patients identified as high or moderate risk. Why is it then that so few practices are aggressively promoting adult fluoride treatments? There seems to be a major misconception by your patients–and unfortunately by many dentists–that fluoride is only beneficial when the teeth are developing, that there is no sustained benefit from fluoride, and that fluoride treatments are just for kids. I recently attended a fabulous three-hour seminar presented by 3M ESPE on CAMBRA. That is the acronym for caries management by risk assessment. Here is what I learned.

1. An actively promoted program is of great benefit to your patients, and it represents a really, really significant revenue stream to the practice through the dispensing of fluoride toothpaste and fluoride varnish treatments.

2. The hygiene department must be supported by the doctor and all staff regarding the importance of risk prevention. Every team member needs to be on board and committed to the program.

3. Patients need to be educated to understand that just treating cavities will NOT prevent future disease.

4. A well-designed, simple, one page caries risk assessment form is essential to success. It is metaphorically similar to a blood pressure cuff at a medical exam. Every time you see your physician, you have your blood pressure taken as part of an assessment of your overall health. So the risk assessment form for caries should be used for every patient visit in hygiene.

I have created a form for your use. You can download the form and personalize it with your practice name. I am also suggesting that you watch this brief video that 3M provides on the application of fluoride varnish. I am also including another brief video that discusses the dispensing of fluoride toothpaste in your office.

This seminar, attended by dentists and hygienists, was a wake-up call for me. As part of the program, we all had to do a self-assessment of our risk for caries. In my case, I am 72 years old, I have significant recession with exposed root surfaces, my mouth is heavily restored with fillings and crowns, and I wear a night guard which causes dry mouth. I am at high risk! I should be receiving fluoride varnish at least twice a year, and the risk assessment form graphically illustrates this fact!

The national average fee for fluoride varnish is about $35. More and more insurance companies are covering this procedure because they recognize the value of prevention. You should be aware that as of January 2013, ADA codes 1203 (child) and 1204 (adult) topical application of fluoride (not varnish) will be combined to code 1208. Code 1206 is now and will continue to be application of fluoride varnish for moderate or high risk patients.  Insurance or no insurance – if patients understand the value, they will buy – it’s that simple.

Establishing an aggressive evidence-based carries prevention program should not be that difficult. Please make it one of your resolutions for 2013.