Integrating Oral & Physical Health: Part 3

“You cannot be healthy without oral health. Oral health and general health should not be interpreted as separate entities. Oral health is a critical component of health and must be included in the provision of health care and the design of community programs.

…caries (tooth decay) and periodontal disease…remain common and widespread, affecting nearly everyone at some point in their life span. What has changed is what we can do about them.”

– Oral Health in America: A Report of the Surgeon General (2000)

According to the Oregon Oral Health Coalition, early childhood caries (ECC), also known as tooth decay, affects five times more children than asthma. However, with regular visits to the dentist and proper home oral care that includes daily brushing with fluoridated toothpaste, ECC is largely preventable.

Reimbursement Available for Dental Assessments & Fluoride Treatment

In Oregon, health care providers can perform dental assessments (D0191) and apply fluoride varnish (D1206) in a medical office setting and be reimbursed. Fluoride varnish can be applied multiple times throughout the year and can reduce tooth decay between 30 and 69 percent in the primary teeth of high-risk children. In order to bill for these services the provider must first complete training through First Tooth (offered by Oregon Oral Health Coalition’s local trainers) or Smiles for Life (an online national oral health curriculum). Following their initial training, providers must retrain once every three years.

The First Tooth Program, which was created by the Oregon Oral Health Coalition, aims to reduce ECCs through education and making preventive services such as dental assessments and fluoride varnish applications more accessible. In addition, First Tooth offers training based on research and best practices to health care professionals to help them recognize the warning signs of ECC and connect their patients with their dental home.

A number of clinics in our region have already received First Tooth training, including:

  • Bayshore Family Medicine
  • Coastal Family Medicine
  • Coastal Health Practitioners
  • Community Health Centers of Benton/Linn Counties
  • The Corvallis Clinic – Corvallis
  • The Corvallis Clinic – Philomath
  • Lincoln County Health Department
  • Lincoln County Health and Human Services
  • Mid-Valley Children’s Clinic
  • Mid-Valley Pediatrics
  • Samaritan Pediatrics
  • Siletz Tribal Community Health Clinic

If you are interested in integrating First Tooth into your practice or would like to learn more about the program, please visit

Clinicians Are Making a Difference in Our Communities’ Oral Health

As more clinics implement the First Tooth program, we have seen a significant rise in fluoride application billings across Benton, Lincoln and Linn Counties. According to InterCommunity Health Network Coordinated Care Organization’s (IHN-CCO) claims data, 489 claims have been received to date for 2016 compared to just 12 for all of 2015 (see the graph below for more details).

Next Issue: Introducing the Smiles for Life Program

Next month, we will feature the national Smiles for Life program, as we continue to explore how oral and physical health are related and the opportunities primary care clinics have to integrate and coordinate dental services. For more information about integrating oral health programs and services in your clinic, please contact us and let us know you would like to be connected with one of our dental coordinators.

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