What is First Dental Home?
- A package of dental services aimed at improving the oral health of children 6-35 months of age.
- Provides simple, consistent messages to parents/caregivers of very young children.
- Materials collaboratively developed by pediatric and general dentists.
- Link to Materials
Who is being trained to provide a First Dental Home?
- Currently enrolled Texas Health Steps pediatric and general dentists.
- Dentists who have submitted a Texas Health Steps dental provider enrollment application.
- Dental team members are encouraged to participate in FDH trainings.
- Link to Training
What is included in a First Dental Home visit?
- Caries risk assessment.
- Dental prophylaxis.
- Oral hygiene instructions with primary caregiver.
- Application of topical fluoride varnish.
- Dental anticipatory guidance.
- Establishment of recall schedule.
Why complete a Caries Risk Assessment?
- Determine potential for development of severe early childhood caries (SECC) by identifying the:
- Oral health status of the child/patient.
- Oral health status of primary caregiver and other family members.
- Potential bacterial transmission sources.
- Direct dental anticipatory guidance content.
- Determine an appropriate recall periodicity schedule for the child.
What is “Dental Anticipatory Guidance”?
- Age appropriate information/education for parents/caregivers based on:
- Questionnaire responses
- Parent/caregiver interview
- Caries risk assessment
- Multi-topic overview of oral health environmental influences.
- Directed at increasing the parents/caregivers’ understanding about the importance of good oral health.
What documentation is required?
Date of FDH visit.
Name of primary caregiver present during FDH visit.
Document what took place during visit (11 Components).
1. Completion of oral health questionnaire by the dentist or a member of the dentist's staff.
2. The dental risk assessment questionnaire by the parent/guardian.
3. Review of the child's health history.
4. Review of the dental history for the:
primary caregiver, and
5. An inital comprehensive oral evaluation performed by the FDH trained dentist.
6. Caries risk assessment performed by the FDH trained dentist.
7. Toothbrush prophylaxis (rubber cup prophylaxis if indicated due to stain, etc.).
8. Topical fluoride varnish application (on all erupted teeth).
9. Dental anticipatory guidance provided to the parent/guardian:
10. Establishment of a dental recall schedule
11. Any necessary referral to dental specialists.
Document all incomplete required procedures and the reason that they were not completed.
How is this service billed to Texas Medicaid?
Upon completion of the training, dental providers are eligible to bill D0145 and receive enhanced reimbursement. Though the dentist must attend training, all dental team members are encouraged to attend.
- D0145 – Oral evaluation for a patient less than 3 years old and counseling with the parent/caregiver.
- D0145 – all inclusive for First Dental Home visit (bundled code).
- Do not bill any other exam, prophy, or fluoride codes with this visit.