FYI

Tooth decay is one of the most prevalent chronic diseases in children and adults, even though it’s highly preventable. Fluoride is a key tool in both preventing and reversing tooth decay.
 

Fluoride quality measures

Delta Dental is committed to using data to improve our members’ oral health, care, and safety. Dental Quality Alliance (DQA) measures help us quantify the quality of dental care by comparing it to evidence-based criteria. We’ve begun using the DQA measures to look at two important quality measures around fluoride treatment:

Topical fluoride through age 21: Percentage of children aged 1–21 years who received at least 2 topical fluoride applications within the reporting year.

Topical fluoride for adults at elevated caries risk: Percentage of adults aged 18 years and older who are at “elevated” risk (i.e., “moderate” or “high”) who received at least 2 topical fluoride applications within the reporting year.
 

What Delta Dental covers

Fluoride should be delivered as a standard of care regardless of insurance coverage. However, most Delta Dental PPO™ and DeltaCare® USA plans cover fluoride treatments for children up to age 12, and many cover treatments up to age 18 and older. Check your patients’ benefit details in Provider Tools to make sure they’re covered.

The specific codes for fluoride treatments are:
 

• D1206 — Topical application of fluoride varnish
• D1208 — Topical application of fluoride excluding varnish
   

The Affordable Care Act also requires health insurance coverage of fluoride varnish applied to the baby teeth of all children ages 5 and younger at no cost.
 

How to talk to hesitant patients

Preventive dental care is important at any age, and you should always inform patients and parents about the role that fluoride plays in that care. That said, some patients may object to fluoride applications. In these cases, ask them why they want to opt out of treatment, and listen closely to help build trust. Reassure your patients that you respect their health care decisions, and make sure that they understand the risk involved if they or their children don’t get treated.