Oral Health

Research shows that there is a strong connection between oral disease and other physical ailments. Preventive care isn’t just important for our bodies – a strong oral hygiene regimen, regular cleanings and check-ups can protect your smile, as well!

Bacteria in the mouth can lead to gum disease, which in turn can lead to oral infections. If those infections enter the bloodstream, they can cause a host of health issues, including diabetes, heart disease, stroke, and even premature birth. Since close to half of American adults suffer from periodontal disease at any given time, the risk is real. The Michigan Department of Health and Human Services’ Oral Health Unit is here to serve all Michiganders, with special emphasis on serving populations that are underserved and most at risk.

  • You can find many more resources for improving the oral health of the clients you serve, including downloadable patient and provider materials, by visiting the Oral Health Program website.

  • Did you know that dental providers are increasingly being encouraged to screen for high blood pressure and diabetes, and refer at-risk patients to primary care? Read a summary report describing the MDHHS 2016 survey of oral health professionals’ screening practices.

Print useful fact sheets that highlight the relationship between oral health and many common chronic conditions, including the Oral Health and Heart Disease Fact Sheet, the MDHHS Oral Health & Diabetes Fact Sheet, the Oral Cancer Fact Sheet, and the Tobacco and Oral Health Fact Sheet

Updates to the Early and Periodic Screening, Diagnosis and Treatment Chapter of the Medicaid Provider Manual and 2017 American Academy of Pediatrics Periodicity Schedule regarding oral health. Effective: January 1, 2018

Oral Health

The dental health of the beneficiary begins with an oral health screening and caries risk assessment by the child’s PCP for beneficiaries at each well child visit as recommended by the AAP periodicity schedule.

Children should be referred to establish a dental home when the first tooth erupts and as recommended by the AAP periodicity schedule. Communication between the dental and medical homes should be ongoing to appropriately coordinate care for the child. If a dental home is not available, the PCP should continue to perform an oral health risk assessment during each well-child visit. The PCP should follow-up, educate, and refer as appropriate. Encourage parents/caregivers to brush their child’s teeth as soon as teeth erupt with fluoride toothpaste in the proper dosage appropriate for the child’s age. The AAPD Caries Risk Assessment Tool is available online at www.aapd.org/media/Policies_Guidelines/G_CariesRiskAssessment.pdf  Refer to the Dental chapter of the Medicaid Provider Manual for additional information.

A. Fluoride Varnish

Providers should apply fluoride varnish as recommended by the AAP periodicity schedule. Fluoride varnish should be applied to the teeth of all infants and children under the delegation and supervision of the PCP when the first tooth erupts until establishment of a dental home as recommended by the AAP periodicity schedule. The AAP recommends that providers receive additional training on oral screenings, fluoride varnish indications and application, and office implementation. Providers and staff are encouraged to complete the online Children’s Oral Health Smiles for Life Course 6: Caries Risk Assessment, Fluoride Varnish and Counseling training module at www.smilesforlifeoralhealth.org  and obtain certification prior to providing oral health screenings and fluoride varnish applications. Providers are no longer required to complete the online training and certification process in order to bill Medicaid for these services. Additional information regarding oral health resources and certification is available on the AAP Oral Health website at www.aap.org  >> About the AAP >> Committees, Councils & Sections >> Section Websites >> Oral Health >> Resources  . Oral Health resource materials can also be found at www.michigan.gov/oralhealth  Contact the MDHHS-Oral Health Program at OralHealth@michigan.gov  for additional education and technical assistance on oral health resources regarding oral screenings, caries risk assessment and fluoride varnish applications.

Billing Instructions: Current Dental Terminology (CDT) code D1206 will be end dated on November 30, 2017, for medical providers. The PCP may bill Current Procedural Terminology (CPT) code 99188 beginning December 1, 2017, for the application of topical fluoride varnish.

B. Fluoride Supplementation

The PCP should consider oral fluoride supplementation as recommended by the AAP periodicity schedule if the primary water source is deficient in fluoride. It is important to consider a child's overall systemic exposure to fluoride from multiple sources (e.g., water fluoridation, toothpaste, supplements, and/or varnish) prior to prescribing fluoride supplements to minimize the risk of mild fluorosis.

If your office is interested in receiving free fluoride varnish through our Babies Too! Program, please contact the MDHHS Oral Health Unit at oralhealth@michigan.gov