News & Publications

Oral Evaluation for Adults with Diabetes

Sep 19, 2019

by Diptee Ojha, BDS, PhD
Senior Manager, Office of Quality Assessment & Improvement
American Dental Association

The 2018 Standards of Medical Care in Diabetes call for initial care management to include a referral to a dentist.1 This recommendation recognizes the established bi-directional relationship between diabetes mellitus and periodontal disease.2,3  Specifically, diabetes is associated with increased prevalence and severity of periodontal disease, while severe periodontal disease is associated with poor glycemic management. Periodontal treatment was projected to reduce HbA1c with efficacy equivalent to supplementary pharmacological intervention.4

Adults with Diabetes – Oral Evaluation is a claims administrative data based dental quality measure that assesses the percentage of adults with diabetes who received a comprehensive or periodic oral evaluation or a comprehensive periodontal evaluation within the reporting year. Oral evaluations represent an important entry point into the dental care system. Diagnosis and treatment planning for the prevention and treatment of periodontal disease at these visits offer patients appropriate dental care with the potential to improve diabetes outcomes. The target population for this measure aligns with the 2018 National Committee for Quality Assurance (NCQA) Healthcare Effectiveness Data and Information Set (HEDIS) ® criteria to identify adults with type I and type II diabetes. The HEDIS ® criteria are used in several existing NCQA performance measures to assess comprehensive diabetes care in adults including rates of hemoglobin A1c (HbA1c) testing and control, blood pressure control, eye exams, and medical attention for neuropathy.5

This measure is developed by the Dental Quality Alliance (DQA), a multi-stakeholder entity with representation from providers, researchers, payer groups within the dental health system and counts federal agencies such as the CMS, HRSA, CDC, VHA and AHRQ as technical advisors on its membership. The DQA develops and maintains dental quality measures that are implemented across both public and private sectors. The DQA provides technical assistance to users of DQA measures by conducting webinars and workshops, developing technical briefs and reports to facilitate the appropriate implementation of these measures.


References 

1. American Diabetes Association. Comprehensive Medical Evaluation and Assessment of Comorbidities: Standards of Medical Care in Diabetes – 2018. Diabetes Care 2018;41(S1):S28-S37.

2. Casanova L, Hughes FJ, Preshaw PM. Diabetes and periodontal disease: a two-way relationship. British Dental Journal 2014;217(8):433-7.

3. Chapple ILC, Genco R, working group 2 of the joint EFP/AAP workshop. Diabetes and periodontal diseases: consensus report of the Joint EFP/APP Workshop on Periodontitis and Systemic Diseases. Journal of Clinical Periodontology 2013;40(14):S106-12.

4. Engebretson S, Kocher T. Evidence that periodontal treatment improves diabetes outcomes: a systematic review and metaanalysis. J Periodontol 2013;84:S153-S169.

5. NCQA. HEDIS ® Measures. Comprehensive Diabetes Care (CDC). Available at: https://www.ncqa.org/hedis/measures/comprehensive-diabetes-care/.

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