| Title |
Children Who Have Dental Decay or Cavities |
||
|---|---|---|---|
| CMS eCQM ID | CMS75v14 | CBE ID | Not Applicable |
| MIPS Quality ID | 378 | ||
| Measure Steward | Centers for Medicare & Medicaid Services (CMS) | ||
| Description | Percentage of children, 1-20 years of age at the start of the measurement period, who have had dental decay or cavities during the measurement period as determined by a dentist | ||
| Measure Scoring | Proportion | ||
| Measure Type | Outcome | ||
| Stratification | None | ||
| Risk Adjustment | None | ||
| Rationale | Dental caries is the most chronic disease among youth aged 6-19 years. Data from the National Health and Nutrition Examination Survey from 2015-2016 showed that approximately 45.8 percent of children and youth aged 2-19 years had total caries (untreated and treated). Prevalence of total dental caries (untreated and treated) in primary or permanent teeth increases with age, going from 21.4 percent, 50.5 percent, and 53.8 percent among ages 2-5, 6-11, and 12-19, respectively. Total dental caries was highest in Hispanic youths aged 2-19 at 57.1 percent compared to 48.1 percent for non-Hispanic black, 44.6 percent for non-Asian, and 40.4 percent for non-Hispanic white youth. Monitoring prevalence of untreated and total caries is vital to preventing and controlling oral disease (Fleming & Afful, 2018).
Children who have dental decay or cavities are less likely to be in very good or excellent overall health than children without decay or cavities (Edelstein & Chinn, 2009). Children with decay are also more likely to have other oral health problems such as toothaches, broken teeth, and bleeding gums (Data Resource Center for Child and Adolescent Health, 2007). |
||
| Clinical Recommendation Statement | The American Academy of Pediatric Dentistry (AAPD) provides clinical recommendations for pediatric oral health assessments and preventative services (AAPD, 2023). The recommendation states that the first clinical oral examination should occur around 12 months of age. The clinical oral exam should be repeated every 6 months or as indicated by the child’s risk status or susceptibility to disease. Further, caries risk assessment must be repeated regularly and frequently to maximize effectiveness. | ||
| Improvement Notation | Lower score indicates better quality | ||
| Definition | None | ||
| Guidance | This eCQM is a patient-based measure.
Telehealth encounters are not eligible for this measure because the measure does not contain telehealth-eligible codes and requires a clinical action that cannot be conducted via telehealth. This version of the eCQM uses QDM version 5.6. Please refer to the QDM page for more information on the QDM. |
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| Initial Population | Children, 1-20 years of age at the start of the measurement period, with a clinical oral evaluation by a dentist during the measurement period | ||
| Denominator | Equals Initial Population | ||
| Denominator Exclusions | Exclude patients who are in hospice care or have a hospice care order documented during any part of the measurement period | ||
| Numerator | Children who had a diagnosis of cavities or decayed teeth in any part of the measurement period | ||
| Numerator Exclusions | None | ||
| Denominator Exceptions | None | ||
| Telehealth Eligible | No | ||
| Next Version | No Version Available | ||
| Previous Version | CMS75v13 | ||
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