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Report of the Council on Clinical Affairs Report of the Council on Clinical Affairs Proposed changes/additions to oral health policies and clinical recommendations of the American Academy of Pediatric Dentistry 3/27/2019 211 East Chicago Avenue, Suite 1600 • Chicago, Illinois 60611 312-337-2169 • Fax: 312-337-6329 • www.aapd.org • www.mychildrensteeth.org NOTICE TO ACTIVE AND LIFE MEMBERS (1) Reference Committee Hearing and Reports & (2) General Assembly Meeting Constitution and Bylaws amendments and proposed changes/additions to oral health policies and clinical recommendations of the American Academy of Pediatric Dentistry will be the subject matter for the Reference Committee hearings at the Annual Session. Recommendations from the Council on Clinical Affairs concerning oral health policies and clinical recommendations were posted as a Members-only document on the AAPD website (www.aapd.org) no later than sixty (60) days prior to the General Assembly. All members will be alerted to this availability via AAPD E-News. The Reference Committee hearing will take place on Saturday, May 25, 2019, from 10 to 11 a.m., in the Waldorf Room at the Hilton Chi- cago. Members are strongly encouraged to attend. Non-members may attend, but will be polled and asked to identify themselves by the chair, and are not allowed to comment. The Reference Committees are intended to be the venue for member discussion on any formal resolutions that will be proposed before the General Assembly. This is an opportunity for members to present testimony on proposed oral health policies and clinical recommendations, and other business to come before the General Assembly. Reference Committee Reports will be available in the back of the Waldorf Room at the Hilton Chicago beginning at 8:30 a.m., on Sunday morning May 26, 2019, prior to the beginning of the General Assembly and Awards Recognition at 9:30 a.m. If available in time, copies will also be provided at District Caucuses on Saturday, May 25, 2019, from 1 to 2 p.m. The Awards Recognition and General Assembly will take place on Sunday, May 26, 2019, from 9:30 to 11:30 a.m., in the Waldorf Room of the Hilton Chicago. The General Assembly is a meeting of Active and Life members for the purposes of conducting the business of the AAPD. Final action on recommendations from Reference Committees takes place at the General Assembly. An agenda for the General Assembly meeting will be posted on the AAPD website (www.aapd.org) approximately one month prior to the meeting. All members will be alerted to this availability via AAPD E-News. Governance | March PDT 2019 11 Table of Contents (Click on a title to go directly to content) Definition of Medically Necessary Care .......................................................... 1 Policy on Patient's Bill of Rights and Responsibilities ........................................ 2 Policy on Infection Control ........................................................................... 8 Policy on Use of Dental Bleaching for Child and Adolescent Patients ................ 13 Policy on Third-party Payer Audits, Abuse, and Fraud .................................... 22 Policy on Medically Necessary Care ............................................................. 31 Policy on Workforce Issues and Delivery of Oral Health Care Services in a Dental Home ................................................................................... 45 Policy on School Absences for Dental Appointments ...................................... 59 Best Practices for Antibiotic Prophylaxis for Dental Patients at Risk for Infection ............................................................................................. 63 Best Practices for Caries-risk Assessment and Management for Infants, Children, and Adolescents .................................................................... 82 Best Practices for Management of the Developing Dentition and Occlusion in Pediatric Dentistry ..........................................................................102 Best Practices for Restorative Dentistry ..................................................... 143 Best Practices for Use of Antibiotic Therapy for Pediatric Dental Patients ....... 174 Best Practices for Informed Consent ......................................................... 183 Best Practices for Acquired Temporomandibular Disorders in Infants, Children, and Adolescents ................................................................... 192 Endorsement: Policy on the Management of Patients with Cleft Lip/Palate and Other Craniofacial Anomalies ......................................................... 211 Monitoring and Management of Pediatric Patients Before, During, and After Sedation for Diagnostic and Therapeutic Procedures: Update 2016 (Revision limited to Personnel section) ........................................... 216 Best Practices for Use of Anesthesia Providers in the Administration of Office-based Deep Sedation/General Anesthesia to the Pediatric Dental Patient (Revision limited to Personnel section) ................................. 266 NEW DOCUMENTS: ...................................................................................... Best Practices for Classification of Periodontal Diseases in Infants, Children, Adolescents, and Individuals with Special Health Care Needs ..... 275 Policy on Management of the Frenulum in Pediatric Dental Patients ................ 309 2019 proposed changes/additions to oral health policies and clinical recommendations of the American Academy of Pediatric Dentistry 1 This draft does not constitute an official AAPD health oral policy or clinical recommendation until approval by the General Assembly. Circulation is limited to AAPD members. 1 Definition of Medically-Necessary Care 2 3 4 Review Council 5 Council on Clinical Affairs 6 Latest Revision Reaffirmation 7 2015 2019 8 9 Medically-necessary care (MNC) is the reasonable and essential diagnostic, preventive, and treatment 10 services (including supplies, appliances, and devices) and follow-up care as determined by qualified 11 health care providers in treating any condition, disease, injury, or congenital or developmental 12 malformation to promote optimal health, growth, and development. MNC includes all supportive 13 health care services that, in the judgment of the attending dentist, are necessary for the provision of 14 optimal quality therapeutic and preventive oral care. These services include, but are not limited to, 15 sedation, general anesthesia, and utilization of surgical facilities. MNC must take into account the 16 patient’s age, developmental status, and psychosocial well-being, in addition to the setting appropriate 17 to meet the needs of the patient and family. 18 19 Dental care is medically-necessary to prevent and eliminate orofacial disease, infection, and pain, to 20 restore the form and function of the dentition, and to correct facial disfiguration or dysfunction. 21 22 This definition was originally developed by the Council on Clinical Affairs and adopted in 1997. This 23 document is an update a reaffirmation of the previous version, revised in 2011 2015 version. CCA.a. D_MedicallyNecessaryCare 2019 proposed changes/additions to oral health policies and clinical recommendations of the American Academy of Pediatric Dentistry 2 This draft does not constitute an official AAPD health oral policy or clinical recommendation until approval by the General Assembly. Circulation is limited to AAPD members. 1 Policy on a Patient’s Bill of Rights and Responsibilities* 2 3 Review Council 4 Council on Clinical Affairs 5 Reaffirmed 6 2014 7 Latest Revision 8 2019 9 10 Purpose 11 The American Academy of Pediatric Dentistry (AAPD) recognizes that pediatric oral health care 12 should be rendered under conditions that are acceptable to both patient and dentist. The expectation is 13 that oral health care providers, their staff, and patients, and parents of patients will support this policy, 14 thereby enhancing patient care. 15 16 Methods 17 This policy was adopted in 2009. The updated document used electronic database and hand searches 18 of the articles in the medical and the dental literature using the following parameters: Terms:: patient 19 freedoms, patient’s Bill of Rights, Bill of Rights, Consumer Bill of Rights; Fields: all; Limits: within 20 the last 10 years and English; birth through age 18. Additionally, when data did not appear sufficient 21 or were inconclusive, recommendations were based upon expert and/or consensus opinion by 22 experienced organizations relating to the concept of patient rights and responsibilities. 23 This policy was adopted in 2009, and is based on a systematic literature search of the PubMed 24 /MEDLINE database using the terms: patient freedoms, patient’s Bill of Rights, Bill of Rights, 25 Consumer Bill of Rights; fields: all; limits: within the last 10 years and English. Eighty-one articles 26 met these criteria. Papers for review were chosen from this list and from the references within 27 selected articles. Documents of health care and public policy organizations relating to the concept of 28 patient rights and responsibilities also were reviewed.(AAPD Vision, AHA 1992, President’s 29 Advisory Commission 1998) * ABBREVIATION AAPD: American Academy Pediatric Dentistry. CCA.b. P_PatientBillOfRights 2019 proposed changes/additions to oral health policies and clinical recommendations of the American Academy of Pediatric Dentistry 3 This draft does not constitute an official AAPD health oral policy or clinical recommendation until approval
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