Course Overview

Intro Picture

Oral Health MOC IV Activity: Promoting Dental Homes for Young Children Through Screenings, Varnishing, and Referrals

The aim of this project is to improve the oral health screening, referral pattern, and follow up in the delivery of care for infants to children age 3 in pediatric and family practices. It is critical to integrate oral care into pediatric and family practices in order to ensure regular, annual visits . This intervention will assess the various practices and protocols in place for screening for oral health.

A multi-faceted intervention that includes 4 learning collaborative sessions (over a period of 6 months), with 3 different methods for the providers to evaluate their progress will be emphasized throughout this activity. The 3 different methods (described below) include a pre and post assessment, a chart extraction tool, and suggested PDSA cycles.

The pre- and post test assessment tool will measure each practice and Diplomate's policies and procedures related to oral health risk screening, dental varnishing, and referral to a dental home quality improvement measures. Within each of these six more general measures, there are 3 specific measures that will be evaluated and tested throughout the activity period through chart extractions and PDSA cycles.

The three chart extractions will be performed on 10 random charts from pediatric well visits (age 6 months to 42 months) to document and gauge 3 specific and measurable indicators relevant to oral health risk screening and dental varnish. These charts extractions will be done at the baseline, mid-way through the activity and post-activity. Chart extraction data will be entered electronically into a database that will be able to store the data and will be viewed by the Activity Director. The specific indicators that will be collected through the chart extraction process will collect specific data on the use of a screening tool;

For OUR LIVE PILOT ACTIVITY, four learning collaborative conference calls will be offered to present an overview and recommendations on integrating oral healthcare and dental varnish within primary care practices and related best practices by qualified professionals. These calls will take place during the lunch time period for the convenience of all participants.

For ALL FUTURE PARTICIPANTS, these webinars have been recorded and are ready to review on the activity webpage for your convenience.

Learning Objectives

  1. Activity Pre-Work: Review and Understand Eligibility Guidelines for Dental Varnish (will be sent in activity registration flyer)
  2. Increase the use of an oral health risk assessment screening tool to 100% of time for pediatric well visits, by the end of the 6 month activity period.
  3. Increase the rate of children getting four or more varnishes to 100% of time for children eligible for dental varnish, by the end of the 6 month activity period.
  4. Increase the provider's referral and follow up rate for pediatric patients by 25% at the end of the 6 month activity period.
  5. Enhance the provider's knowledge of oral health risks and their impact on overall health, the root causes and effects within the first month of the activity period as a result of Learning Collaborative Session I.
  6. Increase the provider's competence in using techniques to follow up with the families and caregivers of pediatric patients on oral health risks by the end of Learning Collaborative Session III, at the end of the third month of the activity.
  7. Increase the provider's knowledge of community resources and how to connect across various disciplines in order to most effectively make referrals for pediatric patients following Learning Collaborative Session III by the third month of the activity.
  8. Activity PDSA Cycle: Outline the dental varnish protocol in your practice. Develop a system in your office to reduce missed opportunities for dental varnish. Examine your current rate for dental varnish. North Carolina's current rate is 42% statewide.

Learning Sessions & Presenting Faculty

  • Learning Session I Activity Kickoff: Pediatric Oral Health Overview and Importance of Routine Screenings | Faculty: Dr. Marian Earls, MD and Dr. Rocio Quinonez, DMD
  • Learning Session II: Performing Oral Health Risk Assessments and Procedures: The Training Materials Needed to Assess Oral Health Risks and Perform Dental Varnish | Faculty: Ms. Kelly Close and Dr. Graham Barden, MD
  • Learning Session III: Linking Across Disciplines To Address Existing Barriers, Improve Referrals and Follow Up | Faculty: Dr. Thomas Koinis, MD and Dr. Frank Courts, DDS
  • Learning Session IV: Evaluation and Wrap Up Call: Provider Showcase | Feature: Goldsboro Pediatrics Spotlight with Dr. Tayloe, MD

Presenting Faculty

Marian F. Earls, MD, FAAP

Marian F. Earls, MD, FAAP
- Marian Earls is the Lead Pediatric Consultant for Community Care of North Carolina, and is the current lead on the state CHIPRA Quality Demonstration Grant for the state. From 1994 to July 2012 she was the Medical Director of Guilford Child Health., a large, non-profit, private Pediatric practice that is the pediatric division of Triad Adult and Pediatric Medicine in Greensboro, North Carolina. She is also a Developmental and Behavioral Pediatrician. Guilford Child Health is a public-private partnership between two community health systems and the department of public health, and serves families at or below 200% of the Federal Poverty Level. She is a Clinical Professor of Pediatrics for the University of North Carolina Medical School. Dr. Earls also is Medical Director of the Neonatal Follow-up Clinic (multidisciplinary) for the Level III NICU at Women’s Hospital in Greensboro. Dr. Earls is Immediate Past President of the North Carolina Pediatric Society (President 2008-2010). She is chair of the Mental Health/School Health Committee for NCPS. She has been a member of the Committee on the Psychosocial Aspects of Child and Family Health of the AAP, and was the lead author on the committees Clinical Report “Incorporating Recognition and Management of perinatal and postpartum Depression into Pediatric Practice,” (PEDIATRICS, November 2010). She is a liaison from the AAP to AACAP (American Academy of Child and Adolescent Psychiatry). She has been elected to the Executive Committee of the AAP’s Section on Early Education and Child Care. She is a member of the Mental Health Leadership Work Group of the AAP that is charged with national dissemination of mental health integration in primary care pediatrics.

Dr. Rocio Quinonez
Dr. Rocio Quinonez- earned her Bachelor of Arts Degree in Psychology/Zoology in 1992 and her Doctorate of Medical Dentistry in 1996 from the University of Manitoba. She earned her certificate in Pediatric Dentistry, Master’s of Science, and Masters in Public Health Policy and Administration at the UNC at Chapel Hill. Dr. Quinonez proceeded to complete a NIH Fellowship in Oral and Systemic Diseases. Her academic and research interest include the interphase between medicine and dentistry, prenatal and infant oral health, and economic analyses related to children’s oral health. Dr. Quinonez returned to full-time academics in 2006 and is currently the Director of the Pediatric Dentistry Pre-Doctoral Program, the Baby Oral Health Program and the Pediatric Dental Faculty Practice at the UNC at Chapel Hill. She is an active member of the Academy of Pediatric Dentistry, the Academy of Pediatrics - Section on Oral Health, and an examiner for the Royal College of Dentist of Canada.

Dr. Graham Barden, III, MD, FAAP
Dr. Graham A. Barden, III was born in New Bern, NC. He graduated Cum Laude from Duke University in 1978 with a Bachelor of Science degree in Zoology and obtained his MD from Duke University Medical School in 1982. His internship and pediatric residency training was conducted at Vanderbilt University in Nashville, TN from 1982 until 1985. In July of 1985, he returned home to New Bern to join Coastal Children's Clinic with G.A. Barden Jr., MD and Hovey E. Aiken, Jr., MD. He and his wife, Nora, have two children, Chase and Emily. In addition to his children, his interests include snow and water skiing, boating, fishing and computers. Dr. Barden serves patients in New Bern and Havelock.

Ms. Kelly Close
Ms. Kelly Close, MHA is a life-long resident of North Carolina and a career public health dental hygienist. She graduated from UNC- Chapel Hill with a BS in Dental Hygiene and a Masters in Healthcare Administration. She worked in a local health department community-based dental program for 16 years before becoming project coordinator for the 'Into the Mouths of Babes' dental varnish program in 2000 and preschool oral health coordinator for the NC Oral Health Section in 2005. Kelly is a Child Care Health Consultant and has 4 young adult sons.

Dr. Thomas Koinis,
Dr. Thomas Koinis – spent 9 years in Cleveland, Ohio completing his BSE and MSE in polymer science as well as his MD at Case Western Reserve University. He headed south for residency in Blackstone, VA as part of the Medical College of Virginia’s Family Medicine residencies, finishing in 1983. He has been in family medicine in Oxford, NC ever since and part of Duke Primary Care since 1995. He is a past president of both the North Carolina Academy of Family Physicians and NCAFP Foundation. He has served as NCAFP delegate to the American Academy of Family Physicians as well being on both the AAFP Committee on Membership and AAFP Commission on Health of the Public and Science. He is the medical director of Community Care Partners, one of the networks that make up Community Care of North Carolina. He has been a member of the North Carolina Immunization Advisory Council since 1997. Married with three children, he enjoys biking, running, doing triathlons slowly, and playing saxophone poorly in his community band.

Dr. Frank Courts,
Dr. Frank Courts, DDS - is in private practice in Rocky Mount, NC. Dr. Courts completed his D.D.S. and Pediatric Dentistry at the UNC School of Dentistry. He also completed his Ph.D. in Microbiology/Immunology at the UNC School of Medicine. He served as associated Professor and Chair of Pediatric Dentistry at the University of Florida, College of Dentistry between 1980 and 2002. He is the Chair of the Physician Advisory Group Dental Committee and also serves on the Executive Board. Dr. Courts is active in the North Carolina Academy of Pediatric Dentistry and the North Carolina Dental Society. His special interest is improving oral health in underserved pediatric populations.

Dr. David  Tayloe,
Dr. David Tayloe - graduated and completed residency at the UNC-Chapel Hill School of Medicine. Dr. Tayloe founded Goldsboro Pediatrics in 1978. He and his wife Denise have 4 children who have all entered the healthcare field. Dr. Tayloe has served on the Goldsboro City School and the Wayne County Public School Boards of Education, is a Fellow of the American Academy of Pediatrics (AAP), and has served as the President the national American Academy of Pediatrics as well as its North Carolina Chapter. He is currently serving an appointment as an Adjunct Professor in the Department of Pediatrics, UNC School of Medicine where he teaches residents. He is also an advocate and much sought after speaker on Child Advocacy and attends St. Stephens Episcopal Church.

Activity Completion

Upon activity completion, the Activity Director, Cameron Graham, will complete a Physician Attestation form on your behalf regarding your completion of the activity in order to receive full MOC IV credit. Participants will need to utilize standard self-report procedure to attain CME credits and will receive a CME certificate. Please contact her with any questions about this MOC IV Activity by email at cameron@camerongrahamconsulting.com.

Activity Fee

The federal CHIPRA grant, awarded to the NC Department of Health and Human Services/ Office of Rural Health, in partnership with Community Care of North Carolina and the NC Foundation for Advanced Health Programs, funded the development of this MOC IV activity through the NC Academy of Family Physicians and the NC Pediatric Society. This funding will end at the end of 2014, and a nominal registration fee for participation in this activity may be incurred at that time. North Carolina providers who register between 2013-2014 can still participate for free due to the CHIPRA funding. A nominal registration fee for out of state providers will be incurred beginning October 2013.