Health Care Department Operations Manual

Chapter 3 – Health Care Operations

Article 3.2 – Dental Care: Scope of Services

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3.3.2.3 Comprehensive Dental Examinations – Mainline Facility

Policy
- All California Department of Corrections and Rehabilitation (CDCR) Mainline Facility patients shall be eligible to receive comprehensive dental examinations.
Purpose
- To ensure that CDCR patients are eligible to receive timely comprehensive dental examinations at a Mainline Facility. The purpose of the dental examinations shall be for the identification, diagnosis and treatment of dental pathology which impacts the health and welfare of patients.
Procedure
- Initial Comprehensive Dental Examination
  - Within ten business days of arrival at a Mainline Facility all patients shall be notified that they are eligible to receive an initial comprehensive dental examination performed by a dentist. (Reference the Health Care Department Operations Manual [HCDOM], Section 3.3.2.2(c)(2)(E) for eligibility notification requirements concerning patients who remain on Reception Center (RC) status at an RC for 180 calendar days or longer).
    - The Office Technician (OT) or designated dental staff shall generate and send a notification slip informing patients:
      - Of their eligibility for the initial comprehensive dental examination.
      - They must submit a CDCR 7362, Health Care Services Request Form, to receive the examination.
    - The OT or designated dental staff shall schedule patients for an initial comprehensive dental examination within 90 calendar days of the dental clinic receiving a CDCR 7362 from the patient asking for the examination. When this timeframe is not respected, the treating clinician shall document the reason in a clinical note in the EDRS, in accordance with EDRS Workflow 1-2 and associated Back Office Job Aid.
    - The notification slip shall be delivered to the patient through the Institution Interdepartmental Mail or the process used for priority ducat distribution.
  - The results of the Mainline Facility initial comprehensive dental examination and the patient’s Dental Priority Classification shall be recorded on the EDRS odontogram, in accordance with EDRS Workflow 1-3 and associated Back Office Job Aid, and in a clinical note in the EDRS, in accordance with EDRS Workflow 1-2 and associated Back Office Job Aid. The initial comprehensive dental examination shall include:
    - Clinically adequate radiographs of diagnostic quality.
    - The quantity and periodicity of radiographs shall be determined by a CDCR dentist based on current American Dental Association guidelines. An examination of the head and neck as well as the hard and soft tissues of the oral cavity with a mouth mirror, explorer and adequate illumination, which includes at least:
      - A cancer screening.
      - Charting of the patient’s missing teeth, existing teeth, restorations and dental decay.
    - Determination of the patient’s baseline plaque index (PI) score.
    - A Comprehensive Periodontal Examination.
    - A health history. (Reference the HCDOM, Section 3.3.6.1(c)(2)(E)).
    - Formulation and documentation of a dental treatment plan as well as sequencing treatment into numbered visits using the EDRS Treatment Planner, in accordance with EDRS Workflow 1-3 and associated Back Office Job Aid.
  - Patients transferring from one Mainline Facility to another and who have already received an initial comprehensive dental examination at a Mainline Facility, need not be re-examined upon transfer from one CDCR facility to another, except as determined by the attending dentist, or unless they meet the requirements for periodic comprehensive dental examinations as outlined in Section (c)(2)(A) through (C).
  - Patients who have paroled and are rearrested and who received a comprehensive dental examination at a Mainline Facility within the past six months, need not receive a new comprehensive dental examination, except as determined by the attending dentist.
  - Patients identified as needing and having requested an initial comprehensive dental examination shall be ducated by the OT or designated dental staff within the mandated timeframe for the procedure to be performed as outlined in Section (c)(1)(A)2.
- Periodic Comprehensive Dental Examination
  - After the initial comprehensive dental examination, all Mainline Facility patients shall be notified they are eligible to receive a periodic comprehensive dental examination by a dentist, every two years (biennially) until the patient reaches the age of 50.
  - After the initial comprehensive dental examination, all Mainline Facility patients 50 years of age or older shall be notified they are eligible to receive a periodic comprehensive dental examination by a dentist annually.
  - Patients with certain chronic systemic illnesses or medical conditions that could compromise their oral health shall be notified they are eligible to receive an annual comprehensive dental examination, regardless of their age. These include:
    - Diabetes
    - Human Immunodeficiency Virus (HIV)
    - Seizures
  - The results of the Mainline Facility periodic comprehensive dental examinations shall be documented as outlined in Section (c)(1)(B). The periodic comprehensive dental examination shall include:
    - Procedures listed in Section (c)(1)(B)1. through 2.
    - Updated charting of the patient’s periodontal status by completing a Comprehensive Periodontal Examination.
    - Re-evaluation of the patient’s PI score.
    - A health history. (Reference the HCDOM, Section 3.3.6.1(c)(2)(E)).
    - Updated charting of the patient’s existing dental restorations and decay.
    - Updated charting of a dental treatment plan as well as sequencing treatment into numbered visits using the EDRS Treatment Planner, in accordance with EDRS Workflow 1-3 and associated Back Office Job Aid.
  - The OT or designated dental staff shall:
    - Generate and send a notification slip informing patients:
      - Of their eligibility for the periodic comprehensive dental examination.
      - They must submit a CDCR 7362 to receive the examination.
    - Notify patients of their eligibility for an annual or biennial periodic comprehensive dental examination based on the date of the last comprehensive dental examination or the anniversary date of the patient’s last exam notification date as determined by the EDRS QM Report.
    - Send the notification slip no later than 60 calendar days before the anniversary date of the patient’s most recent comprehensive dental examination or the anniversary date of the patient’s last exam notification date as determined by the EDRS QM Report, whichever is more recent.
    - Ensure the notification slip is delivered to the patient through the Institution Interdepartmental Mail or the process used for priority ducat distribution.
  - The annual or biennial periodic comprehensive dental examinations shall be completed within 90 calendar days of the dental clinic receiving a CDCR 7362 from the patient asking for the examination. When this timeframe is not respected, the treating clinician shall document the reason in a clinical note in the EDRS, in accordance with EDRS Workflow 1-2 and associated Back Office Job Aid. Patients shall be eligible to receive a periodic comprehensive dental examination regardless of Earliest Possible Release Date (EPRD) if the exam can be completed prior to their release date and performing the examination will not keep other patients from receiving care.
  - Patients may submit a CDCR 7362 requesting a periodic comprehensive dental examination no sooner than 60 calendar days before the date when they are eligible for the examination. If a patient submits a CDCR 7362 requesting a periodic comprehensive dental examination greater than 60 calendar days before the date when they are eligible, a CDCR dentist shall send a written response informing the patient when to submit a request.
- If a patient refuses the initial or periodic comprehensive dental examination, a CDCR 7225-D, Dental Refusal of Examination and/or Treatment, must be completed and signed by the provider and the patient. (Reference the HCDOM, Section 3.3.5.6(c)(6) for other requirements concerning a refusal).
References
- Health Care Department Operations Manual, Chapter 3, Article 3, Section 3.3.2.2, Dental Care – Reception Center
- Health Care Department Operations Manual, Chapter 3, Article 3, Section 3.3.5.6, Patient’s Right to Refuse Treatment
- Health Care Department Operations Manual, Chapter 3, Article 3, Section 3.3.6.1, Health Records Organization and Maintenance
Revision History
- Effective: 04/2006
  Revised: 03/2019, 11/2020, 02/2022