Health Care Department Operations Manual

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Chapter 3 – Health Care Operations

Article 3.2 – Dental Care: Scope of Services

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3.3.2.7 Dental Restorative Services

  • Policy

    • The California Department of Corrections and Rehabilitation (CDCR) shall provide patients with dental restorative services utilizing CDCR approved dental restorative materials.  Dental restorative services shall be limited to the restoration of carious teeth with enough structural integrity to provide long-term stability.

  • Purpose

    • To establish guidelines and parameters for the delivery of dental restorative services to patients incarcerated within CDCR.

  • Procedure

    • Appropriate and current radiographs shall be reviewed before initiating restorative procedures.

    • All CDCR approved restorative materials utilized in the dental clinics shall have the approval of the American Dental Association.

    • CDCR dental staff shall verify that every patient has received a copy of the Dental Materials Fact Sheet prior to restorations being initiated.

    • Permanent Restorations

      • Amalgam is the only material approved by the CDCR for restoration of Class I and II lesions of posterior teeth. CDCR dentists shall not place composite restorations on occlusal or interproximal surfaces of posterior teeth.

      • Amalgam, light cured composite and glass ionomer shall be considered acceptable materials for buccal pit restorations of posterior teeth.

      • Amalgam and glass ionomer shall be considered acceptable materials for Class V restorations of posterior teeth.

      • Light cured composite shall be the material of choice for anterior restorations.  When indicated, glass ionomer may be utilized.

    • Temporary or Sedative Restorations

      • Temporary or sedative restorations shall be placed when indicated.

      • Temporary polycarbonate crowns shall be utilized on anterior teeth that have been previously prepared for crowns or that require a crown. For posterior teeth that have been previously prepared for crowns or that require a crown, stainless steel crowns shall be utilized.

      • Remineralization temporaries, such as glass ionomer that release fluoride into the tooth structure and promote remineralization of tooth structure, shall be placed as early as possible in the treatment sequence to provide holding care for patients with extensive caries. These sedative restorations may be placed before establishment of a treatment plan or shortly after completion of a comprehensive dental examination on patients who exhibit extensive dental caries.

    • Teeth diagnosed with advanced periodontitis shall not be eligible for restorative dental treatment.

    • Although every effort shall be made when restoring anterior teeth to achieve a reasonable esthetic result, cosmetic dentistry shall not be provided.

    • Routine dental care shall be discontinued if, in the judgment of the providing dentist:

      • The patient is not maintaining an acceptable level of oral hygiene necessary to preserve the health of their oral cavity.  (Reference the Health Care Department Operations Manual [HCDOM], Section 3.3.2.13(c)(2)).

      • The patient has a record of intentionally failing to keep appointments. Such patients shall be eligible to receive Emergency and DPC 1 dental treatment only. (Reference the HCDOM, Section 3.3.5.1(c)(4)(C)).

    • Reference the HCDOM, Section 3.3.4.5(c)(3) and (4) for referral requirements.

  • References

    • Health Care Department Operations Manual, Chapter 3, Article 3, Section 3.3.2.13, Facility Level Dental Health Orientation and Self-Care

    • Health Care Department Operations Manual, Chapter 3, Article 3, Section 3.3.4.5, Dental Authorization Review Committee

    • Health Care Department Operations Manual, Chapter 3, Article 3, Section 3.3.5.1, Priority Health Care Services Ducat Utilization

  • Revision History

    • Effective: 04/2006
      Revised: 11/2017, 11/2020, 02/2022