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DQA Ad-Hoc Sealant Workgroup

DQA Initiative to Address Emerging Use Cases for Sealant Measure

The DQA’s Sealant measure appears to be the most popular measure that many implementers have used within their programs. It is important to note that the DQA currently has 2 sealants measures, (1) at the program/plan level that is being used for reporting by state programs (e.g. Medicaid) and dental plans using claims data and (2) at the practice level, an eMeasure, that is being used for reporting by FQHC’s using data from electronic patient records.

The DQA has received feedback based on implementation experience and is looking into options for the program/plan level measure. The DQA seeks your valuable input on a proposed alternative measure. Note that analysis of data is underway and final specifications would be data-driven. However feedback on the concept at this stage is essential to ultimately ensuring face validity of the final measure and specification. Please send comments on this concept to dqa@ada.org

Draft Concept: The Workgroup developing the measure considered the following different options to define measure intent.

  1. Annual performance of program/plan to enable delivery of sealants to children who have not previously received sealants and could benefit from sealants.

    • Of those children enrolled in a program/plan, how many children eligible for sealants receive at least one sealant in the measurement year. [Access/Utilization]

    • Of those children enrolled in a program/plan, how many children eligible for sealants who visit a dentist, receive at least one sealant in the measurement year. [Process]

  2. Percentage of children who have ever received sealants

    • Of those enrolled in a program/plan how many have ever received sealants. [Population Prevalence]

Based on the current usage of the measure at the program/plan level, the Workgroup identified their final focus as follows:

Measure Intent: Annual Performance of program/plan to enable delivery of sealants to children who have not previously received sealants and could benefit from sealants. [Access/ Utilization]

  • Description: Percentage of enrolled children in the age category of 7–9, who have not received a sealant in prior years and have at least one sealable permanent first molar, who receive a sealant on a permanent first molar tooth within the reporting year
  • Denominator: Unduplicated number of enrolled children age 7–9 years who have at least one sealable molar and have not received a sealant in the past years
  • Exclusions: Children who have received at least one sealant in a first permanent molar in prior years and children who have received restorations or extractions in ALL four permanent first molars in prior years
  • Numerator: Unduplicated number of all enrolled children age 7–9 years who received a sealant on a permanent first molar tooth as a dental service

Access the DRAFT specification that operationalizes this intent. 

Significant changes from the current DQA measure

  1. Removes the limitation to children with “elevated” risk to align with the ADA’s Sealant Guidelines.

  2. Adjusts the age to start at age 7 to reduce the effect of un-erupted teeth based on recently published evaluations.

  3. Adds exclusions to denominator to increase the precision of measure scores but this also increases the complexity of measure computation.

Workgroup Acknowledgement:

The workgroup is comprised of 12 members representing payers, state Medicaid agencies, providers and health services researchers and is be chaired by Dr. Frederick Eichmiller, DQA Measure Development and Maintenance Committee (MDMC) member. View the biographies for each workgroup member

Reading Resources: