G-2308-19452

The American Academy of Pediatrics (AAP), specifically the Oral Health Section of the AAP, has been a national partner of CareQuest Institute that is working to bring the pediatrician community together to foster buy-in and support for integrating oral health into primary care. Some of the AAP’s historic work has focused on the elevation of the Campaign for Dental Health as a national leading voice in efforts around community water fluoridation. One notable milestone as a result of CareQuest Institute’s partnership with the AAP has been the development and spread of a model oral health risk assessment tool. With support from CareQuest Institute, the AAP successfully standardized a digital version of the assessment tool through the Fast Healthcare Interoperability Resources process to strategically integrate capabilities into electronic health records.

In 2022, CareQuest Institute provided a grant to AAP to focus on the application of Silver Diamine Fluoride in the pediatric practice setting. This grant funded a survey of selected AAP committees/councils/sections and followed up with key informant interviews with 12 survey participants. The outcome, a report entitled Knowledge and Attitudes about Silver Diamine Fluoride in Pediatric Practice, revealed that fewer than 5% of respondents/participants are currently applying SDF in their practices. To increase knowledge of SDF use in the primary care medical home, the AAP convened an expert interprofessional work group to create a draft implementation guide and 2-page brief which, upon AAP executive approval, can be disseminated to AAP members and other stakeholders. Finally, professionally facilitated workshops brought together the major organizations responsible for seeing, referring, and treating children's dental health needs.

AAP’s request is for support of the next phase of its SDF awareness and implementation work within pediatric and primary care settings. Specifically, the organization plans to pilot a resource it developed, an adaptation of the silver diamine fluoride (SDF) dental guideline to a tool for use by pediatricians in pediatric settings. To do this, AAP is proposing to recruit 5 practices (private, community, or public, Indian Health service) as sites for a quality improvement project. Through this project, the AAP will be able to assess cavitated lesions, engage families in SDF education and treatment, refer patients to dental homes and identify and address barriers to implementation of SDF in primary care practice.

AAP will ensure the voice of families and parents is included in the SDF work through engaging their Families Partnership Network at the national level and local family workgroups at the local level. Currently, a member of the AAP Families Partnership Network sits on the AAP SDF workgroup to ensure bidirectional sharing of information across both groups.

AAP is requesting $166,534 for this work which is less than 1% of the organization’s overall budget. Most of the funds will be used to support staff time, consultants, and provide honorariums for participants.
The successful completion of this grant will include the creation of an initial strategy for engaging pediatric practices in the uptake of fluoride varnish and SDF, dissemination of findings from activities from the pilot sites, a webinar for oral health stakeholders, and a presentation at the National Oral Health Conference, pending acceptance. AAP will assess health professionals’ understanding of techniques to properly determine patient eligibility for SDF and the impact on office procedures, staff time, practice workflow, billing and payment, obtaining and storing necessary supplies & equipment.