Regulación de la implantología dental en México / Regulation of dental implantology in Mexico

Introducción: los implantes dentales se han convertido en uno de los tratamientos odontológicos con mayor demanda en todo el mundo, no sólo por el nivel máximo de funcionalidad y de estética, sino también debido a su estabilidad, osteointegración y facilidad en su rehabilitación. Es incierto si los implantes dentales se encuentran normados formalmente en México, lo que motiva a la revisión del estado actual. Objetivo: evidenciar el estado actual de la legislación de la práctica de la implantología dental en México a través de una revisión en la literatura. Material y métodos: revisión de las legislaciones existentes en México para la aplicación de implantes dentales y su contraparte en el mundo a través de la evaluación de normas expedidas en América y Europa. Resultados: se contabilizó un total de 17 escuelas de implantes dentales que cuentan con el reconocimiento de la Secretaría de Educación Pública, de las cuales tres son públicas y 14 privadas. Se presentó una discrepancia en los planes de estudio que va de 16 a 36 meses. Las escuelas no contaron con un aval normativo. Las normas internacionales para control de calidad y aplicación de la tecnología en implantes se ubicaron en Canadá, Estados Unidos, España, Reino Unido y Francia. Conclusiones: contar con un antecedente normativo establecido por los países de primer mundo y ausente en México permite evidenciar la necesidad de implementar una Norma Oficial Mexicana que regule la fabricación, distribución y almacenamiento de los implantes dentales en México. A la vez, la revisión sugiere que la Secretaría de Educación Pública norme los créditos mínimos necesarios en las instituciones educativas reconocidas para la formación de recursos humanos que ejercen la implantología dental (AU)

Introduction: dental implants have become one of the dental treatments with the highest demand in the world, not only because of the highest level of functionality and aesthetics, but also because of their stability, osseointegration and ease of rehabilitation. It is uncertain if dental implants are formally regulated in Mexico, which motivates the review of the current status. Objective: to demonstrate the current state of the legislation for the practice of dental implantology in Mexico through a review of the literature. Material and methods: review of the existing legislation in Mexico, for the application of dental implants and its counterpart in the world, through the evaluation of standards issued in America and Europe. Results: a total of 17 dental implant schools that have the recognition of the Ministry of Public Education were counted, of which 3 are public and 14 private. There was a discrepancy in the study plans that ranged from 16 to 36 months. Schools will not have regulatory backing. The international standards for quality control and application of technology in implants were located in Canada, the United States, Spain, the United Kingdom and France. Conclusions: having a normative antecedent established by the countries of the first world and absent in Mexico, allows to demonstrate the need for the implementation of an Official Mexican Standard, which regulates the manufacture, distribution and storage of dental implants in Mexico. At the same time, the review suggests that the Ministry of Public Education regulate the minimum necessary credits in recognized educational institutions, for the training of human resources that practice dental implantology (AU)

Detection of human papillomavirus infection in oral cancers reported at dental facility: assessing the utility of FFPE tissues.

Incidence of human papillomavirus (HPV)-associated oral cancers is on the rise. However, epidemiological data of this subset of cancers are limited. Dental hospital poses a unique advantage in detection of HPV-positive oral malignancies. We assessed the utility of formalin-fixed paraffin-embedded (FFPE) tissues, which are readily available, for evaluation of high-risk HPV infection in oral cancer. For protocol standardization, we used 20 prospectively collected paired FFPE and fresh tissues of histopathologically confirmed oral cancer cases reported in Oral Medicine department of a dental hospital for comparative study. Only short PCRs (~ 200 bp) of DNA isolated using a modified xylene-free method displayed a concordant HPV result. For HPV analysis, we used additional 30 retrospectively collected FFPE tissues. DNA isolated from these specimens showed an overall 23.4% (11/47) HPV positivity with detection of HPV18. Comparison of HPV positivity from dental hospital FFPE specimens with overall HPV positivity of freshly collected oral cancer specimens (n = 55) from three cancer care hospitals of the same region showed notable difference (12.7%; 7/55). Further, cancer hospital specimens showed HPV16 positivity and displayed a characteristic difference in reported sub-sites and patient spectrum. Overall, using a xylene-free FFPE DNA isolation method clubbed with short amplicon PCR, we showed detection of HPV-positive oral cancer in dental hospitals.

Marine-Source Quorum Quenching Enzyme YtnP to Improve Hygiene Quality in Dental Units.

Biofilm in dental unit water lines may pose a health risk to patients and dental practitioners. An AdiC-like quorum quenching enzyme, YtnP, was cloned from a deep-sea probiotic Bacillus velezensis, and heterologously expressed in E. coli to examine the application on the improvement of hygiene problems caused by biofilm infection of Pseudomonas aeruginosa in dental units. Pseudomonas bacteria were isolated from dental chair units and used to grow static biofilms in the laboratory. A water filter system was designed to test the antifouling activity of YtnP in Laboratory, to simulate the biofilm contamination on water filter in dental unit water lines. The results demonstrated that the enzyme of YtnP was able to degrade the N-acyl homoserine lactones, significantly inhibited the EPS generation, biofilm formation, and virulence factors production (pyocyanin and rhamnolipid) of P. aeruginosa, and was efficient on the antifouling against P. aeruginosa. The findings in this study indicated the possibility of YtnP as novel disinfectant reagent for hygiene treatment in dental units.

Changes in Dental Benefits and Use of Emergency Departments for Nontraumatic Dental Conditions in Massachusetts.

OBJECTIVES: Research examining the effect of changes in Medicaid dental benefits on emergency department (ED) use for dental conditions has had mixed results. We examined the effect of changes in Medicaid dental benefits on ED use for nontraumatic dental conditions (NTDCs) among adults in Massachusetts before and after Medicaid dental benefits for adults were eliminated (July 2010) and partially restored (January 2013). METHODS: We used 2009-2013 data from the Massachusetts All-Payer Claims Database. The study population included Medicaid enrollees aged ≥21 who made a visit to the ED for an NTDC that was paid for by Medicaid during the study period. We used an interrupted time-series study design and segmented regression model to assess the effect of the policy changes on ED use for NTDCs. We also conducted a subanalysis by patient age, sex, and geographic location. RESULTS: During the study period, 21 731 Medicaid enrollees aged ≥21 made 35 660 NTDC ED visits. Eliminating comprehensive dental benefits led to a significant increase in the use of EDs for NTDCs. This increase occurred over time (11% increase at 15 months after elimination of comprehensive dental benefits; estimate, 0.64 [95% CI, 0.07-1.21]; P = .03) rather than immediately after the policy change took effect. The partial restoration of certain dental benefits led to a significant decrease in the rate of ED visits for NTDCs over time (15.7% decrease at 5 months after partial restoration of certain dental benefits; estimate, -0.97 [95% CI, -1.83 to -0.11]; P = .03). CONCLUSION: Strengthening dental coverage policies for adult Medicaid enrollees could decrease their reliance on EDs for NTDCs.

Functional analysis and generalized treatment of disruptive behavior during dental exams.

Patient disruption during dental visits can impede treatment and may result in invasive approaches to care. The current study evaluated the efficacy of graduated exposure with and without extinction to decrease disruption during dental treatment for 4 young men with autism spectrum disorder (ASD). Modified functional analyses confirmed that disruption was maintained by escape from dental demands for all four young men. Initial treatment consisted of graduated exposure, whereby exam steps were initially removed and then gradually reintroduced as disruption remained low; throughout this phase, disruption resulted in a break from the exam. During the subsequent treatment phase, graduated exposure procedures continued and extinction for disruption was added. Graduated exposure alone did not result in sufficient treatment effects; however, the addition of extinction resulted in greater reductions in disruption and increases in exam completion for all 4 young men, and treatment effects generalized to a dental clinic setting.

Dental Care Needs of Male versus Female Children Visiting a School-based Mobile Dental Facility in West Virginia.

Purpose: Many school-aged children have not received dental care in West Virginia, despite mandated statewide requirements of a dental evaluation and dental treatment before entering school, and the provision of Medicaid/CHIP insurance coverage for children from families below the federal poverty level. An innovative mobile oral health program to educate children, provide preventive care, and bring technology to public schools was developed for West Virginia children in a need shortage area. It was unknown if the unmet dental needs challenge was greater for male or female children residing in that area. The purpose of this study was to determine whether there was a difference by sex in the number of attendees and the incidence of dental caries for children who visited a school-based mobile dental facility.Methods: School-aged children who had not had a dental examination within the previous year were offered school-based examinations/assessments, preventive care, and oral health education via a mobile oral health program following parental/guardian consent. Data were collected concerning the number of current carious teeth in need of restoration. Descriptive statistics and chi square analyses were conducted to analyze the data.Results: There were 429 students evaluated at the school-based mobile dental facility. Half (50.3%) were male. Referrals for additional necessary oral/medical care were made for 214 (50.1%) children; 45.9% of males and 53.3% of females (p= 0.287) had dental caries.Conclusion: Results from this study indicate that sex was not a statistically significant factor in school-based mobile dental facility attendance nor in current dental caries incidence among school-aged children in an underserved area of West Virginia.

Assessment of knowledge and awareness about biomedical waste management among health care personnel in a tertiary care dental facility in Delhi.

AIM: The study was conducted to assess knowledge and awareness of biomedical waste management (BMWM) among undergraduate students, residents, and nursing staff in a tertiary care dental facility in Delhi. MATERIALS AND METHODS: A questionnaire survey (using ten close ended questions) was conducted regarding various aspects of BMWM among undergraduate students, residents, and nursing staff in a tertiary care dental facility. In each group, scores were determined depending upon the correct responses, the participants marked. The data were compiled and subjected to statistical analysis. RESULTS: Only 33.3% undergraduate students gave over 70% correct answers as compared to nursing staff (100%) and residents (62.2%). Undergraduate students showed various lacunae in terms of knowledge regarding BMWM. The difference between the knowledge of the 3 groups i.e., nursing staff, residents, and undergraduate students was statistically significant (P = 0.001). Residents exhibited better awareness regarding BMWM as compared to undergraduate students (P = 0.003). CONCLUSION: The pertinence of the issue of BMWM and lack of adequate preparation of the trainee dentists at undergraduate level reflects the urgent need to fill the lacunae in the dental undergraduate curriculum.

O cuidado no atendimento às crianças no consultório odontológico frente à pandemia da COVID-19 / Dental care for children in dental clinics faced with the COVID-19 pandemic

Objetivo: O presente trabalho visa orientar o odontólogo sobre as novas regras de uso de EPIs, normas de biossegurança, técnicas odontológicas utilizadas no atendimento da criança, para que possamos realizar os procedimentos odontológicos com segurança antes, durante e após a pandemia da COVID-19. Métodos: Após busca em diversos bancos de dados (Google, SciELO, Bireme, Portal de Periódicos da CAPES, PubMed), em 30/03/2020, 21 artigos relacionados ao atendimento odontológico durante a pandemia foram selecionados. O critério de inclusão dos artigos foi se relacionar às normas específicas de biossegurança para o atendimento odontológico durante a pandemia, especialmente em crianças. Resultados: Vinte e um artigos foram incluídos no trabalho sendo sete deles, específicos do atendimento odontopediátrico. As consultas odontopediátricas devem ser marcadas de forma espaçada, evitando o encontro de pessoas na sala de espera. A criança deve vir acompanhada de apenas um acompanhante. Algumas barreiras devem ser usadas nas crianças como máscara, gorro e óculos. O odontólogo deve usar máscara N95 e protetor facial, além dos outros EPI's. Previamente ao atendimento, bochecho de peróxido de hidrogênio a 1% deve ser realizado pela criança. Técnicas operatórias (ART, aplicação de diamino fluoreto de prata e técnica Hall) que gerem menos aerossóis dever ser priorizadas. Se necessário o uso de baixa e alta rotação, estas deverão ser com sistema anti-reflexo e esterilizadas a cada paciente. Um intervalo de 1 a 2 horas deve ser dado entre pacientes, permitindo a ventilação da sala, diminuição dos aerossóis e desinfecção de todo o ambiente clínico. Conclusão: A pandemia do COVID-19 se tornou um risco ocupacional para odontólogos, crianças e responsáveis. Para evitar contágio e transmissão da doença, os odontólogos devem se capacitar por meio de informações seguras e cumprir as normas de biossegurança sugeridas.

Aim: The present work aims to guide the dentist as regards the new rules for the use of PPEs, biosafety standards, and dental techniques used in pediatric dental care, so that we can safely perform dental procedures before, during, and after the COVID-19 pandemic. Methods:After searching several databases (Google, SciELO, Bireme, Portal de Periódicos da CAPES, PubMed), on March 30, 2020, 21 articles related to dental care during the pandemic were selected. The inclusion criteria for the articles was to relate to specific biosafety standards for dental care during the pandemic, especially in children. Results: Twenty-one articles were included in the work, with seven of these specifically treating pediatric dental care. Dental appointments should be scheduled in a staggered manner, avoiding the meeting of people in the waiting room. The child must be accompanied by only one family member or guardian. Some barriers should be used with children, such as a mask, hat, and glasses. The dentist must wear an N95 mask and face shield, in addition to the other PPEs. Before attending, 1% hydrogen peroxide mouthwash must be used by the child. Operative techniques (ART, application of silver diamine fluoride and Hall technique), which generate less aerosols, should be given priority. If the use of low and high speed is necessary, they must be with an anti-reflective system and sterilized for each patient. An interval of 1 to 2 hours must be given between patients, allowing for the ventilation of the room, a reduction in aerosols, and the disinfection of the entire clinical environment. Conclusion: The COVID-19 pandemic has become an occupational hazard for dentists, children, and guardians. To avoid contagion and transmission of the disease, dentists must train themselves through secure information and comply with the suggested biosafety rules.

O diário como dispositivo em pesquisa multicêntrica / Diary as a device in multicenter research

Resumo Este artigo vincula-se a uma pesquisa multicêntrica realizada entre 2013 e 2015 em quatro diferentes cenários: São Paulo, Campinas, Ribeirão Preto e Recife. Tem como objetivo apresentar o diário de pesquisa como um dispositivo da Análise Institucional, que possibilitou explorar diferentes dimensões do vivido pelos diaristas-pesquisadores, bem como restituir a análise de implicações que se cruzaram nos movimentos provocados nas e pelas experienciações deste projeto multicêntrico, registradas nos diários. O uso de diário no trabalho de campo foi prática corrente entre os membros da equipe do projeto. A produção do registro em forma de diários, na perspectiva da Análise Institucional, possibilita a análise das implicações dos pesquisadores, opondo-se à ideia de neutralidade do sujeito na pesquisa. Como dispositivo da intervenção, os diários de pesquisa permitiram a articulação entre os diaristas-pesquisadores dos quatro cenários com seus diferentes saberes e experiências, no cotidiano da saúde bucal, acionando heterogeneidades e os provocando a escreverem, refletindo sobre suas atividades na clínica e, sobretudo, a compartilharem a escrita dessas experienciações vividas com os demais, o que produziu efeitos nos processos de inovação da clínica.

Abstract This article is linked with a multicenter study conducted from 2013 to 2015 in four different scenarios or cities: São Paulo, Campinas, Ribeirão Preto, and Recife. It aims to present the use of Research Diary (RD) as a device of the Institutional Analysis, which made it possible to explore different dimensions of experiences of diary researchers and restore the analysis of the implications that have occurred in the movements provoked in and through the experiences of this multicenter project. The use of research diary in fieldworks was common practice among project team members. The production of records as diaries, from the perspective of Institutional Analysis, made it possible to analyze the implications of the researchers, opposing the idea of subject neutrality in the research. As an interventional device, research diaries allowed an articulation between diary researchers of the four scenarios with their different knowledge and experiences, in daily buccal health, triggering heterogeneities and encouraging them to write, reflecting on their activities in the clinic, and above all, to share the writing of these experiences with others, which has had an effect on the clinical innovation processes.

Leadership in modernising dental facilities.

Providing academic leadership for modernisation projects of dental school and hospital facilities can be challenging; however, a structured approach to such projects is helpful and good communication will reduce much of the stress.

Los pacientes también son clientes / Patients are clients too

El propósito de este artículo es señalar que los pacientes también son clientes y que en realidad las decisiones las toman basadas en factores emocionales y no en los fríos y lógicos datos provenientes de los diagnósticos que hacen los Odontólogos. Cosas como el trato, servicio excepcional al paciente-cliente, conseguirán más la aceptación de tratamiento, que la pericia clínica (AU)

The purpose of this article is to point out that patients are clients also, and that in reality they take their decisions based on emotional factors and not on the cold and logical facts resulting from the diagnosis made by Dentists. Things such as exceptional service, patient-customer service will achieve more treatment acceptance than the clinical skills (AU)

Produção especializada no SUS em capitais brasileiras com centros de especialidades odontológicas: uma análise descritiva / Specialized production in the unified health system in Brazilian capitals with dental specialty centers: a descriptive analysis

Centros de especialidades odontológicos (CEOs) são estabelecimentos de saúde de âmbito especializado que devem realizar uma quantidade mínima de procedimentos. Objetivos: descrever a produção odontológica especializada e reportar o cumprimento das metas nas capitais brasileiras com CEOs. Materiais e método: foi conduzido um estudo do tipo longitudinal retrospectivo, sendo realizada uma busca por CEOs cadastrados no Cadastro Nacional de Estabelecimentos de Saúde (CNES). A produção odontológica foi pesquisada no Sistema de Informações Ambulatoriais do Sistema Único de Saúde (SIASUS), de maio de 2015 a abril de 2016. Resultados: foram encontrados e considerados elegíveis para o presente estudo 59 CEOs, localizados em 19 capitais brasileiras e no Distrito Federal, sendo 48% CEOs tipo II. Cerca de 730 mil procedimentos especializados foram realizados durante os 12 meses avaliados. Uma taxa de 86% das metas foi cumprida, sendo que cirurgia foi à área com maior cumprimento (92%), seguida de periodontia (89%) e endodontia (76%). Uma das capitais apresentou apenas 33% das metas cumpridas. Três capitais não atingiram nenhuma das metas estabelecidas em procedimentos de endodontia. Conclusão: foi observada uma grande variação no cumprimento das metas entre as capitais com CEOs. Enquanto algumas capitais apresentaram elevado cumprimento das metas, outras exibiram dados preocupantes, principalmente nos procedimentos de endodontia. (AU)

Dental Specialty Centers (Centros de Especialidades Odontológicas ­ CEOs) are specialized health facilities that should perform a minimum number of procedures. Objectives: this study aimed to describe the specialized dental production and report the achievement of goals in Brazilian capitals with CEOs. Materials and method: a retrospective longitudinal study was performed with a search for the CEOs listed in the National Registry of Health Establishments. The dental production was searched in the Outpatient Information System of the Brazilian Unified Health System for the period from May 2015 to April 2016. Results: fifty-nine CEOs were found and considered eligible for the present study. They were located in 19 Brazilian capitals and in the Federal District, whereas 48% were CEOs Type II. Approximately 730 thousand specialized procedures were performed during the 12 months evaluated. A rate of 86% of goals was met and surgery presented the highest achievement (92%), followed by periodontics (89%) and endodontics (76%). One of the capitals achieved only 33% of the goals. Three capitals did not achieve any of the goals set for endodontic procedures. Conclusion: there was a great variation in the achievement of goals among capitals with CEOs. While some capitals showed high achievement of goals, others presented concerning data, especially for endodontic procedures. (AU)

An Assessment Model for Evaluating Outcomes in Federally Qualified Health Centers' Dental Departments: Results of a 5 Year Study.

PURPOSE: The purpose of this report was to establish baseline data on 10 oral health performance indicators over 5 fiscal years (2007 to 2008 through 2011 to 2012) for an Iowa health center. The baseline data provides an assessment model and reports outcomes based on the use of the model. Performance indicators show evidence of provider performance, accountability to stakeholders and provide the benchmarks required for dental management to develop future goals to improve oral health outcomes for atrisk populations. METHODS: Using descriptive statistic, this report extrapolated data from the Iowa Health Center's computer management systems software, HealthPro, and Centricity electronic medical records, and analyzed using IBM® SPSS® 19. This report describes the change in utilization for number and type of visits for uninsured and Medicaid patients over 5 fiscal years (a fiscal year is measured from November 1 through October 31). RESULTS: The number of patients receiving at least 1 dental visit in a measurement year showed n=81,673 procedures with 21% (17,167) being unduplicated patients. Preventive averaged 46%, restorative 18%, urgent care 22% and other procedures 14%. CONCLUSION: Federally qualified health centers (FQHCs) with a dental component serve populations with the greatest health disparities. This population includes ethnic and racial minorities, uninsured, underinsured, rural residents, Medicaid and Medicare. Establishing baseline data for FQHCs provides a foundational tool that will allow dental management to analyze successes as well as deficiencies in the goal to provide increased utilization to oral health care for at-risk populations.

[Dynamics of tooth decay prevalence in children receiving long-term preventive program in school dental facilities].

The paper presents the assessment of tooth decay prevalence in clinically homogenous groups of children receiving long-term preventive program (PP) in school dental facilities. Five-years PP were introduced in clinical practice in 2 Moscow schools. Preventive treatment was performed by dental hygienist. The results show that systematic preventive treatment in school dental offices starting from elementary school allows reducing dental caries incidence 46-53% and stabilize the incidence of caries complications. It should be mentioned though that analysis of individualized outcomes proves heterogeneity of study results despite of equal conditions of PP. Potentially significant hence is early diagnostics and treatment of initial caries forms as demineralization foci, especially in children with intensive tooth decay. Optimization of pediatric dentist and dental hygienist activity in school dental facilities is the main factor of caries prevention efficiency.

Anesthesia for off-floor dental and oral surgery.

PURPOSE OF REVIEW: Anesthesia for dentistry is commonly performed outside the operating room. The combination of a shared airway between surgeon and anesthetist, the variety of open airway techniques, and the out-of-operating room setting often results in anxiety and avoidance of dental cases among anesthesia personnel. This review attempts to demystify dental treatment and facilitate the anesthesia provider in providing effective sedation of dental procedures performed in the nonoperating room setting. RECENT FINDINGS: Specific indications for dental anesthesia improve the patient selection process. Airway assessment and strategies to secure the difficult airway are paramount because of the nature of the procedures and the patients on whom they are performed. Pediatric patients and those with special needs present specific preanesthetic assessment, induction, and management challenges. Emergence delirium is disruptive, possibly dangerous, prolongs recovery time, and may necessitate hospitalization. Simplified techniques and objective recovery criteria are necessary to ensure a safe and smooth discharge to home. Airway fire precautions should not be overlooked given the rare but potential risk of airway fire during dental treatment. SUMMARY: This article reviews the indications, facility and equipment needs, monitoring requirements, treatment methods, and recovery protocols necessary for the safe administration of off-floor anesthesia for dentistry.

Microbial control of dental unit water: Feedback on different disinfection methods experience.

A water quality study of dental units showed biofilm and opportunistic microorganisms. We report the steps that ultimately allowed us to obtain water quality as water for standard care with no pathogens throughout all dental units. In summary, treatment with continuous disinfection associated with use of sterile water allowed us to restore the water quality at the output of dental care units while ensuring the safety of care.

Reasons for Seeking Dental Healthcare Services in a Nigerian Missionary Hospital

Objective: To determine the reasons for seeking dental healthcare services in a missionary hospital in Benin City; Nigeria. Materials and Methods: This 14-month retrospective study was conducted in a Pentecostal missionary hospital in Benin City. Data of interest which included age; gender; occupation; primary presenting complaints; and primary diagnosis were collected from the case notes with self-designed proforma. Cases with incomplete data were excluded from this study. The obtained data were subjected to descriptive statistics in the form of frequencies; cross tabulations; and percentages using Statistical Package for the Social Sciences version 17.0. Results: A total of 613 cases were retrieved with the complete information. The majority (56.3) of the patients were young adults (18-40 years). About one-fifth (21.2) of the patients were middle-aged adults. Children and elderly constituted 15.8 and 6.7 of the patients; respectively. A total of 332 (54.2) patients were females. There was diversity in the occupation of the patients with about one-third (37.7) of the patients being students. The majority of the patients had toothache as their primary presenting complaint (71.1). Others were tooth deposits (6.0); fractured teeth (3.8); hole in teeth (3.1); missing teeth for replacement (2.3); routine dental check-up (2.3); and mouth odor (2.0). Diagnosis of dental caries and its complications was made in more than half (58.6) of the patients while one-fifth (20.4) of the patients were diagnosed with gingivitis. Conclusion: Data from this study revealed that these enormous diverse patients of a Nigerian missionary hospital had toothache as their main primary presenting complaint and dental caries and its complication as their main primary diagnosis

An Assessment Model for Evaluating Outcomes in Federally Qualified Health Centers' Dental Departments: Results of a 5 Year Study.

PURPOSE: The purpose of this report was to establish baseline data on 10 oral health performance indicators over 5 fiscal years (2007 to 2008 through 2011 to 2012) for an Iowa health center. The baseline data provides an assessment model and reports outcomes based on the use of the model. Performance indicators show evidence of provider performance, accountability to stakeholders and provide the benchmarks required for dental management to develop future goals to improve oral health outcomes for at-risk populations. METHODS: Using descriptive statistic, this report extrapolated data from the Iowa Health Center's computer management systems software, HealthPro, and Centricity electronic medical records, and analyzed using IBM® SPSS® 19. This report describes the change in utilization for number and type of visits for uninsured and Medicaid patients over 5 fiscal years (a fiscal year is measured from November 1 through October 31). RESULTS: The number of patients receiving at least 1 dental visit in a measurement year showed n=81,673 procedures with 21% (17,167) being unduplicated patients. Preventive averaged 46%, restorative 18%, urgent care 22% and other procedures 14%. CONCLUSION: Federally qualified health centers (FQHCs) with a dental component serve populations with the greatest health disparities. This population includes ethnic and racial minorities, uninsured, underinsured, rural residents, Medicaid and Medicare. Establishing baseline data for FQHCs provides a foundational tool that will allow dental management to analyze successes as well as deficiencies in the goal to provide increased utilization to oral health care for at-risk populations.