Section 415.17 - Dental services

415.17 Dental services. The facility shall provide oral hygiene care and routine and 24-hour emergency dental care in accordance with the comprehensive resident care plan and which meets generally accepted standards of dental and dental hygiene care and services.

(a) Organization. The facility shall appoint a licensed and currently registered dentist to assist the facility in the development and implementation, in cooperation with nursing and medical services, of written dental service and oral hygiene policies and procedures which:

(1) establish oral hygiene and dental care as components of interdisciplinary resident care planning and treatment;

(2) develop an oral hygiene program to be jointly administered by nursing, dental and dental hygiene staff;

(3) set forth in detail how emergency care to alleviate pain, infection, or swelling and routine dental services are to be provided and the specific arrangements with dentist(s) who are to provide these services including the prompt referral of residents with lost or damaged dentures to a dentist if such residents will benefit from such referral; and

(4) establish a system of determining dental treatment goals for each resident based on the resident's need relative to his or her physical and mental level of functioning, the overall plan of care for the resident and the resident's preferences. These treatment goals shall range on a continuum, progressing from all essential dental services to only routine oral hygiene services and emergency services. The decision to defer treatment of identified dental conditions shall be documented based on physical or mental contraindications for care and the resident's informed choice.

(b) Admission. An initial screening of each resident's oral health status shall be conducted within 48 hours of admission to determine the need for emergency care to alleviate pain, infection, or swelling. The presence and functioning of any oral prostheses shall be observed, and, with the resident's consent, the prostheses shall be indelibly marked for identification.

(c) Oral Examination and Treatment. A complete oral examination of each resident shall be conducted by a licensed and currently registered dentist or dental hygienist within 7 days following completion of the initial comprehensive assessment in accordance with Section 415.11 of this Part and by a dentist at least annually thereafter. Based on treatment priorities determined at each time of examination, an individual plan of continuing oral hygiene and dental care meeting generally accepted standards of dental and dental hygiene care and services shall be established, or updated, and carried out for each resident. If treatment by a dentist is needed, such treatment shall begin within 30 days of the examination. This shall include arrangements for transportation when the services of a provider outside the facility are required.

(d) Records. The admission dental record and records of all subsequent dental care shall be maintained as part of the resident clinical record.
 

Effective Date: 
Wednesday, April 1, 1992
Doc Status: 
Complete