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ORANGE COUNTY <br />BOARD OF COMMISSIONERS <br />ACTION AGENDA ITEM ABSTRACT <br />Meeting Date: December 11, 2007 <br />Action Agenda <br />Item No. 4- - G~' <br />SUBJECT: New Dental Fee for Occlusal Guards and Fee Adjustment <br />DEPARTMENT: Health PUBLIC HEARING: (YIN) No <br />ATTACHMENT(S): None INFORMATION CONTACT: <br />Rosemary Summers, 245-2411 <br />PURPOSE: To approve a new fee for occlusal guards and adjustment in one current fee for the <br />Health Department. <br />BACKGROUND: Dental Health Services in the Health Department needs to be able to provide <br />for an occlusal guard, commonly called a nightguard for dental patients. An occlusal guard is <br />designed to minimize the effects of bruxism (grinding) and other occlusal factors and preserves <br />the integrity of teeth. This is a preventive measure that reduces further damage to permanent <br />teeth and more costly future repairs. Currently these patients must be referred to a private <br />practitioner for this service and generally cannot afford to have it provided to them. <br />The proposed full charge Health Department fee for this service is $274, which is comparable to <br />the lowest private practice charge. The fabrication of the appliance would be done by an <br />external lab. The lab cost to fabricate the appliance is $95. The dental patient would be <br />responsible for the full cost of the lab charge in addition to the $274 fee at their per cent <br />payment level on the sliding scale. The Department estimates that approximately 12 patients <br />per year would need this appliance. Approximately 7 patients are estimated to be 20% pay on <br />the sliding scale, paying $54.80 plus the $95.00 lab charge. Four patients are estimated to be <br />80% pay, paying $219.20 plus the $95 lab charge. One patient is estimated to be 100% pay, <br />paying $274 and the full $95 lab charge. In this scenario, the full charge .for these services <br />would be $3,288 with the cost recovery through patient fees being $1,534.40. No new staff or <br />equipment is being added as a result of this service. <br />The Department is also requesting an increase in the 100% fee to $92 for alveolplasty in <br />conjunction with four or more teeth in one quadrant: This prepares the bone to be able to <br />accept a partial or a denture. This requested increase is due to the increase in the Dental <br />Medicaid rates effective 2007-08. The present rate is $84 and the approved Medicaid rate is <br />$92. <br />