Silver Diamine Fluoride (SDF) Coordinating Care

Care coordination for the treatment of dental disease is essential to assure that families and patients have the information they need and can be successfully referred to dental care. Family engagement in decision making is a critical part of the coordination process. 

Engaging Patients and Caregivers 

To begin the process of engaging patients and caregivers, conduct an assessment of the patient's social and emotional needs, identifying both strengths and issues needing accommodation. Educating and providing time and space for caregivers to think and ask questions before consenting to treatment is essential. Note that fear, difficulty sitting still, and/or sensory issues are likely to be more common among children with special health care needs. 

Shared Decision Making 

Shared decision making is an integral component of coordinated care and recognizes caregivers as the managers of their children's health. Health professionals should ask for and consider the family’s opinions and respond to their concerns. Caregivers should be actively involved in arriving at a mutually agreed upon treatment plan. 

Apply the following concepts in discussions with patients, parents and caregivers as you take an oral health history, perform an oral health risk assessment and exam of the mouth, and arrive at a recommendation from your findings. (The following steps are excerpted from The SHARE Approach: A Model for Shared Decision-making - Fact Sheet.) 

1. Seek your patient’s/caregiver’s participation.
2. Help patients/caregivers explore and compare treatment options.
3. Assess your patient’s/caregiver’s values and preferences.
4. Reach a decision with your patient/caregiver(s).
5. Evaluate your patient’s/caregiver’s decision. 

Patient- and Family-Centered Care Coordination 

Pediatric care coordination is an assessment-driven and team-based activity designed to meet the needs of children and youth while enhancing the caregiving capabilities of families. Care coordination addresses interrelated medical, social, developmental, behavioral, educational, and financial needs to achieve optimal health and wellness outcomes. 

Special Health Care Needs

Many children presenting with dental disease will have little or no experience with dental care or may live with medical conditions and/or disabilities that require a unique approach.