Nizel A E
J Am Dent Assoc. 1976 May;92(5):911-29. doi: 10.14219/jada.archive.1976.0097.
The successful practice management of preventive dentistry requires that it be comprehensive and include both chairside and counseling procedures. The chairside clinical procedures are a prophylaxis, topical application of fluorides, application of pit and fissure sealants, and fabrication of mouth-guards and space maintainers. The counseling procedures include plaque control and nutritional guidance. The caries activity test can be used as a means of monitoring excessive sugar intake. It is the responsibility of the dentist to determine the preventive dentistry needs of his patient based on the latter's caries score, periodontal, gingival, and plaque indexes, and diet evaluation. Since patients are prone to certain dental problems during particular age periods, the preventive management procedures must consider the existing and anticipated dental problems on the basis of the patient's age. Each of the preventive services is objective in nature because it involves either chairside or counseling procedures. During the counseling service,worksheets and clinical case notes are kept as part of the patient's dental record. The progressive effectiveness of the home-care preventive dentistry counsling procedures can be measured by scores and indexes. The frequency of repeating the service depends on proven clinical merit and the individual needs of the patient. The delivery of preventive dentistry services can be monitored by dental insurance carriers through peer review of clinical services, data sheets, case notes, a preventive dentistry record, and by patient questionnaire. A method for managing, measuring, and monitoring an objective, comprehensive preventive dentistry service has been presented so that the insurance carrier can underwrite this type of coverage as part of its dental insurance plan.
预防性牙科的成功实践管理要求其具备全面性，涵盖椅旁操作和咨询程序。椅旁临床操作包括预防性洁治、氟化物局部应用、窝沟封闭剂的应用以及制作口腔防护器和间隙保持器。咨询程序包括菌斑控制和营养指导。龋活性测试可作为监测糖分摄入过量的一种手段。牙医有责任根据患者的龋齿评分、牙周、牙龈和菌斑指数以及饮食评估来确定其预防性牙科需求。由于患者在特定年龄段容易出现某些牙齿问题，预防性管理程序必须根据患者年龄考虑现有的和预期的牙齿问题。每项预防性服务本质上都是客观的，因为它涉及椅旁操作或咨询程序。在咨询服务过程中，会保留工作表和临床病例记录作为患者牙科记录的一部分。家庭护理预防性牙科咨询程序的渐进效果可以通过评分和指数来衡量。重复服务的频率取决于已证实的临床价值和患者的个体需求。牙科保险公司可以通过对临床服务、数据表、病例记录、预防性牙科记录进行同行评审以及通过患者问卷来监测预防性牙科服务的提供情况。本文提出了一种管理、测量和监测客观、全面的预防性牙科服务的方法，以便保险公司能够将此类保险范围作为其牙科保险计划的一部分进行承保。
