HAB HIV Performance Measures: 

Oral Health Services 

Performance Measure: Oral Health Services: 

Periodontal Screening or Examination 

Percentage of HIV-infected oral health patients1 who had a periodontal screen or examination2 at least once in 

the measurement year. 

Numerator: Number of HIV-infected oral health patients who had a periodontal screen or 

examination2 at least once in the measurement year 

Denominator: Number of HIV-infected oral health patients that received a clinical oral evaluation3

 at 

least once in the measurement year. 

Patient 

Exclusions: 

1. Patients who had only an evaluation or treatment for a dental emergency in the 

measurement year.4 

2. Edentulist patients (complete). 

3. Patients who were <13 years. 

Data Element: 

1. Is the patient HIV-infected? (Y/N) 

a. If yes, did the patient have a clinical oral evaluation3

 at least once in the 

measurement year? (Y/N) 

i. If yes, did the patient have a periodontal screen or examination2

 at least 

once in the measurement year? (Y/N) 

Data Sources: 

 Data reports required by HRSA/HAB, such as the Ryan White HIV/AIDS Program 

Services Report (RSR), may provide useful data regarding the number of patients 

identified as receiving oral health services. 

 Electronic Health Record/Electronic Medical Record 

 Oral health services patient record data abstraction of a sample of records 

 Provider billing systems may be used; however, this will be dependent on the 

completeness and accuracy of coding of the procedures of interest. 

National Goals, 

Targets, or 

Benchmarks for 

Comparison: 

None available at this time. 

Outcome 

Measures for 

Consideration: 

 Rate of tooth loss due to periodontal disease in the practice population. 

Basis for Selection: 

The American Academy of Periodontology “Parameter on Periodontitis Associated with Systemic 

Conditions” indicates that “some forms of periodontal disease may be more severe in individuals affected 

with immune system disorders. Patients infected with human immunodeficiency syndrome (HIV), may have 

especially severe forms of periodontal disease. The incidence of necrotizing periodontal diseases may 

increase with patients with acquired immunodeficiency syndrome (AIDS).”5 

Oral Health Final | November 23, 2009| Page 7 of 10 
HAB HIV Performance Measures: 

Oral Health Services 

Performance Measure: Oral Health Services: 

Periodontal Screening or Examination 

US Public Health Service Guidelines: 

None. 

References/Notes: 

1 “Patient” includes all patients aged 13 years or older. 

2 A periodontal screen should include the assessment of medical and dental histories, the quantity and quality 

of attached gingival; bleeding; tooth mobility; and radiological review of the status of the periodontium and 

dental implants. “Appropriate screening procedures may be performed to determine the need for a 

comprehensive periodontal evaluation.” (Source: American Academy of Periodontolgy. Parameter on 

Comprehensive Periodontal Examination. J Periodontol 2000;71:847-848). A comprehensive periodontal 

examination (ADA CDT D0180) includes “the evaluation of periodontal conditions, probing and charting, 

evaluation and recording of the patient’s dental and medical history and general health assessment. It may 

include the evaluation and recording or dental caries, missing or unerupted teeth, restorations, occlusal 

relationships and oral cancer evaluation” (Source: American Dental Association. Current Dental 

Terminology: CDT 2009-2010.) The screening or examination may be performed and documented by either 

a licensed dentist or, where state regulations allow, by a dental hygienist, but the interpretation of data and 

diagnosis must be made by a licensed dentist. 

3

 Clinical oral evaluations include evaluation, diagnosis and treatment planning. Pertinent ADA CDT codes 

for patient inclusion in the denominator may include the following: D0120-Periodic Oral Evaluationestablished patient; D0150-Comprehensive oral evaluation, new or established patient; D0160-Detailed and 

Extensive Oral Evaluation; D0170-Re-evaluation, limited, problem focused (established patient; not postoperative visit); and D0180-Comprehensive Periodontal Evaluation-new or established patient. 

4 Pertinent ADA CDT codes for patient exclusion may include the following: D9110-Palliative (emergency) 

treatment of dental pain-minor procedure; and D0140-Limited Oral Evaluation-Problem Focused; however, 

the diagnostic and treatment procedures associated with emergency evaluation and treatment encounters 

(including those using these or other ADA CDT codes, as well as other procedures which may not be coded) 

should be considered when identifying patients for exclusion. 

5

 American Academy of Periodontology. Parameter on Periodontitis Associated with Systemic Conditions. J 

Periodontol 2000; 71:876-879. 

Oral Health Final | November 23, 2009| Page 8 of 10