Integrating Oral Health into Primary Care
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- Providing preventive and restorative oral health services to patients in medical homes has the potential to reduce longstanding barriers to obtaining these services, improve oral health outcomes for vulnerable patients, and decrease oral health disparities. 1
- Medicaid programs’ implementation of policies to support integration of oral health services into primary care is associated with increases in overall use of total preventive oral health services (i.e., services provided by oral health professionals and non-oral-health professionals) to infants and children from birth to age 5. 2
- The goal of improving the oral health of children begins with interprofessional education that lays the foundations for interprofessional practice. 3
- Physicians, nurses, and other health professionals are far more likely to see expectant or new mothers and their infants than are dentists. Therefore, it is essential that these health professionals be aware of the infectious etiology and associated risk factors of dental caries, make appropriate decisions about timely and effective interventions for pregnant women, and facilitate the establishment of dental homes. 4
- Every primary care visit is an opportunity to provide oral health assessments and oral health care. 5
- Preventive oral health services, such as oral health screening and risk assessment, fluoride varnish application, parental oral health counseling, and referral to dentists for further assessment or treatment if needed, delivered in primary care settings, can be cost-effective and possibly cost-saving. 6
- Primary care health professionals can play a role in promoting oral hygiene behaviors such as toothbrushing. 7
- Pediatricians can advocate for oral injury–preventive measures as they provide other injury-prevention messages during well-child visits. 8
- Many barriers to adopting preventive oral health services in primary care settings can be overcome. Training physicians in preventive dentistry should identify and target potential barriers with information and options for introducing office-based systems to improve chances of adoption. 9
- By systematically screening for both oral diseases and chronic diseases, using risk-based assessments to employ evidence-based interventions aimed at preventing disease and controlling disease progression, and employing motivational interviewing, dental hygienists and dental therapists can help accelerate the integration of oral health into primary care. 10
- Braun PA, Cusick A. 2016. Collaboration between medical providers and dental hygienists in pediatric health care. Journal of Evidence-Based Dental Practice Suppl:59–67.
- Arthur T, Rozier RG. 2016. Provision of preventive dental services in children enrolled in Medicaid by nondental providers. Pediatrics 137(2):e20153436.
- Hallas D, Fernandez JB, Herman NG, Moursi A. 2015. Identification of pediatric oral health core competencies through interprofessional education and practice. Nursing Research and Practice Epub 360523.
- American Academy of Pediatric Dentistry, Council on Clinical Affairs. 2011. Guideline on perinatal oral health care.
- Fulmer T, Cabrera P. 2012. The primary care visit: What else could be happening? Nursing Research and Practice Epub 720506.
- Stearns SC, Rozier RG, Kranz AM, Pahel BT, Quinonez RB. 2012. Cost-effectiveness of preventive oral health care in medical offices for young Medicaid enrollees. Archives of Pediatrics and Adolescent Medicine 166(10):945–951.
- Malecki K, Wisk LE, Walsh M, McWilliams C, Eggers S, Olson M. 2015. Oral health equity and unmet dental care needs in a population-based sample: Findings from the Survey of the Health of Wisconsin. American Journal of Public Health 105(Suppl 3):S466–474.
- Keels MA. 2014. Management of dental trauma in a primary care setting. Pediatrics 133(2):e466–476.
- Close K, Rozier RG, Zeldin LP, Gilbert AR. 2010. Barriers to the adoption and implementation of preventive dental services in primary medical care. Pediatrics 125(3):509–517.
- Blue C, Riggs, S. 2016. Oral health care delivery within the accountable care organization. Journal of Evidence-Based Dental Practice Suppl:52–58.
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