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Integrating Oral Health into Primary Care

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This collection of selected resources offers high-quality information about primary care and oral health. Use the tools below for further searching, or contact us for personalized assistance.

Key Facts

  Share these facts to help improve the oral health of pregnant women, children, and adolescents and their families.

  • 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 injurypreventive 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

References

  1. 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.
  2. Arthur T, Rozier RG. 2016. Provision of preventive dental services in children enrolled in Medicaid by nondental providers. Pediatrics 137(2):e20153436.
  3. 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.
  4. American Academy of Pediatric Dentistry, Council on Clinical Affairs. 2011. Guideline on perinatal oral health care.
  5. Fulmer T, Cabrera P. 2012. The primary care visit: What else could be happening? Nursing Research and Practice Epub 720506.
  6. 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.
  7. 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.
  8. Keels MA. 2014. Management of dental trauma in a primary care setting. Pediatrics 133(2):e466–476.
  9. 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.
  10. Blue C, Riggs, S. 2016. Oral health care delivery within the accountable care organization. Journal of Evidence-Based Dental Practice Suppl:52–58.

OHRC Publications

This section contains OHRC-produced materials.


Details

Barzel R, Holt K, Isman B. 2006. Special care: An oral health professional's guide to serving young children with special health care needs. Washington, DC: National Maternal and Child Oral Health Resource Center, 1 v

National Maternal and Child Oral Health Resource Center
Georgetown University Box 571272
Washington, DC 20057-1272

Telephone: (202) 784-9771
E-mail: OHRCinfo@georgetown.edu
Website: https://www.mchoralhealth.org
Available from the website.

This course is designed to help oral health professionals ensure that young children with special health care needs have access to comprehensive, family-centered, and community-based services. Continuing education credits from the Indian Health Service or the American Dental Hygienists' Association will be awarded upon successful completion of the course. [Funded by the Maternal and Child Health Bureau]


Details

Casamassimo P, Holt K, eds. 2016. Bright Futures: Oral health—Pocket guide (3rd ed.). Washington, DC: National Maternal and Child Oral Health Resource Center, 90 pp

National Maternal and Child Oral Health Resource Center
Georgetown University Box 571272
Washington, DC 20057-1272

Telephone: (202) 784-9771
E-mail: OHRCinfo@georgetown.edu
Website: https://www.mchoralhealth.org
Available from the website.

This pocket guide offers health professionals an overview of preventive oral health supervision for five periods—pregnancy and postpartum, infancy, early childhood, middle childhood, and adolescence. The pocket guide is designed to help health professionals implement specific oral health guidelines during these periods. For each period, information about family preparation, risk assessment, interview questions, screening, examination, preventive procedures, anticipatory guidance, measurable outcomes, and referrals are discussed. The content aligns with Bright Futures: Guidelines for Health Supervision of Infants, Children, and Adolescents (4th ed.). [Funded by the Maternal and Child Health Bureau]


Details

Holt K, Barzel R. 2003. A health professional's guide to pediatric oral health management. Washington, DC: National Maternal and Child Oral Health Resource Center, 1 v

National Maternal and Child Oral Health Resource Center
Georgetown University Box 571272
Washington, DC 20057-1272

Telephone: (202) 784-9771
E-mail: OHRCinfo@georgetown.edu
Website: https://www.mchoralhealth.org
Available from the website.

This curriculum is designed to assist health professionals in managing the oral health of infants and young children. The modules include information on performing oral screenings to identify infants and children at increased risk for oral health problems, offering referrals to oral health professionals, and providing parents with anticipatory guidance. Module titles are (1) an introduction to infants' and young children's oral health, (2) managing infants' and young children's oral health, (3) oral conditions and abnormalities, (4) prevention of oral disease, (5) nonnutritive sucking habits, (6) oral injury, and (7) infants and young children with special health care needs. Each module includes an overview, learning objectives, key points, a self-assessment quiz, references, and additional resources. [Funded by the Maternal and Child Health Bureau]


Details

Lowe E, Barzel R, Holt K. 2016. Integrating sustainable oral health services into primary care in school-based health centers: A framework. Washington, DC: National Maternal and Child Oral Health Resource Center, 1 v

National Maternal and Child Oral Health Resource Center
Georgetown University Box 571272
Washington, DC 20057-1272

Telephone: (202) 784-9771
E-mail: OHRCinfo@georgetown.edu
Website: https://www.mchoralhealth.org
Available from the website.

This framework offers ideas for school-based health centers (SBHCs) to consider when integrating sustainable comprehensive oral health services into primary care to improve the quality of oral health care of school-age children and adolescents. The framework presents a description of six levels of integration to help SBHCs evaluate their current level of integration and 10 key elements to more fully integrate sustainable comprehensive oral health services into primary care in SBHCs. [Funded by the Maternal and Child Health Bureau]


Details

National Maternal and Child Oral Health Resource Center. 2010. Open wide: Oral health training for health professionals. Washington, DC: National Maternal and Child Oral Health Resource Center, 1 v

National Maternal and Child Oral Health Resource Center
Georgetown University Box 571272
Washington, DC 20057-1272

Telephone: (202) 784-9771
E-mail: OHRCinfo@georgetown.edu
Website: https://www.mchoralhealth.org
Available from the website.

This curriculum is designed to help health and early childhood professionals working in community settings (e.g., Head Start, home visiting, WIC staff) promote oral health in the course of promoting general health for infants, children, and their families. Topics include tooth decay, risk factors, and prevention; oral health risk assessment and oral health screening; and anticipatory guidance for parents. Each of the four modules includes an overview, learning objectives, key points, a post-test, and resources. A glossary and a list of presentations, print materials, and videotapes are also presented. [Funded by the Maternal and Child Health Bureau]


Details

Oral Health During Pregnancy Expert Workgroup. 2012. Oral health care during pregnancy: A national consensus statement. Washington, DC: National Maternal and Child Oral Health Resource Center, Multiple items

National Maternal and Child Oral Health Resource Center
Georgetown University Box 571272
Washington, DC 20057-1272

Telephone: (202) 784-9771
E-mail: OHRCinfo@georgetown.edu
Website: https://www.mchoralhealth.org
Available from the website.

This resource includes a consensus statement that resulted from an expert workgroup meeting held on October 18, 2011, in Washington, DC, convened by the Health Resources and Services Administration in collaboration with the American College of Obstetricians and Gynecologists and the American Dental Association. It contains guidance on oral health care for pregnant women for both prenatal care health professionals and oral health professionals, pharmacological considerations for pregnant women, and guidance for health professionals to share with pregnant women. [Funded by the Maternal and Child Health Bureau]

     


OHRC Library

This section contains recent materials, not including OHRC-produced materials.


Details

Association of State and Territorial Dental Directors and National Network for Oral Health Access. 2014. Facilitating partnerships and collaborations between state oral health programs and primary care associations: Final project report. Reno, NV: Association of State and Territorial Dental Directors, 4 pp, plus appendices (50 pp)

Association of State and Territorial Dental Directors
3858 Cashill Boulevard
Reno, NV 89509

Telephone: (775) 626-5008
Fax: (775) 626-9268
E-mail: info@astdd.org
Website: http://www.astdd.org
Available from the website.

This report describes a national initiative to provide guidance to oral health programs, primary care associations, and community health centers in identifying and planning collaborative state-level oral-health-improvement projects. Contents include information about the state application process; coaches who provide guidance to the project; resource materials; the launch webcast; team work plans in Colorado, Hawaii, Illinois, Kentucky, Ohio, and Oklahoma; responses to a follow-up survey; and recommendations.


Details

Langelier M, Moore J, Baker BK, Mertz E. 2015. Case studies of 8 federally qualified health centers: Strategies to integrate oral health with primary care. Rensselaer, NY: Oral Health Workforce Research Center, 84 pp

Oral Health Workforce Research Center
New York Center for Health Workforce Studies University of Albany, SUNY, School of Public Health 1 University Place, Suite 220
Rensselaer, NY 12144-3445

Telephone: (518) 402-0250
Fax: (518) 402-0252
Website: http://www.oralhealthworkforce.org
Available from the website.

This report presents case studies of eight federally qualified health centers (FQHCs) across the United States. It describes findings from a project conducted to understand the barriers and facilitators to integration of oral health services into primary care in FQHCs as well as to understand FQHCs’ use of different types of oral health professionals to provide access to oral health services within their delivery systems. The report also identifies useful technologies that enable service integration in FQHCs.


Details

Maxey H. 2015. Integration of oral health with primary care in health centers: Profiles of five innovative models. Bethesda, MD: National Association of Community Health Centers, 27 pp

National Association of Community Health Centers
7501 Wisconsin Avenue, Suite 1100W
Bethesda, MD 20814

Telephone: (301) 347-0400
Website: http://nachc.org
Available from the website.

This monograph presents information on five health centers that have successfully integrated oral health into primary care. Contents include background on oral health disparities and health center leadership in providing access to oral health care; a framework for exploring integration; an overview of the participants, methods, and results; and profiles of the health centers in Colorado, Kansas, Kentucky, Massachusetts, and Washington.


Details

Pourat N, Martinez AE, Crall J. 2015. Better together: Co-location of dental and primary care provides opportunities to improve oral health. Los Angeles, CA: UCLA Center for Health Policy Research, 8 pp

UCLA Center for Health Policy Research
10960 Wilshire Boulevard, Suite 1550
Los Angeles, CA 90024

Telephone: (310) 794-0909
Fax: (310) 794-2686
E-mail: chpr@ucla.edu
Website: http://www.healthpolicy.ucla.edu
Available from the website.

This brief presents findings from a study to assess oral health care capacity in community health centers (CHCs) in California. Topics include the geographic distribution of CHCs with co-located oral health care and primary care; size, productivity, and revenues of co-located sites compared to those without on-site oral health care capacity; and opportunities to improve access to oral health care in CHCs.


Details

Safety Net Medical Home Initiative. 2016. Organized, evidence-based care: Oral health integration. Seattle, WA: Safety Net Medical Home Initiative, multiple items

Safety Net Medical Home Initiative
Qualis Health P.O. Box 33400
Seattle, WA 98133-9700

Telephone: (800) 949-7536
Secondary Telephone: (800) 833-6384
Fax: (206) 368-2419
Website: http://www.safetynetmedicalhome.org
Available from the website.

These resources provide guidance for primary care practices on providing evidence-based oral health care that is intended to optimize patients’ health. Contents include an executive summary, an implementation guide, a video, and a white paper. Topics include implementing an oral-health-care-delivery framework that includes conducting an oral health screening, offering brief interventions, and coordinating referral to a dentist as needed. Field-testing results and case examples are provided.

     

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