Curriculum influence on interdisciplinary oral health education and practice

Clark, Melinda; Quiñonez, Rocio B.; Bowser, Jonathan; Silk, Hugh

doi:10.1111/jphd.12215

Cited by 12 publications

(16 citation statements)

References 14 publications

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“…The barriers noted above point to opportunities that can maximize delivery of preventive oral health services to very young children. The push toward interprofessional education and practice, as well as medical and dental integration has been well described (27)(28)(29)(30). In addition to training physicians to provide oral health screening and apply fluoride varnish, two ideas that have been implemented at local and state levels include co-located services and care coordination.…”

Section: Discussionmentioning

confidence: 99%

The Impact of COVID-19 on Preventive Oral Health Care During Wave One

Meyer

Danesh

2021

Front. Dent. Med

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Introduction: Early childhood caries burdens children, their families, and the health care system. Utilizing fluoride varnish at medical well-child visits with non-dental primary care providers can be an interprofessional strategy to combat early childhood caries. The COVID-19 pandemic dramatically altered preventive health care delivery and the effects on preventive oral health care delivery have not been previously described.Methods: This analysis used descriptive statistics and non-parametric Wilcoxon Mann-Whitney tests to compare preventive oral health utilization among 1 to 5-year old children in two state Medicaid agencies before and during the pandemic. Fluoride utilization rates at dental visits and medical well-child visits were calculated as number of users per 1,000 enrolled children. Additionally, the proportion of well-child visits that included fluoride application was calculated for each state.Results: During the pandemic, the quarterly fluoride utilization rate significantly decreased at dental visits (pre-pandemic = 153.5 per 1,000 enrolled children; pandemic = 36.1 per 1,000 enrolled children, p < 0.001) and signficantly decreased at medical well-child visits (pre-pandemic = 72.2 per 1,000 enrolled children; pandemic = 32.3 per 1,000 enrolled children, p = 0.03) during the pandemic.Conclusions: The findings highlight the importance of interprofessional collaboration among non-dental primary care providers and dental providers to provide access to preventive oral health services, particularly when access to dentists is limited. Future directions might include rigorous evaluations of co-located medical and dental services or the use of interprofessional telehealth technologies.

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Section: Discussionmentioning

confidence: 99%

The Impact of COVID-19 on Preventive Oral Health Care During Wave One

Meyer

Danesh

2021

Front. Dent. Med

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“…Evidence from a 2012 national survey of oral health practices of pediatricians reported that while 41% of pediatricians agreed that they should apply fluoride varnish, 7% reported applying it to most patients eligible to receive it (Quinonez et al 2014). Strategies to increase the delivery of medical POHS include providing oral health training to primary care providers (Bernstein et al 2016; Dooley et al 2016; Clark et al 2017; Silk et al 2018), emphasizing the importance of POHS to providers (Dooley et al 2016), offering incentives to motivate staff to incorporate POHS into medical visits (Bernstein et al 2016), and reducing clinical workflow demands (Sengupta et al 2017). These strategies are most successful when tailored to a practice’s specific needs and when implemented together, addressing multiple barriers simultaneously (Bernstein et al 2016; Dooley et al 2016; Clark et al 2017; Silk et al 2018).…”

Section: Discussionmentioning

confidence: 99%

Do Oral Health Services in Medical Offices Replace Pediatric Dental Visits?

et al. 2020

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In the United States, state Medicaid programs pay for medical and dental care for children from low-income families and support nondental primary care providers delivering preventive oral health services (POHS) to young children in medical offices (“medical POHS”). Despite the potential of these policies to expand access to care, there is concern that they may replace dental visits with medical POHS. Using Medicaid claims from 38 states from 2006 to 2014, we conducted a repeated cross-sectional study and used linear probability regression to estimate the association between the annual proportion of children in a county receiving medical POHS and the probability that a child received 1) dental POHS and 2) a dental visit in a given year. Models included county and year fixed effects and controlled for child- and county-level factors, and standard errors were clustered at the state level. In a weighted population of 45.1 million child-years (age, 6 mo to <6 y), we found no significant nor substantively important association between the proportion of children in a county receiving medical POHS and the probability that a child received dental POHS or a dental visit. Additionally, we found an almost zero probability (<0.001) that the reduction in dental POHS was at least as large as the expansion in medical POHS (full substitution) and a 0.50 probability that increased medical POHS was associated with an increase in dental POHS of at least 6.6% of the expansion of medical POHS. Results were similar when receipt of dental visits was examined. This study failed to find evidence that medical POHS replaced dental visits for young children enrolled in Medicaid and, in fact, offers evidence that increased medical POHS was associated with increased utilization of dental care. Given lower-than-desired rates of dental visits for this population, delivery of medical POHS should be expanded.

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“…Changes wrought by the pandemic and the evolving recognition of oral-systemic interactions (3,50) support increased interest in expanding the role of dentists. A growing emphasis on IPE and integration of oral health into primary care is evident in curriculum development, specific funding programs, and other efforts (51)(52)(53)(54)(55). Ongoing changes in dentistry and dental education are in keeping with these OP-PCP competency statement proposals: 2.20.2, participate in an interprofessional team approach that integrates oral health for the promotion and maintenance of overall health, and the prevention and treatment of disease; 2.24D.2, perform basic nutritional, safety, and other lifestyle counseling, including administration of vaccinations where permitted by law; and 2.24D.6, function effectively as medical team members in disaster relief efforts.…”

Section: Discussionmentioning

confidence: 99%

Dentists as Primary Care Providers: Expert Opinion on Predoctoral Competencies

et al. 2021

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Dentistry and medicine traditionally practice as separate professions despite sharing goals for optimal patient health. Many US residents experience both poor oral and general health, with difficulty accessing care. More efficient collaboration between these professions could enhance health. The COVID-19 pandemic disclosed further disparities while underscoring concerns that physician supply is inadequate for population needs. Hence, enhancing healthcare provider education to better meet the public's health needs is critical. The proposed titles “Oral Physician” or “Oral Health Primary Care Provider” (OP-PCP) acknowledge dentist's capacity to diagnose and manage diseases of the orofacial complex and provide some basic primary healthcare. The US Surgeon General's National Prevention Council and others recommend such models. Medical and dental education already overlap considerably, thus it is plausible that dental graduates could be trained as OP-PCPs to provide primary healthcare such as basic screening and preventive services within existing dental education standards. In 2018, 23 dental and medical educators participated in an expert-opinion elicitation process to review educational competencies for this model. They demonstrated consensus on educational expansion and agreed that the proposed OP-PCP model could work within existing US Commission on Dental Accreditation (CODA) standards for predoctoral education. However, there were broader opinions on scope of practice details. Existing CODA standards could allow interested dental programs to educate OP-PCPs as a highly-skilled workforce assisting with care of medically-complex patients and to helping to reduce health disparities. Next steps include broader stakeholder discussion of OC-PCP competencies and applied studies including patient outcome assessments.

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Curriculum influence on interdisciplinary oral health education and practice

Cited by 12 publications

References 14 publications

The Impact of COVID-19 on Preventive Oral Health Care During Wave One

The Impact of COVID-19 on Preventive Oral Health Care During Wave One

Do Oral Health Services in Medical Offices Replace Pediatric Dental Visits?

Dentists as Primary Care Providers: Expert Opinion on Predoctoral Competencies

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