Dentists as Primary Care Providers: Expert Opinion on Predoctoral Competencies

Abstract

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.

Atypical presentation of maxillary osteomyelitis in an immunocompromised patient

“…Thus, oral physicians or “Oral Health Primary Care Provider” (OP-PCP) play a substantial role as primary care providers by managing the diseases of the orofacial complex, for the betterment of overall health outcomes. [ 15 ] Early identification, systematic investigative workup, judicious use of antibiotics, LDD, and photodynamic therapy, highlighted in the present case, resulted in better postoperative recovery, thereby reducing morbidity post-treatment.…”

Trends in Scope of Practice for Oral Health Care: Future Transformative Effects

“…Ensuring that future dentists are trained as potential primary care providers for basic health care services such as screening for medical and behavioral concerns and for preventive services such as vaccinations (Gordon et al 2021)…”

“…• Ensuring that future dentists are trained as potential primary care providers for basic health care services such as screening for medical and behavioral concerns and for preventive services such as vaccinations (Gordon et al 2021) • Adding routine primary care procedures to dental care to improve patient health. This could improve access to potential risk factor assessment, early disease diagnosis, interventions to prevent future disease complications, and/or immunization to prevent disease spread.…”

“…If oral health care workers worked in an integrated clinical environment with the rest of the medical team, their collaboration could increase effectiveness and efficiency, potentially reducing health care disparities and costs (US Department of Health and Human Services 2000). Through only a small expansion in their scope of practice, dentists could become primary care providers within dental licensure (National Prevention Council 2011; American State and Territorial Dental Directors 2018; Gordon et al 2021), although this would require changes in the ways that dentists are trained, licensed, and compensated. One recent article explored expert opinion on how dental education could enable such change (Gordon et al 2021).…”

“…Through only a small expansion in their scope of practice, dentists could become primary care providers within dental licensure (National Prevention Council 2011; American State and Territorial Dental Directors 2018; Gordon et al 2021), although this would require changes in the ways that dentists are trained, licensed, and compensated. One recent article explored expert opinion on how dental education could enable such change (Gordon et al 2021).…”