Perspectives on Innovations in Oral Health Care

Abstract

A downward trend in dental caries in permanent teeth of children that began in the 1970s has leveled out at historic lows. Severe periodontal disease affects a small percentage of people, and tooth loss has plummeted so that complete tooth loss, once a common occurrence, now is almost non-existent in upper socioeconomic groups. But not all people have benefited equally from these positive trends. Dental problems continue to affect the disadvantaged in society at unacceptable rates, and their disease burden is likely to increase because of trends in social determinants of oral diseases.Personal dental care alone usually is unable to provide a sufficient buffer against these risks to maintain adequate oral health. Extensive disease in young children too often requires treatment in the hospital with a high chance of relapse. A national health goal is to "achieve health equity, eliminate disparities, and improve the health of all groups." Achieving this goal in oral health requires that things be done differently.This issue of the highlights several approaches being tried here in North Carolina and elsewhere to address oral health problems. Initiatives fall into 4 categories: advocacy, workforce policies, integration of oral health and primary care, and the medical management of caries.

Does Education in Oral Health Competencies in Physician Assistant Education Programs Translate to Delivery of Oral Health Services in Clinical Practice?

“…4 Early initiatives to encourage integration have specifically focused on primary health care providers because they are uniquely positioned to provide oral health screening services and navigate patients to appropriate oral health service providers. 1 In 2010, the National Interprofessional Initiative on Oral Health (NIIOH) provided support for the creation of the PA Leadership Initiative in Oral Health to leverage the rapid growth and adaptive nature of the PA workforce. Leadership of the Accreditation Review Commission on Education for the Physician Assistant (ARC-PA), the Physician Assistant Education Association (PAEA), the National Commission on Certification of Physician Assistants (NCCPA), and the American Academy of PAs (AAPA) engaged with the initiative to encourage PAs to incorporate oral health assessment and screening services into clinical practice.…”

“…The slow progress of efforts to integrate oral health screening into primary health care practice has resulted in disparities in oral health outcomes for some population groups. 1 In 2011, the Institute of Medicine published companion reports that discussed the responsibility of primary care providers to address the oral health needs of patients. 2,3 A subsequent report described core oral health clinical competencies for primary care clinicians, including physician assistants (PAs).…”

“…4 Early initiatives to encourage integration have specifically focused on primary health care providers because they are uniquely positioned to provide oral health screening services and navigate patients to appropriate oral health service providers. 1…”