Health Center News, Uncategorized

Oral Health Is Overall Health: Salud Family Health and Petaluma Health Center

dental graphic

This article originally appeared in NACHC’s Care Teams Digest, published bimonthly. Subscribe to receive future issues delivered directly to your inbox.

“The mouth is the gateway to the body, because oral health is an essential component to overall health.”

Ethan Kerns, DDS, Chief Dental Officer, Salud Family Health

A growing body of evidence builds the relationship between oral health and health problems such as high blood pressure, diabetes management, Alzheimer’s disease, even pregnancy complications. As integrated health care experts, Community Health Centers are leading the way in dental-medical provider collaborations to improve patient health outcomes.

One clear strategy is to focus on preventative dental care during medical care visits. At Salud Family Health, a hygienist goes to the medical exam room to perform preventative screenings, patient education, and fluoride treatment following a patient’s primary care appointment. If the hygienist learns that the patient has an urgent need, the patient can immediately be seen in the dental clinic.

With health center programs being smaller than medical programs, dental teams must be very strategic in their use of staff, space, and financial resources for comprehensive oral health care. “We don’t have enough capacity,” says Ramona English, DDS, Chief Dental Officer, Petaluma Health Center (PHC), “so we focus on upstream intervention for more impact.”

Using its Electronic Health Record (EHR) the dental team at PHC runs a care gap report every morning to identify patients eligible for integrated dental care. When patients 6 months to 3 years old come in for a well-child visit in the medical clinic, the dental team is notified to give a dental examination, risk assessment, cleaning, fluoride varnish, anticipatory guidance, and self-managing goal setting without the patient and parent leaving the medical exam room.

As part of the medical-dental integration, dental teams regularly perform blood pressure screenings and blood glucose screenings. In health centers where medical and dental teams use the same EHR, both teams can review prescriptions, screening and lab results, and note any special concerns that would affect patient care during a visit. At PHC, dental assistants perform A1Cs while a patient is waiting for the dentist. This helps the medical teams with chronic disease management and population health outcomes.

These are just a few examples of how health centers practice integrated dental care.

Tips to Strengthen Your Dental-Medical Team Collaboration

  • Don’t reinvent the wheel. Learn and adopt from other health centers.
  • Connect to experts. Consider dental teams from other clinics or tap into resources from the CareQuest Institute for Oral Health, National Network for Oral Health Access, and Oral Health Progress and Equity Network.
  • Champions are the “secret sauce.” Get support from the Chief Medical and/or Dental Officers. They can motivate staff and drive the process.
  • Establish priorities. If not able to offer comprehensive services, you can offer prevention. Start small, evaluate, refine, re-evaluate, and then expand.
  • Create a structure. For example, dental teams can routinely incorporate chronic disease screenings that support medical care teams.
  • Consider oral health care with trained medical providers. If your health center does not have a co-located dental clinic, train medical providers to administer fluoride varnish.