An Assessment of Oral Health Training Among Geriatric Fellowship Programs: A National Survey

Abstract

Oral health (OH) has profound effects on the overall health of elderly people. While oral disease is prevalent in the geriatric population and access to care is a major issue, it is unclear the extent of OH training among US geriatric fellowship programs. A 19‐item electronic survey was sent to all 148 accredited geriatric fellowship training programs via the Association of Directors of Geriatric Medicine. Directors were asked about hours of trainings, barriers, and evaluation of trainees among other topics. Univariate and bivariate analyses were performed. Seventy‐five directors completed the survey (51% response rate). Sixty‐three percent (46/73) report their fellows receive 1 to 2 hours of OH instruction (ie, lectures, workshops) during their training. Almost a quarter (23%; 17/73) reported 0 hours of OH content. Only 17% (13/75) have clinical experiences in a dental setting. Barriers to more OH education include competing priorities or lack of time (57%; 43/75), lack of faculty expertise (55%; 41/75), and no clear geriatric national educational competencies (44%; 33/75). Programs with an OH champion or dental school/residency affiliation had more hours of OH instruction. Geriatric fellowships appear to need more OH training, which could be achieved by creating OH champions and connecting fellowships with dental schools/residencies. Barriers could be overcome by exposing fellowships to existing resources and creating national competencies. J Am Geriatr Soc 67:1079–1084, 2019.

A comprehensive assessment for community-based, person-centered care for older adults

“…A recent literature review projected a primary care workforce shortage in primary care in community-based settings that is prepared to care for older adults, and that new models that can support collaboration across all caregivers on care teams are needed [46]. Dentists are frequently omitted from these types of care teams and lack sufficient training in geriatrics [47], but there is recognition among dental providers that training support is needed, so that they can care for older adult patients that may transition from being independent to becoming more dependent [48].…”

Effectiveness of an oral health promotion program for the elderly in Khiri Mat district, Sukhothai province: A randomized control trial

“…Future studies should focus on the long-term effects of this oral health promotion program on the elderly's oral health status and behaviors, as most of the studies have a duration of study <2 years. [222324] Furthermore, evidence from this study suggests that health workers should be trained, both informal and formal,[2526] to apply appropriate oral health promotion including continuing re-enforcement. To confirm the success of the program as recommended by the WHO,[27] extensive community engagement to enhance ownership of the program is needed, whereas the Ministry of Health should have policy and funding to support the promotion program among local health service organizations.…”

Oral health care in the 21st century: It is time for the integration of dental and medical education

“…The Center for Integration of Primary Care and Oral Health (CIPCOH), a national center based at Harvard University and funded by the Health Resources and Services Administration, surveyed 14 primary care specialties ranging from nursing to pediatrics to family medicine to pharmacy about their oral health curricula and learning objectives. [8][9][10][11][12][13][14] Although a majority of survey respondents agreed that oral health knowledge is important for their learners, most reported that their curricula includes only 1-3 hours of oral health instruction. [8][9][10][11][12][13][14] Given the close association of poor oral health and its attendant inflammation with cardiovascular disease, diabetes, and other noncommunicable diseases, this is not enough.…”

“…[8][9][10][11][12][13][14] Although a majority of survey respondents agreed that oral health knowledge is important for their learners, most reported that their curricula includes only 1-3 hours of oral health instruction. [8][9][10][11][12][13][14] Given the close association of poor oral health and its attendant inflammation with cardiovascular disease, diabetes, and other noncommunicable diseases, this is not enough. 15,16 There are also the increased personal and systemic costs of failure to deliver appropriate care to patients requiring heart valve replacement or chemotherapy when dental decay, abscessed teeth, and poor dentition puts them at risk for infections and complications, cancelling or delaying necessary medical care.…”