Integration of an Oral Health Team into a Student-Faculty Collaborative Clinic: Successes and Challenges

Abstract

Vulnerable populations are more likely to access medical care than visit a dentist. We introduced a dental team into a student-faculty collaborative clinic that serves a low-income Latino population. Documentation of oral exam findings rose from 11.88% to 50.50% in the year following integration of dental students into the clinic.

Strategies to integrate oral health into primary care: a systematic review

“…The initial search resulted in the identification of 8731 unique articles, of which 213 were assessed for eligibility. On completion of the full text review, 49 studies describing various interventions were included in this review 25–73. List of studies excluded during the full text review, along with the reasons, is presented in online supplemental table S4.…”

“…In terms of integration strategies, most studies explored the provision of oral healthcare by non-dental primary care professionals in the primary care setting (n=24), where integration was achieved primarily via training/education and/or policy changes. Some strategies were implemented in the community setting and focused on interprofessional collaboration between community health workers and oral health professionals,31 33 48 delivery of community-based oral health services by dental, medical and allied health students,30 57 and oral health promotion by trained community nutrition educators 27. Other strategies involved policy changes including the extension of scope for non-dental primary care professionals (general practitioners (GPs), midwives, nurses) to cover oral health with support for the required training,52 expansion of health insurance policy coverage to include oral health and reimburse non-dental primary care professionals for oral health services,38 extend eligibility to subgroups such as people with a disability,68 and organisational changes to facilitate integration 29.…”

“…It is important to differentiate between these two concepts when studying integration strategies as it provides insight into where the strategy (study/programme/policy) is in terms of its implementation process. Among studies aligned with ‘having access’ were integration strategies that improved referral pathways, documentation processes, operating efficiencies and the number of available health staff 25 49 50 57 61 66 72. ‘Having access’ is not always associated with actual utilisation of a service; a fact that was highlighted in the recent Victorian Auditor-General’s Report on access to public dental services in Victoria, Australia, which reported that only one in four eligible people actually use the service 82.…”

“…Simon et al 201857 Dental, medical and nursing students delivering community-based oral healthcare Trudnak Fowler et al 201858 Oral health services integrated within existing schoolbased health centresTynan et al 2018 59 Telehealth: Remote real-time oral examination Ajwani et al 2019 60 Midwives providing oral healthcare Basso et al 2019 61 An oral health team is organised to work together with a family health team Dahlen et al 2019 62 Midwives providing oral healthcare George et al 2019 63 Midwives providing oral healthcare Villena et al 2019 64 Training for nurses to deliver oral healthcare Aagaard et al 2020 65 Training and education for nursing staff Aronoff-Spencer et al 2020 66 Geriatric Assessment tool with an oral health assessment and a real-time referral process Kanan et al 2020 67 Oral healthcare training for primary care professionals Song et al 2020 68 Policy change: Access to Medicaid managed care plans for children with disabilities Wood et al 2020 69 Colocation and collaboration between oral and medical services Arif et al 2021 70 Oral healthcare training for primary care professionals Brännemo et al 2021 71 Child health nurses providing oral health education Ho et al 2021 72…”