Interprofessional Oral Health Collaboration: A Survey of Knowledge and Practice Behaviors of Hospital-Based Primary Care Medical Providers in New York City

Abstract

Background:The siloed delivery of oral and medical health care in the United States has contributed to a lack of awareness of the consequences of poor oral health and has hampered effective interprofessional education and collaboration. The aim of this study was to assess the knowledge and practice behaviors of primary care medical providers in an urban safety-net hospital regarding collaboration with dentists and integration of oral health into overall health-care delivery. Methods: A 36-item survey was designed in a web-based platform (Survey Monkey ® ) and electronically distributed in September 2020 to 181 primary care medical providers (physicians, nurses, physician assistants) within a municipal hospital in the Bronx, New York. The questionnaire included sections on demographics, current practices, oral health knowledge, and opinions regarding interprofessional collaboration. Descriptive statistics and bivariate analyses using the chi-square and Fisher's exact test were performed with a significance level of 0.05. Results: The response rate was 66% (119 respondents). The vast majority (80%) reported little or no training in oral health and 85% reported no team experience with oral health professionals. Medical providers' confidence in examining the oral cavity was positively associated with previous additional training (p = 0.001) and with team experience (p = 0.005). The two most commonly reported barriers to willingness to collaborate were lack of formal relationships with dental providers (74%) and competing priorities (69%). Conclusion: Overall, there is very limited awareness and integration of oral health into the clinical practice of medical providers at this safety-net hospital. However, those providers with previous training and team experience had greater oral health confidence. Given the critical importance of oral health to overall health, increased efforts should be directed to further educate and train medical providers and address barriers to interprofessional care.

Mixed methods evaluation of an oral health education program for pediatric dental, medical and nursing providers

“…All pediatric medical residents, PNPs and FNPs who completed the year‐end online survey reported the program led to an increase in knowledge and skills to screen for ECC, provide anticipatory guidance to prevent dental caries and apply fluoride varnish to a child's teeth. These findings support previous research on the positive effects of programs on primary care providers’ oral health‐related knowledge, skills, and practice patterns 18,21,24–28 . There was a significant increase in mean scores from pre‐program to post‐program among pediatric medical residents, PNPs and FNPs who reported providing oral health anticipatory guidance during a patient visit.…”

“…Previous studies on oral health education programs for health care providers have indicated improvement in PNPs, general NPs, medical students, and internal medicine residents/physicians’ oral health‐related knowledge, attitudes, and skills. These studies have also shown that knowledge and skills learned in oral health education programs translated into changes in professional practice patterns regarding providing preventive oral health care services to their pediatric and adult patients and referring patients to dental providers when needed 16,20–28 . However, there continues to be little published research on oral health education in FNP programs 18,27 .…”

Attitudes toward and knowledge of collaboration of dental and medical practice among medical students in Southern India: a cross-sectional questionnaire survey

“…4 Guidelines must be set to improve confidence in a provider's ability with regard to cases pertaining to both fields and have access to updated knowledge about the collaboration between medical and dental practice. 17,18 The existing body of medical and dental professionals play an important role since they have the ability to lay the guidelines. They can set guidelines for the indications, timing, protocols, and responsibilities of referral and consultation among physicians and dentists.…”

Bridging gaps in oral health education in a medical school in the United States: a pilot study

“…In addition to knowledge-based questions, students were given seven questions, assessed via a Likert scale, regarding their familiarity with oral health topics, attitudes, and comfort regarding oral health care, providing oral health care education and guidance, and performing oral examinations on patients. These questions were adapted from validated questionnaires utilized by similar articles that assessed provider attitudes and comfort [ 7 ].…”

“…However, currently oral health care and general health care in the United States (U.S.) are delivered in fragmented siloes. Care processes and workflows in the U.S. are compartmentalized between medicine and dentistry, which prohibits cooperation between practitioners and worsens healthcare outcomes for patients [ 6 , 7 ]. This fragmented United States healthcare delivery model is reflected in the oral health care education given to physicians.…”