Oral Health in Primary Care

Phillips, Kathryn E.; Hummel, Jeffrey W.

doi:10.1177/2380084415625634

Cited by 20 publications

(8 citation statements)

References 3 publications

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“…In order to effectively improve oral health, NHI in Taiwan provides free dental check‐ups and dental scaling twice‐yearly to promote the prevention of periodontitis and gingivitis. There are many advantages to incorporating preventive oral health into regular primary care (Phillips & Hummel, ). Patients with oral disease who receive regular oral preventive services (e.g., tooth scaling) may have more healthy oral conditions and are less likely to have stroke.…”

Section: Discussionmentioning

confidence: 99%

Dental treatment procedures for periodontal disease and the subsequent risk of ischaemic stroke: A retrospective population‐based cohort study

Lin

Chen

Yeh

et al. 2019

J Clinic Periodontology

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Aim To investigate the association between specific dental therapy for periodontal disease and the risk of ischaemic stroke. Materials and Methods We conducted a population‐based cohort study that used data from the Taiwan National Health Insurance Research Database 2005 for the period of 2000–2013. Our observations focused on patients with the diagnoses of gingivitis or periodontitis with and without specific treatment and subsequent incidence of ischaemic stroke. Dental care services include dental scaling, intensive treatment (subgingival curettage and root planing) and tooth extraction. Multivariate Cox regression analysis was used to estimate the hazard ratios and corresponding 95% confidence intervals (95% CI). Results Compared with those in the gingivitis cohort, patients with periodontitis have a higher risk of ischaemic stroke and a lower survival rate of stroke over the 10‐year follow‐up period. After integrative dental care, both dental scaling and intensive treatment, the risk was reduced, especially in patients with periodontitis, while patients with periodontal disease may have an increased risk of stroke after tooth extraction therapy. Conclusions Our study showed that periodontitis is a risk factor for ischaemic stroke. Both dental scaling and intensive treatment for periodontal disease are associated with a lower risk of further ischaemic stroke events.

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Section: Discussionmentioning

confidence: 99%

Dental treatment procedures for periodontal disease and the subsequent risk of ischaemic stroke: A retrospective population‐based cohort study

Lin

Chen

Yeh

et al. 2019

J Clinic Periodontology

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“…The broad range of this international literature, which calls for more interprofessional collaboration, shows that the separation of professions is persistent and is not specifically a German problem [3, 46, 48, 49]. Thus, policymakers should implement the recommended changes to the system [50]. …”

Section: Discussionmentioning

confidence: 99%

GPs’ and dentists’ experiences and expectations of interprofessional collaboration: findings from a qualitative study in Germany

Sippli

Rieger

Huettig

2017

BMC Health Serv Res

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BackgroundAgainst the background of well-described associations between oral and general health, collaboration between dentists and general practitioners (GP) is crucial to provide therapeutic and preventive patient care. However, in the German health system, GPs and dentists are organizationally separated, implying that interprofessional collaboration can only occur informally and on a voluntary basis. Given the scarce evidence of interprofessional collaboration between dentists and GPs, an explorative study was conducted. This paper outlines the findings of this study with regard to GPs’ and dentists’ experiences and expectations of interprofessional collaboration.MethodsSemi-structured interviews were conducted with GPs (n = 15) and dentists (n = 13) from three structurally different regions in Baden-Wurttemberg, Germany. The interview guide included questions on occasions, expectations and experiences of interprofessional collaboration. The interviews were transcribed verbatim and analysed using qualitative content analysis according to Mayring.ResultsBoth GPs and dentists reported perceived knowledge deficits of the other profession with regard to medication, particularly anticoagulants and bisphosphonates, as well as systemic and general respectively dental diseases. Expectations regarding the scope of collaboration diverge: whereas dentists were interested in extending collaboration, most GPs saw no need for collaboration.ConclusionsThe perceived medical knowledge deficits of the other profession as well as divergent expectations concerning the scope of collaboration hinder profound and regular interprofessional collaboration between GPs and dentists. These perceived knowledge deficits may be rooted in the separate education of dentists and GPs in Germany. Fostering interprofessional education is a promising way to improve cooperation between GPs and dentists in the long term.

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“…Implementation of dental referral guidelines in primary care faces a number of barriers. Some of the more commonly reported barriers to integration of oral health into primary care are lack of clinical knowledge and skills, lack of time, inadequate reimbursement, and staff buy-in [23,24,25]. More specifi c to dental referral, pediatric primary health care providers in North Carolina are generally aware of American Academy of Pediatrics dental referral guidelines, know which patients should be referred, and support oral health screening and risk assessment, yet they consistently under-refer, particularly if the child is at low to moderate risk for dental caries [26].…”

Section: Clinical Referral Guidelines and Performance Measuresmentioning

confidence: 99%

“…Performance measures for monitoring the appropriateness and eff ectiveness of medical-dental referrals are even less well developed. The Oral Health Delivery Framework and Implementation guide supported by the National Interprofessional Initiative on Oral Health (NIIOH) and its partners prominently identifi ed the key features of a dental referral in primary care and provided recommendations [24,30]. The framework, endorsed by 18 professional academies and organizations, defi ned a dental referral as a "structured" process in which "an order for a referral placed in the electronic health record (EHR) to a specifi c dentist .…”

Section: Box 1 | Examples Of Communication Risk Management Issues Assmentioning

confidence: 99%

Integration of Oral Health and Primary Care: Communication, Coordination and Referral

Atchison¹,

Rozier²,

Weintraub³

2018

NAM Perspectives

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This discussion paper focuses on some particularly challenging aspects of bridging primary care and oral health care for low health literacy populations. Because of the lack of physical proximity between most dental and medical practices, even in some co-located places, many patients and providers have diffi culty navigating this divide. This discussion paper expands on three of the recommendations from a paper commissioned for the Roundtable on Health Literacy of the National Academies of Sciences, Engineering, and Medicine. The discussion paper focuses on the weak links in the integration process of communication, coordination, and referral across professions. Examples and health literacy solutions are presented, such as having personnel assist patients with navigation, electronic tools for appointments and guidance, shared electronic health records, referral guidelines, and educational curricula for health care providers to increase their interprofessional knowledge and practice. Health literacy strategies and systems are needed to establish formal communication, collaboration, and referral networks across professions at all levels. Practice-based research can advance the most eff ective models. Our vision is a patient-centered health home that includes bidirectional access and communication across oral health and primary care.

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Oral Health in Primary Care

Cited by 20 publications

References 3 publications

Dental treatment procedures for periodontal disease and the subsequent risk of ischaemic stroke: A retrospective population‐based cohort study

Dental treatment procedures for periodontal disease and the subsequent risk of ischaemic stroke: A retrospective population‐based cohort study

GPs’ and dentists’ experiences and expectations of interprofessional collaboration: findings from a qualitative study in Germany

Integration of Oral Health and Primary Care: Communication, Coordination and Referral

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