Integrating Oral Health Into Primary Care

Timothy Martinez DMD

April 6, 2023

Integrating oral health into primary care holds the key to delivering affordable, accessible, and quality health care. Integrated primary health care includes several delivery functions such as access and continuity, planned oral care, risk-stratified care management, patient engagement, and coordination across the medical neighborhood.

Communication, coordination, and referral between dental and medical professionals are key to advancing this goal of seamless care delivery. In this paper, we discuss the strategies that can support these efforts.

Interprofessional Collaboration

Interprofessional collaboration is a key component of Integrating Oral Health into Primary Care. It is a way for healthcare professionals to work together to address complex patient issues and improve the quality and safety of patient care.

When healthcare team members operate in silos, their voices are often not heard, and their job satisfaction can suffer. However, the benefits can be huge if they can learn to collaborate with other health professionals.

Moreover, it can lead to better staff relationships and retention, which is essential to the success of an integrated primary care model.

To evaluate oral health and interprofessional collaboration knowledge and practice, we conducted an anonymous cross-sectional survey among primary care medical providers (physicians, nurses, and physician assistants) at Jacobi Medical Center in the Bronx, NY. The survey instrument was designed in a web-based platform and electronically distributed to 181 respondents. The questionnaire included sections on demographics, current practices, oral health knowledge, and opinions regarding interprofessional collaboration.

Patient-Clinician Relationships

The patient and clinician relationship is an important element in primary care. It is based on mutual knowledge, trust, loyalty, and regard.

Patients often reveal to their doctor secret fears, worries, and concerns that they have not shared with other people. This is important because a doctor can be the only source of support for a patient during a difficult time.

However, there are many nuances in the doctor-patient relationship, and various factors can interfere with it. This article highlights four categories of factors (patient factors, provider factors, patient-provider mismatch, and systemic factors) that can negatively impact it and suggests possible solutions to address these factors.

The doctor-patient relationship is integral to a healthcare encounter, which evolves through multiple stages during a patient’s treatment. These stages include rapport building, eliciting concerns, and establishing a plan. It continues to evolve as continuity of care is established, which may involve the patient alone or with family members and caregivers.

Patient Education

Patient education has enhanced patient compliance with treatment plans and improved patient outcomes. It also helps patients manage their health and understand the importance of preventive care, such as scheduling regular dental appointments or screenings.

In addition, it can reduce unnecessary trips to the emergency department or hospital by reminding patients of appropriate self-care and when to seek care from a specialty physician. Promoting self-care can also support faster recovery and lower costs of hospital readmissions.

Several programs have been developed to integrate oral health into primary care, including safety net clinics or health commons sites that pool resources from medical, dental, behavioral, and social services to treat patients [3]. 

Patient Self-Management

The patient-centered care model requires patients to have the information and skills they need to manage their health. This includes encouraging patients to take responsibility for their care between regular visits and providing a supportive environment where patients can make healthy choices.

In addition, patients and providers should be provided with tools to support self-management and problem-solving. These include action plans, goal-setting worksheets, and problem-solving techniques.

A literature review found that training health professionals in patient self-management interventions were associated with improved patient outcomes. These included improved self-efficacy, autonomy, motivation to change, functional capacity, pain-free days, and quality of life.

To successfully integrate oral health into primary care in sub-Saharan Africa, training must be context-reliant, with the right approach to training and evaluation methods and a flexible scope to accommodate other healthcare cadres. It should be based on practice-based research that measures outcomes across the health care continuum.