Public health dentists offer recommendations to better integrate oral health and primary care

In practice, policy and education, oral health care and primary health care have traditionally been considered separate. In an effort to change that, a group of public health dentists has issued recommendations on improving the integration of the two with a goal to influence policymakers, clinicians, educators and health researchers.

In a paper, commissioned by the National Academies of Sciences, Engineering and Medicine’s Roundtable on Health Literacy, experts found that additional work is needed to integrate primary care and oral health to provide more comprehensive and improved access to care.

The authors, from the UCLA School of Dentistry and the University of North Carolina, also found that the amount of time devoted to oral health in health-professional training programs remains low and topics are limited.

“One of the biggest takeaways from our analysis was that the integration of primary care and oral health care is still in its early stages — with little guidance and support from professional associations, governing bodies and policymakers,” said the lead co-author, Dr. Kathryn Atchison, professor of public health at the UCLA School of Dentistry and the Fielding School of Public Health. “We see this report as a blueprint for policymakers to better understand what is needed to best serve the public in the rapidly changing health care delivery system.”

The report outlines 21 recommendations, including:

• Applying a comprehensive framework that includes integration theory, oral health and primary care — with attention to health literacy — into practice, education, research and policymaking
• Prioritizing oral health promotion and disease prevention in integration activities to reduce health disparities
• Exploring the best ways to establish formal collaboration and referral networks among health care systems, medical practices and dental practices in local regions
• Developing and refining quality-of-care metrics that include the degree of integration between primary care and oral health

Two examples of the experts’ recommendations already in practice are the UCLA–First 5 LA Children's Dental Care Program, established in 2012 by Dr. Jim Crall; and UCLA Dentistry’s Infant Oral Care Program, initiated in 2009 by Dr. Francisco Ramos-Gomez. Both initiatives are designed to offer educational programs to care providers with a goal to provide preventative oral health services to children and improve oral health care.

“Integration must be at the forefront of policymakers’ and educators’ minds in order to best prepare health care professionals to treat the general population,” said Dr. Paul Krebsbach, dean of the UCLA School of Dentistry.

Report collaborators include Dr. R. Gary Rozier, professor of health policy and management at the University of North Carolina Gillings School of Global Public Health, and Dr. Jane Weintraub, distinguished professor at the University of North Carolina School of Dentistry.