A strategy to expand on-site direct dental services is through integration of oral health and primary care practice (IOHPCP). The aim of IOHPCP is to improve access for early detection and preventive interventions by expanding oral health clinical competency of primary care clinicians.

Background

In 2011, the Institute of Medicine published the reports, Improving Access to Oral Health Care for Vulnerable and Underserved Populations and Advancing Oral Health in America. These reports identified the appropriate training for non-dental professional to perform oral disease screenings and provide preventive services as a method of improving oral health care of the underserved. As a result, HRSA released the 2014 white paper, Integration of Oral Health and Primary Care Practice. This paper outlines the five oral health core clinical competencies for primary care providers.

Implementation of IOHPCP

Health centers expanding on-site direct dental services may consider IOHPCP as an option by engaging primary care providers in oral health activities such as completing oral health risk assessments, completing oral evaluations, and administering preventive interventions (i.e. fluoride varnish).

The following resources may be helpful in implementing IOHPCP:

• NNOHA received supplemental HRSA funding to pilot the implementation of the interprofessional core clinical competencies and to develop the User’s Guide for Implementation of Interprofessional Oral Health Core Clinical Competencies.

• NNOHA’s webinar highlighting results from one of the pilot health centers.

• NNOHA’s webinar featuring two health center experiences with using the five oral health core clinical competencies.

• NNOHA and the National Health Care for the Homeless Council’s webinar, Oral Health and Diabetes in Patients Experiencing Homelessness features a health center’s IOHPCP experience for prenatal care and diabetic management.

• A promising practice, Adding Mobile Dental Services to a Pediatrics Clinic, describes a health center’s experience in adding portable dental equipment to a pediatrics site by utilizing an existing medical exam room.

Health centers may also consider embedding dental providers (dental hygienists, dentists, etc.) in the medical program to further integrate oral health and primary care. Health centers should also carefully review their state dental practice act to ensure that dental hygienists are able to practice in the medical setting.

Training Resources

When developing an integration program, a training system should be developed for primary care providers on oral health topics. The HRSA OHI funding can be used for training activities that enhance the integration of oral and primary care practice by improving the oral health core clinical competencies of primary care providers and interdisciplinary training. A few training resources include:

• Smiles for Life is considered the most comprehensive oral health training curriculum for medical staff and providers. Smiles for Life has online modules that are self-paced and provides continuing education credits.

• The American Academy of Pediatrics has a list of resources and training tools for medical providers to engage in oral health.

• The National Maternal and Child Oral Health Resource Center website also has many resources that are useful for primary care providers in oral health topics.