The COVID-19 pandemic proved the need for medical-dental integration
With increased awareness of the link between oral care and overall health and the decrease in the availability of both medical and dental care, today is the perfection time to integrate the two disciplines to provide more complete service to a greater number of people. While medical-dental integration was once a dream among healthcare visionaries, it is now a tangible reality.
The pandemic made people aware that their neighbor’s health has direct impact on the health of their family, friends, and themselves. It’s also become more evident that there is an oral-systemic link that can’t be ignored. Among the issues that bridge the medical-dental continuum are:
- Gum disease is associated with an increased risk for heart disease and stroke
- Women with gum disease are more likely to give birth to underweight or pre-term babies
- Caries and tooth decal can lead to headaches and ear aches, sinus or ear infections, swelling, fever, which can, in extreme cases spread to the brain and blood.
- People with diabetes have more difficulties managing insulin levels if they have gum disease.
Good oral health means more than just having a good smile, although the mental, social, and emotional impact of healthy teeth can’t be discounted.
The pain associated with oral health issues challenges children in school and workers alike. Unfortunately, the people who suffer the most are minorities, lower income families, the poor, and those without insurance. Poor oral health is a significant issue for many Americans and has a huge economic impact for all. The CDC has estimated that every year 34 million school hours are lost due to unplanned dental care, $520 million is spent by Medicare annually on dental emergency room visits and $45 billion is lost in US productivity due to untreated dental disease.
A significant factor in these appalling statistics is that dental, as well as medical and mental care is not available to too large a portion of the population. This is due to a lack of practitioners, a shortfall that will only increase in the coming years. The HRSA estimates that 95 million people don’t have access to primary care, 68 million lack dental health access, and 152 million people don’t have access to mental health care¹. Based on those statistics they estimate that 16,461 new health practitioners are needed today. The American Academy of Medical Colleges has determined that, based on the rate of retirement and delays in education due to the pandemic, that shortfall is actually be between 54,000 and 139,000 by 2033².
These shortages only underscore the need to make the best use of the resources that are available. The best way to do that is through medical-dental integration. Poor oral health can lead to numerous systemic diseases and complications. Conversely, many diseases and health issues can manifest themselves orally.
What is medical-dental integration, where do you start, and how does it work?
We’ve established that there are too many people who don’t have, or only have very limited access to care. Part of the solution is to optimize any appointment they may have. If they see only a dental or medical professional, it’s important to treat the patient as a whole.
As dental professionals we understand the oral-systemic link and the importance it plays in our patients’ health. What more can we do? To begin with, you can ensure that your team is conducting a thorough medical history and consistently update this. Innovations in technology have made it easier than ever to test patients for diseases and complications. Dental professionals can administer vaccines, test for HbA1c levels, take blood pressure readings, perform oral cancer screenings, advise on smoking cessation options, and help patients with nutritional choices. Many dental professionals haven’t been aware that these are all things that can be performed in the dental setting.
Similarly, medical offices have oral health options that can be performed in their office such as: the use of intraoral cameras, referring patients via teledentistry, provide oral health recommendations, apply fluoride treatments like varnish and SDF (silver diamide fluoride), and perform oral cancer screenings
All of these options, regardless of who performs them, will help close the long-standing gaps in American healthcare. Dental professionals can, and should, be an integral part of the medical-dental-mental integration of care to improve the overall health of each patient.
The American Academies of Medical Colleges explains that: “We need to make better use of the capabilities of all the members of the medical teams.”
The CDC deems medical-dental integration so important that is has awarded funding to the National Association of Chronic Disease Directors (NACDD) to develop a viable national framework that can be used in different types of healthcare settings, especially public health settings that support populations that have unmet oral health needs associated with chronic diseases.³
There is widespread support for integration: 79% of patients, 96% of dentists, 90% of physicians and 92% of employees surveyed by DentaQuest believed that oral health and overall health are connected and that greater collaboration between disciples would improve patient care.
Advances in technology that allow medical professions to treat oral issues and dental professionals to treat health issues can only benefit patients. The advent of medical-dental integration is an exciting advance in healthcare.
