When AHCJ Executive Director Len Bruzzese shared this Grantmakers in Health report with me, I thought it provided great food for thought for health reporters anywhere in the country. The paper – “Returning the Mouth to the Body: Integrating Oral Health and Primary Care” (PDF) – summarizes weaving together these two varieties of basic, essential health care.
Mary Otto, AHCJ’s topic leader on oral health is writing blog posts, editing tip sheets and articles and gathering resources to help our members cover oral health care.
If you have questions or suggestions for future resources on the topic, please send them to mary@healthjournalism.org.
The whole idea might ring a bell for those of you in states such as Washington, Colorado and Michigan where officials have examined the concept. The rest of you might want to stay tuned. A pilot project may be coming to a community near you.
As the Grantmakers in Health brief points out, combining primary and oral health care systems can potentially save money as well as pay off in streamlined information sharing and improved chronic disease management and prevention. Ultimately, integrated services might also get oral health care to at least some of the millions of Americans who are unable to get it.
“According to the American Dental Association, an estimated 30 percent of the population has difficulty accessing dental services via the predominantly private practice delivery system,” the brief points out.
“By expanding entry points into the dental care system, integration of oral health into primary care has the potential to improve access, especially for at-risk and underserved populations that typically have greater access to primary care professionals than to dental care.”
There are, however, barriers and challenges. The country suffers from a severe lack of oral health providers, particularly in poor and rural areas. Oral health care has long been financed separately from primary care. Primary and oral health providers have not communicated across disciplines.
Still, models are being explored.
In an “Oral Health Disparities Pilot” sponsored by the Health Resources and Services Administration, for example, four health centers experimented with the full integration of dental and primary care services. Other models have encouraged varying levels of cooperation between oral health and primary care providers working in separate locations.
Evidence so far supports some approaches, while others are untested but show promise.
In these days of increased demand for systemic effectiveness and efficiency, the idea of trying some of them seems to be catching on.
An August Capitol Hill event entitled “Oral Health: Putting Teeth into the Health Care System” encouraged legislators and policymakers to open their minds to the possibilities.
Moderator David Krol, a pediatrician and program officer with the Robert Wood Johnson Foundation suggested that working through the larger health care system to tackle the challenges of oral health care delivery would make a lot of sense.
“There are racial and ethnic and geographic disparities, challenges with access to care. There are financial challenges and issues of determining and maintaining quality of care. There are workplace controversies, just like with overall health,” he said.
“There is a great opportunity for all makes and models of patients, providers, and policymakers to play a role in improving oral health.”
