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Integrating Oral Health into the Primary Care Setting

School-based oral health programs are especially effective in reaching children and youth in school, where they spend most of their day. Targeting schools with higher rates of minorities and low-income families also increase access to prevention, education, and care, and decreases disparities.

Yet increasing options for oral health care in schools will not alone solve the burden of oral disease. The two disciplines of primary care and dentistry must work together to systemically change their approach, and bring the mouth back into the whole body through the integration of oral health care into primary care. Integrating oral health into primary care requires multilevel changes in systems, attitudes, and policies. Although integration of oral health into primary care is not the focus of the Playbook, it is key to the broader strategy to decrease oral health disease, especially in children and youth.  For schools with school-based health centers, adding dental services to existing primary care services expands the comprehensive care capabilities of this model.

For more information on this important strategy, the following resources will frame the key elements:

https://www.dentaquest.com/oral-health-resources/americas-oral-health-emerging-crisis/   A DentaQuest panel discussion addresses America’s Emerging Oral Health Crisis and the critical need to integrate oral health into overall health.

http://www.niioh.org/sites/default/files/Oral_Health_white_paper_executive_summary_final.pdf   The Oral Health Delivery Framework is a conceptual model for integrating preventive oral health care in routine medical care. It directly aligns with the oral health core clinical competencies identified by the Health Resources and Services Administration in 2014. The Oral Health Delivery Framework delineates the activities for which a primary care team can take accountability. These activities are within the scope of practice for primary care.

Learning about the oral health — overall health connection needs to start early as health behaviors develop, along with beliefs and attitudes, during the critical school years. The earlier children establish healthy oral health habits and ideas, the better the long-term outcomes.

https://pediatrics.aappublications.org/content/pediatrics/134/6/1224.full.pdf  The link provides you the complete policy statement from AAP to maintain and improve the oral health of young children, focused on helping the pediatric provider understand the connection between oral health and overall health and their role in prevention and intervention of oral health disease.

https://www.smilesforlifeoralhealth.org/  Smiles for Life is a comprehensive, online learning tool for health professionals made up of learning modules and resources to help integrate oral health and primary care across the lifespan. Look for specific modules on Child Oral Health and Caries Risk Assessment, Fluoride Varnish, and Counseling. Content includes practice tools, patient education, publications, guidelines, education and IPE, videos, interactive games, oral health information links, and Android/IOS apps.

https://ilikemyteeth.org/ohpp/  Oral Health Prevention Primer from Campaign for Dental Health, Academy of Pediatrics.  The primer is a comprehensive tool designed to help pediatricians and other health professionals address oral health in practice, understand the roles of oral health allies, and learn how to collaborate and advocate to achieve optimal oral health for their community to prevent dental disease before it starts.