Presenter:
Shelly D. Taylor, DMD – Joseph L. Henry Oral Health Fellow in Minority Health Policy, Harvard Medical School
Project Title:
“Integrating Diabetes & Oral Health within Federally Qualified Health Centers”
Host Organization:
National Network for Oral Health Access (NNOHA)
Objectives:
- To evaluate the attitudes, behaviors, and expectations of members of the learning collaborative towards integrating diabetes and oral health
- To offer recommendations that enhance the functions and outcomes of the learning collaborative
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Background:
Successful and sustained integration of primary care and oral health is key for increasing positive health outcomes and access to care for under resourced populations. Expanding working partnerships between dentists and primary care physicians expands the potential for these individuals to seek treatment for both their medical and dental needs. In America, the trends of diabetes diagnosis among males and females is increasing. Additionally, people of color are disproportionately diagnosed with diabetes. Research demonstrates that providing dental care can support patients in controlling blood sugar levels and improve outcomes for people living with diabetes.
There is a bidirectional relationship between periodontitis and diabetes. Periodontitis is a disease that causes infection and inflammation of the gingiva and bone that surround and support the teeth. Diabetes is believed to promote periodontitis through an exaggerated inflammatory response to the periodontal microflora, while the effect of periodontitis is reported to influence blood sugar levels through production of inflammatory mediators which can gain access to tissues and organs at distant sites. Due to this interactive relationship, increasing working partnerships between medical and dental providers is essential to promoting optimal health.
The purpose of this project is to assist the NNOHA Integrating Oral Health and Diabetes Learning Collaborative goal of improving health outcomes for people with diabetes by increasing the number of dual users of medical and dental services and offer recommendations that enhance the functions and outcomes of the learning collaborative.
Methods:
- Sampled 10 health centers for participation in the learning collaborative
- Selection Criteria:
- Co-located on-site medical and dental services
- Expanded state adult Medicaid coverage
- Utilize electronic medical records (EMR)
- Ability to report the race and ethnicity of dental patients
- Constructed a survey instrument within Qualtrics to evaluate the participant’s thoughts on the ease of providing integrative care, expectations of the integrative care model and knowledge of quality improvement exercises\\
- Participants: Medical Champion, Dental Champion, IT Dept, Senior Leader, Team Lead
- Collaborated with participants and experts in the fields of quality improvement, periodontics, diabetes management, and motivational interviewing to develop clinical practice workflows
Results:
The creation of preliminary clinical practice workflows that expand and enhance working partnerships between the medical and dental departments within Federally Qualified Health Centers.
Future Directions:
The learning collaborative is still in progress. The final learning collaborative meeting for this cohort will be on June 4, 2021.
- Evaluate the sustainability of the clinical practice workflows developed
- Advocate for expanded adult Medicaid dental coverage
- Increase interdisciplinary education at the pre- and post-doctoral level
Preceptors:
Colleen Lampron MPH, Irene Hilton DDS, MPH