Geographic and health system correlates of interprofessional oral health practice

Geographic and health system correlates of interprofessional oral health practice

In the current issue of Family Medicine and Community Health (Volume 6, Number 2, 2018, pp. 77-84(8); DOI: https://doi.org/10.15212/FMCH.2018.0104, researcher Sean G. Boynes, The DentaQuest Institute, Westborough, MA, USA, and coresearchers Abigail Lauer and Amy Martin from Medical University of South Carolina, Charleston, SC, USA examine geographic, system, and organizational constructs that predict medical care teams' willingness to administer fluoride varnish and conduct oral health risk assessments. Caries activity is one of the most common diseases of childhood, and prevention/intervention by primary care teams can positively impact patient results. This analysis examined unknown correlates of oral health prevention and intervention at geographic, organizational, and system levels relating to the impact of referral mechanisms and systems as well as health information technology on fluoride varnish administration and risk-based oral evaluations.

The case for interprofessional oral health care to address the epidemic of early childhood caries has been well litigated. The evidence supports the clinical and cost-effectiveness of primary care-based oral health risk assessments and fluoride varnish applications. Many studies have demonstrated the successful adoption of interprofessional oral health practices at the clinic, system, and state levels. While the personal attributes and opinions of individual physicians and pediatricians have been explored, few studies have examined the organization and system characteristics that enable or facilitate use of fluoride varnish or oral health risk assessments.

Physicians have communicated they are more likely to provide fluoride varnish if they have proper training, have access to patient data to determine eligibility, have access to dentists to whom they can refer patients, and are engaged by leadership in the decision to provide the services. The business case for oral health interprofessional practice was presented in a single state study that demonstrated its cost-efficiency albeit with diminishing returns depending on reimbursement levels.

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