Integration Of Oral Health Into Health-Care Systems

By Christine Nathe, RDH, MS

As practicing dental hygienists, we’re well aware that although dental diseases are preventable, dental health in the United States remains an issue. We hear repeatedly that oral health is a major unmet need in this country, and that disparities based on health status, income level, and ethnicity exist in the oral health status of our citizens. Often the people who need dental care the most are not receiving it.

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Dental hygienists are also aware of the need to educate our patients about the link between oral diseases and systemic health. Actually, we’ve been doing this since the inception of dental hygiene a century ago. Fones early textbooks are a testament to the creation of the dental hygiene science to prevent dental disease, but also as a means to prevent subsequent systemic infections which are associated with oral diseases. Fones’ devoted chapters to this relationship and the role of the dental hygienist in educating patients.

This relationship between oral health and total health underscores the need for oral health care to be integrated into health-care systems. Realizing that oral health is an integral part of total health, dental hygiene science that emphasizes disease prevention and treatment of oral infection fits perfectly in an interdisciplinary model to provide comprehensive health care to all populations.

There is an unprecedented focus on risk assessment and prevention. This is the perfect time for dental hygienists to make the move from “cleaning teeth” and providing health education in a traditional fashion, to providing care as part of a multidisciplinary team.

Historically, dental care has been managed on a case-by-case business-type basis and has not been effectively positioned in comprehensive health care, nor practiced in a multidisciplinary fashion. Dental hygiene must take a look back at its inception. Dental hygiene initially had a strong foundation in managing dental care delivery. In fact, dental hygienists were created to prevent dental disease and to intercept dental infections before they became too severe to treat, refer to appropriate health-care providers as needed, and prevent dental disease to all populations. Essentially, dental hygienists were in the unique position to provide the link to comprehensive oral health care.

Dental hygienists should be working to create positions that integrate oral health into health-care systems. I remember years ago when I was teaching at Fones School of Dental Hygiene, I came across some old dental hygiene association annual session brochures. The programs included panel discussions on the integration of dental hygiene into existing school systems, health-care facilities, and businesses.

We should be doing the same. We should be striving to create positions with the help of medical and dental insurance executives, a multitude of health-care providers, and social advocates. We should strive to provide primary preventive oral health care in a cost-effective manner to people who have limited or no access to oral health-care services.

Dental hygienists can collaborate in a multidisciplinary network of health and social care providers and provide leadership in oral health outcomes. Comprehensive health care is a great way to provide medical and dental care. Dental hygienists have the skills to function within effective multidisciplinary teams to create a consistent oral health component in the existing health-care delivery system. RDH

CHRISTINE NATHE, RDH, MS, is a professor and graduate program director at the University of New Mexico, Division of Dental Hygiene, in Albuquerque, N.M. She is also the author of “Dental Public Health Research” (www.pearsonhighered.com/educator), which is in its third edition with Pearson. She can be reached at [email protected] or (505) 272-8147.