Oral Health and Primary Care Integration

The U.S. Surgeon General’s landmark report “Oral Health in America” HRSA exit disclaimer (PDF - 36 MB) brought national attention to the importance of and disparities present in oral health. Furthermore, the Institute of Medicine (IOM) report "Improving Access to Oral Health Care for Vulnerable and Underserved Populations" (PDF - 3.4 MB) showed that unmet oral health care needs and barriers faced by these populations have a great impact on overall health.

Health centers continue to increase access to oral health care in the communities they serve. According to 2017 Uniform Data System (UDS) data, health center dental programs achieved the following:

  • 6.1 million patients served
  • 15.7 million patient visits
  • More than 17,801 oral health Full-Time Equivalents (FTEs) to include dentists, dental hygienists, and dental therapists:
    • Dentists: 4,882.4 FTEs
    • Dental Hygienists: 2,497.9 FTEs
    • Dental Therapists: 31.4 FTEs
    • Other Dental Personnel: 10,390.1 FTEs
  • Dental sealants on 6-9-year-old children with elevated caries risk increased from 42.5% in 2015 to 50.7% in 2017
  • Additional health center data and reporting information

HRSA Oral Health Initiatives

Resources

The following resources provide tips, promising practices, and recommendations on improving oral health and primary care integration in health centers.

  • National Network for Oral Health Access (NNOHA) HRSA BPHC exit disclaimer
    This HRSA-funded National Cooperative Agreement provides technical assistance resources to address the unique challenges faced by safety-net oral health programs.
  • Oral Health: An Essential Component of Primary Care White Paper HRSA exit disclaimer
    Qualis Health makes the case for incorporating preventive oral health care as a component of routine medical care and structuring referrals to dentistry. The Oral Health Delivery Framework provides a practical method for primary care teams of all types to engage patients and families in the prevention and early detection of oral disease.
  • The Oral Health Integration Implementation Guide HRSA BPHC exit disclaimer
    Qualis Health provides an action plan to implement screening for oral health risk factors and active disease, initiate appropriate preventive interventions, and coordinate dental care for those with active disease.
  • Online Learning Center: Resource Library HRSA BPHC exit disclaimer
    DentaQuest Institute’s Safety Net Solutions provides resources with best practices, tools, strategies, and sample policies and guidelines for safety net health programs.

The performance measure is the percentage of children, aged 6 through 9, at moderate to high risk for caries who received a sealant on a first permanent molar during the reporting period. The following resources provide additional information on the UDS Dental Sealant Measure:

  • Update on the HRSA UDS Dental Sealant Measure Webinar HRSA BPHC exit disclaimer [December 2018]
    Presents results from the 2017 HRSA UDS dental sealants measure; common challenges in developing, modifying, and/or implementing clinical workflows and procedures to report on the measure; and best practices and work-arounds to address data collection and reporting challenges.
  • HRSA UDS Sealant Measure FAQs 2019 HRSA BPHC exit disclaimer
    Provides answers to Frequently Asked Questions about the UDS sealant measure for at-risk children between the ages of 6-9 years. These questions were raised during NNOHA training and technical assistance sessions and webinars.
  • Infection Prevention and Control in Dental Settings Webinar HRSA BPHC exit disclaimer [March 2019]
    Presenter reviews documented transmission of infectious agents in dental settings and the implications of this information, as well as standard precautions (emphasis on sterilization and disinfection of patient care items and devices). She also shares infection prevention and control resources designed to increase adherence with existing CDC recommendations.
  • ECRI Resource Page: Dental Services and Oral Health HRSA BPHC exit disclaimer
    Provides resources to support the integration of oral health into primary care and patient safety within dental programs.
  • CDC Oral Health Page: Infection Prevention and Control in Dental Settings
    The Centers for Disease Control and Prevention provides infection prevention and control resources including the "Summary of Infection Prevention Practices in Dental Settings: Basic Expectations for Safe Care" document that outlines current infection prevention recommendations, checklists that can be used to evaluate compliance, and a mobile application (CDC DentalCheck) to help dental facilities monitor compliance for using recommended infection prevention practices.
Date Last Reviewed:  March 2019