Lessons from the Pandemic: What COVID-19 Is Teaching Us About Medical-Dental Integration
By Sean Boynes, DMD, Vice President of Health Improvement, and Kelli Ohrenberger, Director of Interprofessional Care, DentaQuest Partnership for Oral Health Advancement
The mouth and the body are integrally connected. Over the past decade, both medical and dental practices have become more attuned to the importance of the links between oral health and overall health and have made strides in developing programs and services that integrate medicine and dentistry.
However, the COVID-19 pandemic is placing stress on the health care system, limiting access to preventive dental care and challenging the progress that medical-dental integration has made in recent years. At the same time, COVID-19 has exposed new opportunities for innovative solutions to integrate and coordinate care between medicine and dentistry.
So, what has COVID-19 taught us about medical-dental integration?
1. Medical-Dental Integration Can Improve Access During the Pandemic
Medical-dental integration has been an important strategy for increasing access to care for vulnerable populations for many years. Since the COVID-19 pandemic began, many dental practices across the country have been limited in the scope of care that they can provide patients. They’ve placed a heavy focus on the provision of emergency treatment, therefore minimizing access to highly important preventive dental procedures.
Even as dental practices have reopened, many patients are slow to return to dental offices to receive preventive services, placing them at higher risk of dental disease. More than ever before, there is a need for integration of oral health into other health disciplines. As patients return to their primary care office for medical treatment, an opportunity exists for primary care providers to address oral health by assessing oral health risk and reinforcing at-home care messaging, creating an access point for patients who would otherwise not seek dental care at this time.
2. Dentists Have an Opportunity to Redefine Their Role
Likewise, dental providers can expand their role as critical members of the health care team during the pandemic. The American Dental Association recently added new CDT codes for dentists to test for COVID-19, which further opens up needed access points to testing for patients.
The integration of physical health services within dental offices has been an area of growth in recent years, with dentists providing critical services such as screenings for chronic diseases like diabetes, high blood pressure and cholesterol. These services have shown to provide substantial cost savings to health systems as well as benefits to patients. Dentists could also potentially play a role in vaccine administration, for vaccines such as HPV and eventually a COVID-19 vaccine. Adding these services to the dental care team’s portfolio would afford dentists the opportunity to assist in the timely distribution of a vaccine and ease patient concerns about returning to the dentist for routine oral health care.
3. Telehealth Can Play a Role in Providing Integrated Care
Synchronous telehealth visits, which involve real-time communication via video chat between dental provider and patient, have increased during the pandemic. They provide an opportunity to interact with patients in a way that ensures patient-provider safety and reinforces prevention. Similarly, synchronous visits create an opportunity for integrated, interprofessional care. Health care providers can arrange for a more holistic care experience for their patients that includes interaction with both medical and dental care teams via telehealth to comprehensively meet the needs of a patient.
Primary care teams, especially those within integrated care systems, are increasingly looking to utilize telehealth for consultations with specialists (cardiology, diabetes specialists, etc.) that they may not have access to on-site. This highlights a growing opportunity for dental providers to offer virtual consults with medical providers, which further cements the dental provider’s essential role as a part of the interdisciplinary health care team.
The DentaQuest Partnership is exploring and testing these opportunities to use telehealth to improve integrated care through its COVID-19 Oral Health Recovery and Transformation (COHRT) initiative.
4. There’s a Greater Need for Interoperability
With those exciting steps forward in telehealth that provide opportunities for improved medical-dental integration, it is important to note that the current health information technology infrastructure creates significant challenges. Electronic medical and dental records often do not interact in a way that facilitates efficient transfer of information, forcing practices to rely on manual processes or time-intensive workarounds to communicate inter-professionally. In this era that demands a heavier reliance on electronic communication, the role of interoperability becomes even more vital.
The use of health information exchanges and development of common data and language between medicine and dentistry, among other HIT solutions to integrate medical and dental records, will be crucial for long-term adoption of interprofessional strategies.
The COVID-19 pandemic has changed the way that patients seek and access dental care. At a time when patients are looking for safe, convenient, holistic care more than ever before, medical-dental integration can play a key role in satisfying that need. It can also help build toward a prevention-focused approach to health and oral health care.
There are challenges, to be sure, including the lack of interoperability between medical and dental practices. But by improving access, expanding dentistry’s role and utilizing telehealth in innovative ways, medical-dental integration has the opportunity to emerge from the pandemic with an important role to play in the future of health care delivery.
Learn more about medical-dental integration.