Details:

Alternative Title:
Prev Chronic Dis
Personal Author:
Bernstein, Judith ; Gebel, Christina ; Vargas, Clemencia ; Geltman, Paul ; Walter, Ashley ; ... More +
Bernstein, Judith ; Gebel, Christina ; Vargas, Clemencia ; Geltman, Paul ; Walter, Ashley ; Garcia, Raul I. ; Tinanoff, Norman Less -
Description:
Introduction

Early childhood caries, the most common chronic childhood disease, affects primary dentition and can impair eating, sleeping, and school performance. The disease is most prevalent among vulnerable populations with limited access to pediatric dental services. These same children generally receive well-child care at federally qualified health centers. The objective of this study was to identify facilitators and barriers to the integration of oral health into pediatric primary care at health centers to improve problem recognition, delivery of preventive measures, and referral to a dentist.

Methods

We collected and analyzed background data and data from structured observations and 39 interviews with administrators and staff at 6 clinics in 2 states, Maryland and Massachusetts.

Results

Participants valued oral health across professional roles but cited limited time, lack of training and expertise, low caregiver literacy, and lack of shared medical and dental electronic records as barriers to cooperation. Facilitators included an upper-level administration with the vision to see the value of integration, designated team leaders, and champions. An administration’s vision, not structural determinants, patient characteristics, or geographic location, predicted the level of integration. Interviewees generated multilevel recommendations to promote delivery of oral health preventive measures and services during a well-child visit.

Conclusion

Poor oral health contributes to health care disparities. Barriers to integrating dental care into pediatric medical practice at health centers must be overcome to improve oral health for children living in poverty, with a disability, at a rural address, or any combination of these. Implementation will require adapting delivery systems to support multidisciplinary collaboration. Strategies suggested here may point the way to enhancing children’s oral health.


Subjects:
[+]
Adolescent Child Child, Preschool Dental Care For Children Dental Caries/prevention & Control Female Healthcare Disparities Health Services Accessibility Humans Male Medicaid Oral Health Poverty Referral And Consultation Young Adult
Source:
Prev Chronic Dis. 13.
Pubmed ID:
27126556
Pubmed Central ID:
PMC4856482
Document Type:
Journal Article
Funding:
U54 DE019275/DE/NIDCR NIH HHS/United States
Place as Subject:
Maryland ; Massachusetts ; United States
Maryland ; Massachusetts ; United States Less -
Collection(s):
Preventing Chronic Disease
Main Document Checksum:
[+]
urn:sha256:ad38a94255f537c1756d8bdc5ab9851eb12b97497f02088f75c412e48cef8235
Download URL:
https://stacks.cdc.gov/view/cdc/39664/cdc_39664_DS1.pdf
File Type:

Supporting Files

• PCD-13-E58.nxml

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