Integration of Oral Health Into the Well-Child Visit at Federally Qualified Health Centers: Study of 6 Clinics, August 2014–March 2015

Details

• Journal Article:
  Preventing Chronic Disease (PCD)
• Personal Author:
  Bernstein, Judith ; Gebel, Christina ; Vargas, Clemencia ; Geltman, Paul ; Walter, Ashley ; Garcia, Raul I. ; Tinanoff, Norman
• 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

  More +
• Source:
  Prev Chronic Dis. 13.
• DOI:
  http://dx.doi.org/10.5888/pcd13.160066
• ISSN:
  1545-1151
• 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
• Volume:
  13
• Collection(s):
  Preventing Chronic Disease
• Main Document Checksum:
  urn:sha-512:d6f80c623e5f7e5550183432f4ff7eac55acaaee2be5046b1b12f1dbb10d3cff88d3a918652b5ae8a8bb9d81f41d7e07d63cbf2218b87279f5a0c192402444cb
• Download URL:
  https://stacks.cdc.gov/view/cdc/39664/cdc_39664_DS1.pdf
• File Type:
  [PDF - 326.64 KB ]