The benefits of integrating dental care with medical visits

By Kathryn Hart

The traditional process of accessing medical and dental care is fairly straightforward. Does your child need a well-child checkup? Find a pediatrician who accepts your insurance and schedule an appointment. Need a dental check-up, cleaning or a cavity filled? Schedule a separate appointment with a dentist.

The mouth is the gateway to the health of the rest of the body, but many of our state’s youngest and most vulnerable residents struggle to access dental care. As a result, Colorado is facing a silent epidemic. The Centers for Disease Control and Prevention (CDC) reports that cavities, which are largely preventable, are the most common chronic illness among U.S. children. 

The statistics are grim:

■ One in seven Colorado kindergarteners has untreated cavities. 
■ Children without dental insurance or those insured by Medicaid have more than twice the rate of cavities as commercially/privately insured children.
■ A 2012 CDC report estimated that Hispanic children ages 2-8 have double the rate of untreated cavities (26 percent) as non-Hispanic white children (14 percent).
■ Eight of Colorado’s 64 counties are classified as dental deserts, meaning they do not have a dentist providing oral health services.

Long-term implications of poor oral health include gum disease and tooth loss as well as less control of heart disease and diabetes.

Knowing these disparities exist and that oral health is an indicator of overall health, what options do those living on the Western Slope, and specifically in Mesa County, have to receive the oral health care they need to succeed? One option is the Marillac Clinic and a unique project we are implementing to provide preventive dental services during regular medical visits.

We are able to offer these services through a grant Marillac received from Delta Dental of Colorado Foundation (DDCOF).

Through DDCOF’s Colorado Medical Dental Integration (CO MDI) Project, we have a registered dental hygienist, Patrick Andrews, who is an integrated member of the medical care team. When children come in for a medical visit, they also receive an oral health screening. Andrews provides additional services including cleanings, fluoride varnish, sealants and/or x-rays. Children who do not have a dentist are referred to one. We are also able to offer screenings and oral health education to expectant moms during prenatal visits.

CO MDI is the first project of its kind to integrate preventive dental services into medical practices. The intent is to expand access to oral health care. The project is especially beneficial for families who have limited access to dental care due to where they live, insurance issues (no insurance or certain types of insurance) or transportation barriers.

Oral health integration into primary care medical settings has many benefits. It’s more convenient for families when medical and dental concerns can be addressed at the same time and at the same place. Preventive dental care also reduces the risk of more serious oral health conditions that are expensive to treat. And our providers are able to work as a team to gain a better understanding of the full scope of needs Marillac patients have.

CO MDI is featured as a promising model of delivering dental and medical care in the June 2016 issue of The Journal of Evidence-Based Dental Practice. 

We’re seeing the project’s impact first-hand at Marillac. More than 450 patients have received preventive dental care through CO MDI to date.

Whether it’s catching tooth decay before it turns into a large cavity or providing preventive dental services to an expectant mom to reduce the risk of pre-term labor, CO MDI is helping us create not only a medical home but also a whole health home for Mesa County families.

Dr. Kathryn Hart, pediatric dentist, has served Marillac Clinic since July 2008. Dr. Hart previously taught full time at the University of Colorado School of Dentistry.  She is the director of the NYU AEGD Residency Program at Marillac Dental Clinic and works 40 hours per week doing pediatric dentistry including dentistry performed at St. Mary’s Hospital with general anesthesia. 

Marillac Clinic is a Community Health Center in Mesa County serving approximately 11,000 patients of all ages each year. Marillac provides full scope of health care services: primary medical, behavioral health, dental, optical and medication assistance to those on Medicaid, Medicare, Rocky Mountain Health Plans, and Uninsured. A sliding-fee scale is available to anyone, based on household income and family size. Two main clinics located at 2333 N. 6th Street (adjacent to St. Mary’s Hospital) and 510 29 ½ Road, co-located within the Mesa County Health Department. Medical: 970-298-1782. Dental 970-298-6320. Website:
www.MarillacClinic.org


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