The Problem with Combining Primary Care with Dentistry

Support is growing for a proposal that seeks to more closely integrating dental care and primary care. With the recent support of the American Academy of Family Physicians (AAFP), the proposal has moved into a testing phase to see how well it works.
 

Recognizing the Links Between Oral and General Health

This new approach, called the Oral Health Delivery Framework, emphasizes that general healthcare and oral healthcare have a number of important overlaps. For example, dental cavities is the most common chronic childhood disease, and gum disease is a keystone illness among adults linked to heart problems (with evidence even from the ancient world!), kidney problems, and even different types of cancer.

This is an important, and, frankly, long overdue perspective. The division among the medical professions keeps these problems from being addressed in a fully integrated fashion.

The Oral Health Delivery Framework also emphasizes the contagious nature of oral diseases, especially among family members. It notes that a family physician, who has relationships with the entire family, can provide advice, education, and care to adults and children in a comprehensive fashion. For example, children of stressed mothers tend to have more cavities. A family physician could preventively help treat these linked conditions.

In particular, the Oral Health Delivery Framework emphasizes that preventive dental care for children could be provided at children’s normal wellness visits. Basic exams for adults could also be performed by a primary healthcare provider, while referrals to a dentist could be used as necessary to manage treatment. Utilizing existing relationships with a primary care physician could help increase access to oral healthcare, according to the paper.
 

Potential Weaknesses of the Proposal

Of course, for all the supposed benefits of this approach, there are a number of significant drawbacks.

First, it’s worth noting that, although kids visit their doctor more often than their dentist, most adults are more likely to go to the dentist than the doctor. So, although shifting preventive dental care to the doctor might make sense for children, it makes no sense for adults. Instead, we might want to have dentists perform more screening at their office, such as screening for diabetes and other common health conditions.

In addition, combining some features of a dental visit with the primary care might cause more people to think they don’t have to go to the dentist. Since only basic procedures would be performed at the doctor’s office, this might actually decrease many people’s access to dental care.

And then there’s the matter of cost. Dental care costs grow much more slowly than the costs of general healthcare. Combining dental care into general healthcare might significantly increase dental costs.

Finally, it’s important to note that this proposal remains untested. Currently, it’s being tested in 19 family care practices across five states. Once we have seen the Oral Health Delivery Framework in action, we should have a better idea about its strengths and weaknesses.

In the meantime, we note that at our practice we emphasize the links between your oral health and general health, and strive to maintain both. To learn more about this important connection, please call (702) 873-0324 for an appointment with a Las Vegas dentist at the office of Dr. James B. Polley.

By |January 6th, 2016|Oral Health|