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Mills DA, Chu AS, Burns A, Hoover EB, Wild J, Post G, Sears R, Herrick A, Black D, Roberts EP, Roberts BS. Dental Bite-Sized Bits: A Module for Teaching Common Oral Health Conditions to Multidisciplinary Students. MEDICAL SCIENCE EDUCATOR 2023; 33:451-458. [PMID: 36855684 PMCID: PMC9951137 DOI: 10.1007/s40670-023-01760-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Accepted: 02/14/2023] [Indexed: 05/31/2023]
Abstract
The Surgeon General's report in the year 2000 highlighted the association between chronic diseases and oral health infections. Current healthcare education programs, regrettably, report only 1 to 3 h of oral health instruction within curricula. In the years 2020-2022, as part of their respective oral health curricula, 278 first-year physician assistant and 12 pre-clinical second-year pharmacy students were invited to participate in a voluntary survey examining the effectiveness of animated succinct, online video-based oral health units. Among all student responses for the post-use survey, respondents "strongly agreed" or "agreed" that learning objectives of the unit(s) were achieved after reviewing the videos. Of the participants, 97% "strongly agreed" or "agreed" that the videos helped them understand information of which they had no prior knowledge. Similarly, 98% "strongly agreed" or "agreed" the information was appropriate for their level of knowledge. Most students, 93%, "strongly agreed" or "agreed" the exercise was a valuable learning experience. Regarding the importance of future interprofessional collaboration pertaining to a mutual patient's oral health, 95% of participants "strongly agreed" or "agreed" that they would be likely to collaborate. This study demonstrates the importance of oral health as a critical area of focus in healthcare education. The study also confirms the hypothesis that Dental Bite-Sized Bits units deliver engaging, valuable oral health education for preclinical healthcare learners, incorporating interprofessional perspectives from the disciplines of dental, pharmacy, and physician assistant.
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Affiliation(s)
- Denise A. Mills
- Midwestern University College of Dental Medicine, Glendale, AZ US
| | - Anita S. Chu
- Midwestern University College of Dental Medicine, Glendale, AZ US
| | - Andrea Burns
- Department of Pharmacy Practice, Midwestern University College of Pharmacy, Glendale, AZ US
| | - Eve B. Hoover
- Midwestern University College of Health Sciences Physician Assistant Program, Glendale, AZ US
| | - Jennifer Wild
- Midwestern University College of Health Sciences Physician Assistant Program, Glendale, AZ US
| | - Gretchen Post
- Midwestern University College of Health Sciences Physician Assistant Program, Glendale, AZ US
| | - Robyn Sears
- Midwestern University College of Health Sciences Physician Assistant Program, Glendale, AZ US
| | - Amber Herrick
- Midwestern University College of Health Sciences Physician Assistant Program, Glendale, AZ US
| | - Deborah Black
- Midwestern University College of Health Sciences Physician Assistant Program, Glendale, AZ US
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Vernon LT, Teng KA, Kaelber DC, Heintschel GP, Nelson S. Time to integrate oral health screening into medicine? A survey of primary care providers of older adults and an evidence-based rationale for integration. Gerodontology 2022; 39:231-240. [PMID: 34050554 PMCID: PMC9162478 DOI: 10.1111/ger.12561] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2021] [Revised: 04/20/2021] [Accepted: 05/03/2021] [Indexed: 11/28/2022]
Abstract
OBJECTIVE Primary care providers were assessed regarding their training and interest to screen oral conditions in patients ≥55 years old. BACKGROUND Oral health (OH) is an essential component of overall health and can affect systemic health. Medical/dental integration in older adults is underdeveloped. METHODS A brief survey assessed primary care providers' self-reported skills, practices and barriers towards integrating OH screening into adult primary care. Data were collected using Survey Monkey® . Respondents were physicians and advanced practice providers (APPs) working at a large mid-western safety-net hospital. Descriptive statistics, T-tests and Chi-squared tests were reported. RESULTS Eighty-two of 202 participants (41%) completed the survey. Most respondents were female (75%). A majority were physicians (68%); the remainder APPs. All providers (100%) reported OH was important or extremely important to overall health. More physicians (93%) reported not being well-trained to address adult OH issues and perceived less medical-oral health integration in their practice (16%) compared to APPs (P < .05). Time was more of a barrier with APPs (74%), compared to physicians (51%), to integrate OH screening activities (P < .05). Most providers reported other barriers such as inadequate OH training and insurance coverage. Providers endorsed that OH should be assessed frequently (56%) including providing referrals to dentists (77%) and educating patients on oral-systemic issues (63%). More female than male providers endorsed dental referrals and educating patients (P < .05). CONCLUSION Primary care providers embraced greater medical/dental integration for older adults. Instituting OH activities appears to be supported. Future interventions that are feasible in primary care settings are examined.
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Affiliation(s)
- Lance T Vernon
- Veteran Affairs Quality Scholar's Program, Cleveland VA Medical Center, Cleveland, OH, USA
- The MetroHealth System, Cleveland, OH, USA
- Mid-America Health, Columbus, OH, USA
| | - Kathryn A Teng
- Case Western Reserve University School of Medicine, Cleveland, OH, USA
- Adult Health and Wellness Service line in The MetroHealth System Cleveland, Cleveland, OH, USA
| | - David C Kaelber
- Pediatrics and Population and Quantitative Health Sciences, Case Western Reserve University, Cleveland, OH, USA
- Center for Clinical Informatics Research and Education, The MetroHealth System, Case Western Reserve University, Cleveland, OH, USA
| | - Gregory P Heintschel
- Case Western Reserve University School of Dental Medicine, Cleveland, OH, USA
- Department of Dental Medicine, The MetroHealth System, Cleveland, OH, USA
| | - Suchitra Nelson
- Community Dentistry, Case Western Reserve University School of Dental Medicine, Cleveland, OH, USA
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Chandel T, Alulaiyan M, Farraj M, Riedy CA, Barrow JR, Brennan L, Thompson L, Bass MB, Chamut S. Training and educational programs that support geriatric dental care in rural settings: A scoping review. J Dent Educ 2022; 86:792-803. [DOI: 10.1002/jdd.12885] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2021] [Accepted: 01/08/2022] [Indexed: 12/18/2022]
Affiliation(s)
- Tejasvita Chandel
- Department of Oral Health Policy and Epidemiology Harvard School of Dental Medicine Boston Massachusetts USA
| | - Mohammed Alulaiyan
- Department of Oral Health Policy and Epidemiology Harvard School of Dental Medicine Boston Massachusetts USA
| | - Malik Farraj
- Department of Oral Health Policy and Epidemiology Harvard School of Dental Medicine Boston Massachusetts USA
| | - Christine A. Riedy
- Department of Oral Health Policy and Epidemiology Harvard School of Dental Medicine Boston Massachusetts USA
| | - Jane R. Barrow
- Department of Oral Health Policy and Epidemiology Harvard School of Dental Medicine Boston Massachusetts USA
| | - Leonard Brennan
- Department of Oral Health Policy and Epidemiology Harvard School of Dental Medicine Boston Massachusetts USA
| | - Lisa Thompson
- Department of Oral Health Policy and Epidemiology Harvard School of Dental Medicine Boston Massachusetts USA
| | - Michelle B. Bass
- Department of Oral Health Policy and Epidemiology Harvard School of Dental Medicine Boston Massachusetts USA
| | - Steffany Chamut
- Department of Oral Health Policy and Epidemiology Harvard School of Dental Medicine Boston Massachusetts USA
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Savageau JA, Sullivan K, Hargraves JL, Silk H. Oral health curriculum evaluation tool (OHCET) for primary care training programs. J Dent Educ 2021; 85:1710-1717. [PMID: 34312837 DOI: 10.1002/jdd.12750] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2021] [Revised: 07/01/2021] [Accepted: 07/15/2021] [Indexed: 11/07/2022]
Abstract
BACKGROUND Primary care training schools and programs lack a validated tool to assess their oral health curriculum, and researchers lack a tool to compare oral health curricula across programs/schools and different disciplines. OBJECTIVE This study describes the process and results of creating a 15-item oral health curriculum evaluation tool (OHCET). METHODS Three-phased development of the OHCET from 2018 to 2020 including (a) Delphi group/tool development; (b) tool pilot test; and (c) tool validation/cognitive interviews. RESULTS A total of 23 program deans/directors participated in the tool validation/cognitive interviews. Summarizing accuracy scores of all 15 items, the mean accuracy score was 87.1. There was a high correlation (0.917) between the program's total score and the program director's self-assessed competence of their learners at the time of graduation. CONCLUSIONS The OHCET was validated and can be used in primary care training programs and schools across the country for institutional evaluation and for research purposes. Program directors and deans can also have some confidence that their ability to subjectively assess their learner's oral health knowledge and skills at graduation is accurate.
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Affiliation(s)
- Judith A Savageau
- Department of Family Medicine and Community Health, University of Massachusetts Medical School, Worcester, Massachusetts, USA
| | - Kate Sullivan
- Department of Family Medicine and Community Health, University of Massachusetts Medical School, Worcester, Massachusetts, USA
| | - J Lee Hargraves
- Department of Family Medicine and Community Health, University of Massachusetts Medical School, Worcester, Massachusetts, USA.,Center for Survey Research, University of Massachusetts Boston, Boston, Massachusetts, USA
| | - Hugh Silk
- Department of Family Medicine and Community Health, University of Massachusetts Medical School, Worcester, Massachusetts, USA
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Aronoff-Spencer E, Asgari P, Finlayson TL, Gavin J, Forstey M, Norman GJ, Pierce I, Ochoa C, Downey P, Becerra K, Agha Z. A comprehensive assessment for community-based, person-centered care for older adults. BMC Geriatr 2020; 20:193. [PMID: 32503440 PMCID: PMC7275322 DOI: 10.1186/s12877-020-1502-7] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2019] [Accepted: 03/03/2020] [Indexed: 11/25/2022] Open
Abstract
Background Many health and social needs can be assessed and met in community settings, where lower-cost, person-centered, preventative and proactive services predominate. This study reports on the development and implementation of a person-centered care model integrating dental, social, and health services for low-income older adults at a community dental clinic co-located within a senior wellness center. Methods A digital comprehensive geriatric assessment (CGA) and referral system linking medical, dental, and psychosocial needs by real-time CGA-derived metrics for 996 older adults (age ≥ 60) was implemented in 2016–2018 as part of a continuous quality improvement project. This study aims to describe: 1) the development and content of a new CGA; 2) CGA implementation, workflows, triage, referrals; 3) correlations between CGA domains, and adjusted regression models, assessing associations with self-reported recent hospitalizations, emergency department (ED) visits, and clinically-assessed dental urgency. Results The multidisciplinary team from the senior wellness and dental centers planned and implemented a CGA that included standard medical history along with validated instruments for functional status, mental health and social determinants, and added oral health. Care navigators employed the CGA with 996 older adults, and made 1139 referrals (dental = 797, care coordination = 163, social work = 90, mental health = 32). CGA dimensions correlated between oral health, medical status, depressive symptoms, isolation, and reduced quality of life (QoL). Pain, medical symptoms, isolation and depressive symptoms were associated with poorer self-reported health, while general health was most strongly correlated with lower depressive symptoms, and higher functional status and QoL. Isolation was the strongest correlate of lower QoL. Adjusted odds ratios identified social and medical factors associated with recent hospitalization and ED visits. General and oral health were associated with dental urgency. Dental urgency was most strongly associated with general health (AOR = 1.78,95%CI [1.31, 2.43]), dental symptoms (AOR = 2.39,95%CI [1.78, 3.20]), dental pain (AOR = 2.06,95%CI [1.55–2.74]), and difficulty chewing (AOR = 2.80, 95%CI [2.09–3.76]). Dental symptoms were associated with recent ED visits (AOR = 1.61, 95%CI [1.12–2.30]) or hospitalizations (AOR = 1.47, 95%CI [1.04–2.10]). Conclusion Community-based inter-professional care is feasible with CGAs that include medical, dental, and social factors. A person-centered care model requires coordination supported by new workflows. Real-time metrics-based triage process provided efficient means for client review and a robust process to surface needs in complex cases.
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Affiliation(s)
| | - Padideh Asgari
- Gary and Mary West Health Institute, 10350 N. Torrey Pines Road, La Jolla, CA, 92037, USA
| | - Tracy L Finlayson
- San Diego State University, 5500 Campanile Drive, San Diego, CA, 92182-4162, USA.
| | - Joseph Gavin
- Serving Seniors, 1525 Fourth Avenue, San Diego, CA, 92101, USA
| | - Melinda Forstey
- Gary and Mary West Senior Dental Center, 1525 Fourth Avenue - second floor, San Diego, CA, 92101, USA
| | - Gregory J Norman
- Gary and Mary West Health Institute, 10350 N. Torrey Pines Road, La Jolla, CA, 92037, USA
| | - Ian Pierce
- Gary and Mary West Health Institute, 10350 N. Torrey Pines Road, La Jolla, CA, 92037, USA
| | - Carlos Ochoa
- Serving Seniors, 1525 Fourth Avenue, San Diego, CA, 92101, USA
| | - Paul Downey
- Serving Seniors, 1525 Fourth Avenue, San Diego, CA, 92101, USA
| | - Karen Becerra
- Gary and Mary West Senior Dental Center, 1525 Fourth Avenue - second floor, San Diego, CA, 92101, USA
| | - Zia Agha
- Gary and Mary West Health Institute, 10350 N. Torrey Pines Road, La Jolla, CA, 92037, USA
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Donoff RB, Daley GQ. Oral health care in the 21st century: It is time for the integration of dental and medical education. J Dent Educ 2020; 84:999-1002. [PMID: 32436218 DOI: 10.1002/jdd.12191] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2020] [Revised: 05/04/2020] [Accepted: 05/08/2020] [Indexed: 11/10/2022]
Abstract
Major issues exist in the provision of oral health care in America, especially to underserved populations. Access to care, health disparities, an aging population with higher chronic disease burden, and rising healthcare costs continue to impact health outcomes for millions. The marginalization of oral health care, like that of behavioral health care, is a contributor. This perspective presents an idea whose time has come: putting the mouth back in the body. Several national reports stress the imperative to better integrate the practice of medicine and dentistry, including the first-ever Surgeon General's Report on Oral Health in 2000. A plan to lead a multifaceted integration of oral health into overall health is proposed. Leaders will come from new educational and practice models stressing teamwork, interprofessional education, innovative residency training programs and even dual degree options.
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Affiliation(s)
- R Bruce Donoff
- Department of Oral and Maxillofacial Surgery, Harvard School of Dental Medicine, Boston, Massachusetts, USA
| | - George Q Daley
- Faculty of Medicine, Harvard Medical School, Boston, Massachusetts, USA
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Keyong E, Thitasomakul S, Tianviwat S. Effectiveness of an Oral Health Promotion Program for the Elderly in Khiri Mat District, Sukhothai Province: A Randomized Control Trial. J Int Soc Prev Community Dent 2019; 9:225-231. [PMID: 31198693 PMCID: PMC6559037 DOI: 10.4103/jispcd.jispcd_27_19] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2019] [Accepted: 03/19/2019] [Indexed: 11/04/2022] Open
Abstract
Objectives: Oral disease is one of the most common health problems among the elderly, which impacts the quality of life. Applying the Health Belief Model (HBM) in oral health promotion is expected to improve the effectiveness of prevention and promotion that restricts oral health problems. The aim of the present study was to determine the effectiveness of an oral health promotion program on oral health behavior and oral status among the elderly in Khiri Mat, Thailand. Materials and Methods: A prospective randomized control trial was carried out among 162 elderly people for 6 months. They were interviewed to gather oral health behaviors and perception information, followed by an oral health examination. The experimental group received oral health education based on the HBM theory and tooth brushing practice in a small group of 4–5 persons, and then they were remotivated to support behavior change at 1 and 3 months. The control group received traditional oral health activity. All the elderly were followed up at 6 months. Data were analyzed using the t-test, Mann–Whitney test, Chi-square, and logistic regression. Results: The elderly in the experimental group had significantly higher oral health perception, lower plaque scores, lower gingival inflammation, and lower clinical attachment loss than those in the control group (P < 0.05). Conclusion: This oral health promotion program improved oral health perception, behavior, and oral health status of the elderly.
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Affiliation(s)
- Eakpong Keyong
- Dental Department, Khiri Mat Hospital, Khiri Mat, Sukhothai, Thailand
| | - Songchai Thitasomakul
- Department of Preventive Dentistry, Children Oral Health Promotion and Caries Prevention Research Unit, Faculty of Dentistry, Prince of Songkla University, Hatyai, Songkhla, Thailand
| | - Sukanya Tianviwat
- Department of Preventive Dentistry, Evidence-Based Dentistry for Oral Health Care and Promotion Research Unit, Faculty of Dentistry, Prince of Songkla University, Hatyai, Songkhla, Thailand
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