Medical-Dental Integration in Public Health Settings: An Environmental Scan

McKernan, S.C.; Kuthy, R.A.; Reynolds, J.C.; Tuggle, L.; García, D.T.
06/2018

Abstract

Noncommunicable chronic diseases (NCDs) account for almost 90% of total deaths in the United States. The four most common NCDs—cardiovascular diseases, diabetes, cancers, and chronic respiratory diseases—share common risk factors, including cigarette use, alcohol use, and dietary behaviors associated with obesity and elevated blood sugar. The most common oral diseases—dental caries, periodontal disease, and oral cancer—also share these same risk factors. 

A coordinated approach to primary prevention, the “common risk factor approach,” argues that coordinated primary prevention of oral and systemic diseases will reduce programmatic costs, and increase efficiency and effectiveness. However, use and evaluation of this coordinated approach in primary prevention activities in the United States has not been well documented. 

This report describes the results of an environmental scan to identify, categorize, and describe examples of medical-dental integration in US public health settings. Findings are intended to inform public health officials and other stakeholders about existing programs and policies that encourage coordination and integration.

Acknowledgements
Executive Summary
Chapter 1 - Introduction
Chapter 2 - Methods
Chapter 3 - Integration in Clinical Settings
The majority of integrated programs that we identified were based in clinics. We have organized findings into sections based on the systemic disease or risk factor primarily targeted by each program. For programs that target more than one risk factor, we have included information about each in the relevant sections of this report.

Chapter 4 - Multimedia Health Campaigns
Chapter 5 - Co-location of Medical and Dental Services
Chapter 6 - Health Workforce Innovations
Chapter 7 - Integrated Insurance Benefits
Chapter 8 - Health Care Reform
Chapter 9 - Conclusions
Appendix A - Data Extraction Form
Appendix B - Survey of State Oral Health Programs
Appendix C - Survey of State Chronic Disease Programs
Appendix D - Survey of Community Dental Programs
Appendix E - Key Informant Interview Guide
References