Integrating Oral Health Screening Into Primary Care to Promote Dental Referrals in Maryland

J Dr Nurs Pract. 2020 Mar 1;13(1):42-63. doi: 10.1891/2380-9418.JDNP-D-19-00041. Epub 2020 Jan 27.

Abstract

Background: Vulnerable populations are more likely to present to non-dental healthcare locations with dental issues. Oral health screening in those settings, such as primary care, is an effective way to identify individuals with unmet oral health needs and facilitate dental referrals.

Objective: To implement and evaluate the integration of oral health screening at an outpatient transitional primary care clinic in Maryland.

Methods: The quality improvement project occurred over 12 weeks. The project leader obtained support from institutional stakeholders, collaborated with dentistry, provided evidence-based resources, and developed referral strategies. Patients received a pre-screen at registration. Primary care providers used an oral health assessment tool (OHAT) for further screening and/or gave a dental referral.

Results: Approximately 108 patients completed pre-screen: 73% had not seen dentist in the past 12 months; 12% had current oral problem or pain; 53% had no established dentist; <5% had a completed OHAT; 20% referred to existing dentist; 56% received dental resource listing.

Conclusions: Oral health disparity continues to exist among vulnerable populations.

Implications for nursing: Oral screening by advanced practice nurses is an effective way to identify patients with unmet oral health needs and to promote dental referral.

Keywords: dental referrals; oral health disparity; oral health screening; primary care.

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Female
  • Humans
  • Male
  • Maryland
  • Mass Screening / standards*
  • Middle Aged
  • Mouth Diseases / diagnosis*
  • Mouth Diseases / therapy*
  • Oral Health / standards*
  • Practice Guidelines as Topic*
  • Primary Health Care / standards*
  • Referral and Consultation / standards*
  • Surveys and Questionnaires
  • Vulnerable Populations