Medical Dental Integration in Pediatric Primary Care

The Medical-Dental Integration anchor strategy (Mouth Matters) of Smile Spokane seeks to integrate pediatric preventive oral health services into primary care workflow, aiming to improve children’s health outcomes and reduce the cost of care. Smile Spokane and Arcora, through the Local Impact Network, currently work with the three largest systems in Spokane: CHAS Health, Multicare, and Providence. 

This strategy uses a peer model to help identify system barriers and creative solutions to integration.

Children see their pediatric medical provider for well-child visits sooner and more often than a dentist. Pediatric visits are a crucial opportunity to provide preventive oral health services and ensure parents and caregivers understand the importance of early dental care.

 

Arcora Foundation logo with "Arcora" in all caps and bright green

 

 

 

Logo for Providence featuring a Blue cross with green chevrons in each inner corner.

 

Oral Health Is Important for Overall Health

Dr. Marcus Baca has seen every health-related scenario imaginable. He’s a primary care pediatrician and director of pediatric health at CHAS Health. A relatively common scenario: a child whose ongoing oral health issues negatively affect their general well-being.

“Medical care and dental care should be merged in our conversations,” Dr. Baca says. “They shouldn’t be separate.” Dental care isn’t often included with other aspects of physical and mental health care, Dr. Baca explains, but they’re all connected in more ways than we think. 

As a nonprofit health center, CHAS Health is dedicated to improving the health of the communities it serves, and it offers dental care as part of its health ecosystem. CHAS Health and other health care systems like Providence Health & Services and MultiCare Health System, all partner with Smile Spokane on our Medical-Dental Integration Strategy. Through this strategy, Arcora Foundation provides training, tools, and technical assistance to medical teams to integrate oral health screenings into patient visits. 

The percentage of Medicaid-insured children under 6 years accessing dental care in 2020 is significantly lower than the portion of similarly aged children accessing primary medical care (49% versus 87% in 2020).[1] Integrating oral health care into medical care ensures more children get needed oral health screenings.

Oral disease, an almost entirely preventable condition, is largely ignored by the current health system until the teeth or gums deteriorate to the point that they require aggressive, expensive, and painful interventions.

“Dental pain can affect your entire body, your entire sense of well-being,” Dr. Baca says. “Health care providers should be thinking about them simultaneously.”

That’s a problem when everyone can’t access health care and when oral health care isn’t a priority for everybody. CHAS Health and Smile Spokane are on a mission to change that.

“When you come to see us for medical care, we’re also thinking about the health of your mouth and your teeth, and we want you to think about it, too,” Dr. Baca says. “We want to remind families that their oral health is a key part of their overall medical care.”

This requires compassion from health care providers. “At some point in our lives, we’ve all needed someone to be there for us.” Dr. Baca says. “Working in this kind of place allows me the opportunity to give back to the community I live in.”


[1] Washington State Health Care Authority, Apple Health Dental Services Enrollment, and Utilization Data. Washington State Health Care Authority, Washington Apple Health 2020 Comparative and Regional Analysis Report. Comagine Health

Smiles for Life

Smiles for Life is currently the nation’s most comprehensive and widely used oral health curriculum for primary care clinicians. It has been endorsed by 20 national organizations and is in wide use in professional schools and post-graduate training programs.

Visit the Smiles for Life website to view their Continuing Education courses and resources.