By Nicole Fauteux
Twelve years ago, when Tracy Garland was running the Washington Dental Service Foundation, she met with the head of the state dental association to inform him about an effort to reach out to organized medicine. His advice to her: keep your efforts strictly local or expect serious pushback.
Today the climate for collaboration related to oral health has warmed considerably, and Ms. Garland is working hard to make sure it stays that way. She directs the National Interprofessional Initiative on Oral Health (NIIOH), a partnership between health professionals and philanthropists to engage primary care clinicians in eradicating dental disease. The initiative is premised on the idea that the dental professions need to work in collaboration with others to fully address oral health.
“We create a space that allows relationships to occur across the professions,” says Ms. Garland, “and those relationships predispose people to collaborate.”
To facilitate that collaboration, NIIOH works in the education, practice, and policy spheres and actively promotes the use of a modular, online oral-health curriculum, Smiles for Life. According to the Smiles for Life website, the curriculum is the nation’s most comprehensive oral health curriculum for primary care clinicians. Twelve health professions associations, including the American Dental Association, have endorsed Smiles for Life, and tens of thousands of people have downloaded curricular components or completed online courses. Although designed for non-oral health professionals, the curriculum is useful for dental educators who want to see what the other health professions are learning. ADEA members can access it through MedEdPORTAL.
Ms. Garland and others involved with the work of NIIOH spoke at the 2013 ADEA Annual Session & Exhibition. Anita Glicken, President and CEO of the nccPA Health Foundation, is a champion for oral health within the physician assistant (PA) community. In 2011, she paid a visit to a Head Start classroom in New Orleans where children’s teeth were being varnished, and seeing three-year-olds who couldn’t wait to get what they perceived as “sticky brown stuff” put on their teeth made her realize just how much the PA community could do to address oral health.
“It’s allowed us to reach beyond our different professional cultures to work on disparities in oral health,” she says.
Ms. Glicken reported that currently five PA education programs are using Smiles for Life and community interventions to contribute to oral health. These inroads into the PA community should help NIIOH achieve its mission. As Ms. Glicken told the audience, the number of PAs is growing fast, and they make up a significant portion of the primary care workforce in rural and minority communities.
So do nurse practitioners (NPs), who were represented on the panel by Judith Haber, Ph.D., Associate Dean for Graduate Programs at the New York University School of Nursing (NYU SON). NYU SON is situated within the NYU College of Dentistry (see an update on this partnership in the May 2013 Charting Progress). Dr. Haber spoke briefly about this unique interprofessional educational collaboration, calling it “one-stop oral-systemic health shopping under one roof.”
Dr. Haber directs the Oral Health Nursing Education and Practice Initiative (OHNEP), a joint venture of NYU SON and NIIOH, funded by DentaQuest Foundation, Washington Dental Service Foundation, and Connecticut Health Foundation. OHNEP is striving to integrate oral health in the baccalaureate nursing curriculum by making presentations, establishing a protocol that nurses can follow for oral health assessment, and awarding grants to interprofessional teams developing oral-systemic curriculum resources.
“Two years ago, there was only one nurse-led oral health initiative in the United States. Now there is at least one nurse-led oral health initiative in 22 states,” Dr. Haber tells the audience. Her hope is to see additional nurse-led initiatives take root in all 50 states.
Caswell Evans, D.D.S., M.P.H., Associate Dean for Prevention and Public Health Sciences at the University of Illinois at Chicago College of Dentistry and Chair of the DentaQuest Foundation Board of Directors, facilitated the session. He lauded the motivation of our colleagues in the other health professions to educate themselves about oral health and asked attendees to consider what dental education is doing to prepare students to collaborate in interprofessional initiatives.
“In some regards, they’re outpacing us,” he suggests.
During the question and answer period, one attendee asked the presenters whether dentists could also learn to provide some aspects of primary care. Comments from a nurse, a physician, and a dental hygienist supported the idea that oral health professionals might expand their roles in addressing the systemic needs of patients. Some audience members also asked that all oral health professionals be included in interprofessional efforts to promote oral-systemic health. As one attendee put it, “Dental hygiene has an enormous role to play in the health home. A dental hygienist will always know more than a physician about oral health.”