Medical-Dental Integration: A Promising Approach To Address Unmet Dental Needs of Children and Youth With Special Health Care Needs

Abstract

Background: This review presents strategies on how medical-dental integration and a patient-centered approach may address the unmet dental needs of children and youth with special health care needs (CYSHCN).Methods: Programs, strategies and frameworks to implement medical-dental integration to improve the overall quality of life of CYSHCN were reviewed. The authors propose a patient-centered health home (PCHH) as a step toward a patient-centered approach to medical-dental integration for CYSHCN.Results: Many federal, state and local organizations have emphasized the importance of medical-dental integration. Models and frameworks to implement integrated care in multiple settings have been developed and can be applied for CYSHCN. The proposed PCHH model includes integrated education, improved clinical collaboration, integrated health information technology and integrated financing. Ravenswood clinic is an example of an organization that has developed an integrated care model that serves children and adults with special health care needs.Conclusion: CYSHCN often seek services from multiple specialties that may or may not integrate care with a patient-centered approach. It is imperative to develop care systems that make oral health an inseparable part of general health and well-being.Practical implications: The PCHH is a promising approach to improve the overall health of CYSHCN. Incorporating oral health competencies for primary care providers and increasing the skills of dental providers to care for CYSHCN are important steps. Improved communication and clinical collaboration between dental and primary care providers to increase preventive dental services to CYSHCN will reduce the burden on the health care system. However, PCHH can only be practical by reforming the health care financing system.