Oral health key to overall health improvement

Abstract

Abstract Background Countries with healthier workforces have stronger economic health. Contributing to this relationship is the effort of dentists in improving the oral and systemic health of the country's population. The role of oral health in systemic health has been firmly established for many conditions, but national- and state-level data supporting this finding remain limited. Methods The relationship between oral health and overall well-being was explored using (1) data on dental service use from the National Oral Health Surveillance System, (2) self-rated overall health data from the Centers for Disease Control and Prevention surveys on behavioral risk factors, and (3) dental benefits data from Medicaid and State Children's Health Insurance Program Payment and Access Commission files. Self-reported health was selected because it seems to provide insight into individuals' general health and can guide future outcomes. In addition, self-reported health correlates with self-rated oral health. When dental care use is associated with self-care, good overall health is the most common outcome. Analysis Analysis revealed that the proportion of adults who paid dentists a visit in the past year was related to the proportion of adults reporting fair or poor overall health in the same state. Dental visits and overall self-rated health were strongly related, with increasing strength as time passes. Therefore states where adults are more likely to visit the dentist have the lowest proportion of adults who report fair or poor health. The results suggest that dental care teams have an opportunity to play an effective role in improving both health and health care. The three aims of their participation should be improvement in the experience of care, improvement in the population health, and reduced per capita costs for care. The integration of medical and dental health care provision is needed to achieve these three aims. Such integration and long-term success rates must be based on accurate cost-effectiveness assessment and a structured approach to the effort. Data indicate that providing dental treatment lowers medical costs for both patients and states. Interventions Dentists can play a significant role in the systemic health of their patients, but this intervention goes beyond stabilizing and preventing oral disease. Because many medical disorders can first be observed in oral conditions, early diagnosis and treatment can often be undertaken. Screening tests to identify systemic disease indicators during dental visits are being offered more widely than in the past and are well-received by patients. Studies indicate patients would view their dentist's competence and compassion more favorably if medical screening tests were part of the dental visit. Dental offices could provide access points for patients who do not seek primary medical care routinely, for those in poor health, and for those who need referrals to medical care. The referral process to medical care is, however, challenging and unnecessarily cumbersome, making this experience less than attractive to medical and dental practitioners. Improvements to the process would be the use of electronic referrals, more consistent communication, and increased numbers of dentists who accept Medicare and Medicaid. A possible starting place in overhauling referrals may be federally qualified health centers, where health care could be integrated more efficiently and effectively than in private settings. Improvement networks may help to provide the structured approach that would help dental facilities address medical care. It may be possible to address a single health issue and focus on integrating medical and dental care for persons with that condition as a first step toward this structured approach. Meeting the specific needs of the clinic's population will provide the best opportunity for success. Clinical Significance Dentists could play an important role in bridging the gap between medical and dental care, improving health throughout the country, and reducing costs for care. A coordinated approach is essential, but oral health care is a vital part of the process.