HJAR Jan/Feb 2021

HEALTHCARE JOURNAL OF ARKANSAS I  JAN / FEB 2021 59 Up to 1.65 million ER visits can be referred to dental clinics yearly, representing a po- tential $1.7 billion in savings for the health- care industry. 2 Dental caries, or tooth decay, remains the most prevalent chronic disease worldwide in both children and adults. 3 There is great room for improvement inArkansas, where 62% of adults feel life in general is less sat- isfying due to the condition of their teeth andmouth. Thirty-five percent of Arkansans avoid smiling due to the condition of their teeth, 28% of adults feel embarrassed about the appearance of their teeth and 27% report the appearance of their teeth affects their ability to interview for a job. 4 Since dental caries is entirely preventable, there is immense opportunity for medical and dental practitioners to intervene be- fore minor issues become major and the patient has more pain and higher expenses. By incorporating a dental component into medical exams, the two disciplines can work together to identify these oral health issues and direct patients to the correct resources. Signs and symptoms of conditions in the oral cavity can be detected through a simple exam and patient interview. It is important to catch oral health conditions as soon as possible to begin treatment and promote the best outcome. The destruction of teeth by the cariogenic process is curable if the teeth are treated early enough before loss of tooth structure. Oral preventive measures are also impor- tant for the well-rounded care of any ill pa- tient, especially those with systemic illnesses that are directly linked to oral health, such as diabetes, heart disease, kidney disease AS THE SYSTEMS of medical and dental care remain largely siloed in the U.S., it’s difficult for different healthcare profession- als to work together to create comprehen- sive care plans. However, every healthcare provider has the ability to impact their pa- tients’oral health – and closely linked overall health – outcomes. As the need for medical and dental inte- gration is increasingly apparent, it’s impera- tive for the larger healthcare community to invest in patients’ oral health statuses. It is estimated that each year more than 100 million Americans see a physician who do not see a dentist. 1 This widespread lack of dental care can be attributed to care costs for the uninsured or underinsured, as well as access to care in rural areas. Most recently, loss of income or de-prioritization of dental care due to the COVID-19 pandemic has af- fected the number of people seeking care. Although primary care providers routine- ly ask patients about their overall health, it is rare for them to investigate oral condi- tion symptoms such as dry mouth, bleeding gums, and other risk factors such as chewing tobacco or family history of oral disease. Their oral examinations may also be incom- plete, representing missed opportunities for primary care providers to engage patients in oral health education, screening, preventive strategies and referral to a dental provider for necessary treatment. Many patients who lack access to dental services seek care in hospital emergency de- partments where they often receive only an- tibiotics and pain medication without help to integrate them into the primary dental care system for more definitive treatment. Niki Carter, DMD Dental Director Delta Dental of Arkansas and liver disease. For some diseases, such as cancer, treatment cannot begin until any oral health issues are remedied, and clear- ance is given by a dentist. For any patient, regardless of age or oral status, proper oral hygiene habits at home are paramount to increasing positive oral health outcomes. Encouraging patients to brush twice a day and floss once daily is a simple way to make an impact, no mat- ter the original purpose of the medical visit. This is especially important for children, as a patient’s oral health over the course of their life is greatly improved when good oral health habits are established early in life. The cleaning and care of primary teeth also has direct effects on the development of permanent adult teeth. 5 Until a greater proportion of dental prac- tices is incorporated into larger healthcare settings, it is imperative for healthcare pro- viders to build on ways to connect these systems of medical and dental care so that patient care can be improved, especially for underserved populations and those who have difficulty making it to the dentist’s of- fice. Educating healthcare professionals and the public of the fact that patients cannot have good overall general health without good oral health is key. n REFERENCES 1 https://jada.ada.org/article/S0002-8177( 14) 60204-X/fulltext 2 https://www.ada.org/en/public-programs/ action-for-dental-health/er-referral 3 https://www.mdedge.com/fedprac/article/114729/ pain/tooth-decay-most-prevalent-disease 4 https://www.electricteeth.com/dental-statistics 5 https://www.deltadental.com/us/en/protect-my- smile/life-stages/oral-care-for-infants---toddlers/ dental-care-timeline-for-infants-and-children.html