Doctors Perform Dental Duties for Low-Income, Uninsured Patients

Article Summary –

Pediatrician Patricia Braun is part of a growing trend in the United States to incorporate oral health into routine medical check-ups for children, pregnant women, and other disadvantaged groups. This comes in response to an increased prevalence of oral disease in these populations, often due to a lack of access to affordable dental care. Despite facing challenges such as socioeconomic disparities, workforce shortages, and the needs of new immigrants, programs integrating oral health into primary care have expanded over the last decade, backed by federal and private funding.


Integrating Dental Care into Pediatric Medical Checkups

At a Denver community health clinic, pediatrician Patricia Braun and her team perform routine medical checkups and also address oral health concerns. This innovative approach aims to meet the growing need for oral health care in underprivileged communities.

Braun works at Bernard F. Gipson Eastside Family Health Center, part of Denver Health, the largest safety-net hospital in Colorado. She notes a higher rate of oral disease among their patients, underscoring the need for integrated care.

This trend of combining oral health assessments with regular medical checkups is gaining momentum across the US. Despite facing challenges such as socioeconomic barriers and workforce shortages, with federal and private funding, these programs have expanded over the past decade.

Thanks to a $6 million federal grant, Braun and her colleagues have trained 250 primary care providers in oral health in Colorado, Montana, Wyoming, and Arizona. Similar initiatives are underway in Illinois, Michigan, Virginia, and New York.

Tara Callaghan, director of operations for the Montana Primary Care Association, emphasizes the importance of this integrated care, particularly for children who lack access to dental care. It not only increases the frequency of preventive measures like fluoride application but also improves parental knowledge about child dental care.

However, challenges persist. Montana, for instance, struggles with dental professional recruiting due to its large geographical area and sparse population. The state also ranks low in residents’ access to fluoridated water, which can prevent cavities and strengthen teeth.

The Role of Dental Hygienists in Integrated Care

Valerie Cuzella, a dental hygienist at Denver Health, works closely with Braun and other medical doctors to provide oral health care during medical visits. This collaborative approach is part of an effort to break the traditional silos between medical and dental care.

Despite the progress, integrating dental care into medical visits can be challenging. In Denver, barriers such as housing instability, language differences, lack of transportation, and the high cost of dentistry without insurance can make it difficult for many children, immigrants, and seniors to access dental care.

Organizations like STRIDE Community Health Center strive to overcome these barriers by providing interpretation services and affordable care options for uninsured patients. The center has seen an increasing influx of migrants and refugees who require extensive dental care.

However, the future of these integrated programs is uncertain due to financial instability. Especially with the ongoing Medicaid “unwinding,” providers are concerned about meeting the upfront costs of new staff and replacing aging dental equipment.

Despite these obstacles, the success of integrating dental care into pediatric checkups offers a promising model for at-risk children. With Braun’s program, providers have applied over 17,000 fluoride varnishes and increased preventive oral healthcare to 78% from 33% among children under the age of 3.


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