Nelson S, Kim E G R, Kaelber D C. Integrating Oral Health into Primary Care: Perspectives for Older Adults. J Dent Res 2023; DOI: 10.1177/00220345231165011. Online ahead of print.

Wider health benefits for little time cost.

The causal relationship between oral and systemic diseases is unclear but 'there is unquestionably a bi-directional relationship between oral health (OH), cardiovascular disease and diabetes in older adults.' Poor OH impacts quality of life but older people tend to assume tooth loss is inevitable with age and are unaware of the links between OH and systemic disease.

The barriers to the integration of medical and oral care include a lack of compatibility of electronic health care records (EHR) and inadequate education and training for medical providers. There is evidence that interventions delivered by medical practitioners have been effective for other medical issues such as smoking cessation but no studies exist for medical/dental interventions.

Suggestions for change include co-locating medical and dental care facilities and providing 'EHR clinical decision support augmentation' which are OH screening-related prompts which ask (risk indicator questions) advise (re: dental visits) assess (whether referral needed) and connect (to appropriate resources). It is suggested that these activities would only add a few minutes to a routine health review appointment.