According to the recent article “Offering Oral Health Services in Your Office” in Family Practice Management, family practitioners have been addressing children’s oral health for years. But, there is a lack of guidelines for physicians to effectively incorporate oral health services into their primary care practices. To help with this, the article offers suggestions for better incorporating oral health at the family physician’s office.

Suggestions for a medical assistant or nurse:

• Assist parents in completing a caries risk assessment at intake—the American Academy of Pediatrics offers a downloadable risk assessment tool for use.

• Apply fluoride varnish, necessary vaccinations and follow-up service requirements after the physician’s oral exam—application of the varnish can be learned through the Smiles for Life curriculum.

• Provide patient education about oral health, which can be added to the practice’s web site or printed off from resources such as the American Dental Association and the Academy of Pediatric Dentistry.

Suggestions for the family physician or midlevel provider:

• Perform the oral exam using the knee-to-knee approach, which involves the parent and physician facing each other with the child sitting on the parent’s lap and the child’s head on examiner’s lap.

• Offer dietary and hygiene education during the visit.

• Provide the exam and dental hygiene education after completing the free online training, Smiles for Life, for a CME credit.

• Refer to a local dentist if further dental services are needed.

Other Reminders

All staff members can assist with record-keeping by documenting their portion of service and any findings, education and referrals provided.

In Kentucky, physicians are eligible for a reimbursement of $15 from Medicaid for fluoride varnish services for one to five-year-olds up to two times in 12 months. Fluoride varnish is an effective preventive oral health service, especially for children in need.

Physicians also have the authority to fill out the dental screening or exam form required for children entering kindergarten. Non-dental professionals should always refer the patient to a local dentist if they notice the child or adult hasn’t visited a dentist in a while or if they recognize any dental related issues while providing a screening or exam.

Prevention and early detection of oral health problems can reduce risk of further health complications. Integrating oral health services into regular doctor’s visits can prevent dental caries in children, pregnancy complications in women and periodontitis in adults. Offering oral health screenings, dental hygiene advice and referrals to a dental home is an easy and effective way for physicians to provide integrated care to their patients.

– Mahak Kalra is the Kentucky Oral Health Coalition Policy Director.