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Organized, Evidence-Based Care

Oral Health Integration

Organized, evidence-based care (OEBC) is care that is based on scientific evidence and planned and delivered so that the team optimizes the health of its entire panel of patients.

Oral health is an essential component of comprehensive primary care. Oral health problems are common, negatively impact other conditions such as diabetes and pregnancy, and result in expensive interventions that could be avoided with early detection and intervention.

The Oral Health Delivery Framework presents a model for primary care to:

  • Screen for oral health issues
  • Offer brief interventions
  • Coordinate structured referrals to dentistry as needed

Go to the Implementation Guide
| Go to the Coaching Tools

Oral Health Integration Implementation Guide 

The Oral Health Integration Implementation Guide provides advice and instructions for primary care practices on implementing the Oral Health Delivery Framework. Providing care for patients' oral health problems is a critical component of OEBC.

Download individual sections of the guide below

Section 1: Introduction and Section 2: The Case for Change: Delivering Preventive Oral Health Services in the Primary Care Setting
Building on the white paper, Oral Health: An Essential Component of Primary Care, the importance of oral health is discussed and the case for integrating oral health preventive services into primary care is made.

Section 3: The Oral Health Delivery Framework
This section details the oral health interventions that can be carried out in the primary care setting and defines the responsibilities of the medical and dental teams.

Section 4: How to Prepare for Successful Implementation
This section describes how to plan and develop an oral health integration program. Necessary staff roles, strategies to engage patients and families, and solutions to common challenges are discussed. The tools available to support implementation are outlined in detail.

Section 5: Staffing Options and Workflow
While the Oral Health Delivery Framework defines what primary care practices can do to protect and promote oral health, how each practice completes those tasks depends on its staffing model and care delivery processes. This section reviews primary care staffing options and methods for incorporating the Framework into primary care workflows.

Section 6: Structuring Referrals to Dentistry
Many patients screened during a primary care visit will need care that only a dental team can provide. In the Oral Health Delivery Framework, dental referrals should be as simple for patients as referrals to any other specialist. In this section, structured referrals from primary care to dentistry are described, an effective process for developing a referral workflow is presented, and guidance is offered for building referral networks that serve diverse patient populations.

Section 7: Using Data for Quality Improvement
How do you know if a change is an improvement? This section explores measures practices can use to show their oral health integration efforts are improving patient care. Collecting and reporting the right data allows practices to effectively tell the story of their work.

Section 8: Leveraging Success: Spreading and Sustaining
In order to achieve long-term success, oral health integration program planning must include sustainability and spread. In this section, strategies to support sustainability are described. This section also describes methods of spread and tactics to ensure successful spread.

Section 9: Field-Testing Results and Case Examples
This section includes summary results, impact data and in-depth case examples from field-testing of the Oral Health Delivery Framework. Between 2014 and 2016, the Framework was tested by 19 primary care practices in five states. These sites included private practices (hospital-based, independent, and part of a large integrated delivery system) and community health centers (mostly FQHCs) of varying sizes in urban, suburban and rural locations. Collectively, they focused on four unique populations and utilized five different electronic health records.

Annotated Oral Health Integration Toolset
Tools to support oral health integration were developed during field-testing of the Oral Health Delivery Framework. These tools were used by the participating practices and refined based on their feedback.


Oral Health Integration Coaching Tools 

These Coaching Tools were developed to enhance the coaching skills of staff guiding oral health integration activities within their primary care practice. In order to use the Coaching Tools effectively, coaches must be familiar with the Oral Health Integration Implementation Guide and Toolset.

The Case for Change Summary
This summary of The Case for Change: Delivering Preventive Oral Health Services in the Primary Care Setting includes talking points that coaches can deliver in a minute or less.

Oral Health Integration Program Development Timeline
This sample project plan assumes a total development time of 15 months, but can be adjusted to meet individual practice needs.

Oral Health Integration Clinical Content FAQs
This document answers the questions most often asked during clinical content training.

Oral Health Integration Workflow Optimization Mapping: A Coach's Guide
This companion to the tool Oral Health Integration Workflow Optimization: A Streamlined Guide for Primary Care Practices helps coaches plan and carry out a successful workflow optimization mapping event.

Oral Health Integration Workflow Mapping Report
This document, which accompanies the tool Workflow Optimization for Oral Health Integration, is a template for the final report produced by coaches after a workflow optimization mapping event.

Data Flow for Oral Health Reporting
This tool presents a simplified explanation of the oral health integration data flow pathway.

Oral Health Integration Referral Mapping: A Coach's Guide
This document helps coaches conduct a successful referral workflow mapping event and optimize an oral health referral process.