MD, MPH, FAAP, Adult and Child Center for Health Outcomes Research and Delivery Science (ACCORDS), Children's Hospital Colorado, University of Colorado School of Medicine, Aurora, CO, USA; MD, MPH, FAAP, Denver Health and Hospital, Denver, CO, USA.
MPA, CHES, Senior Program Officer, Delta Dental Dental of Colorado Foundation, Denver, CO, USA.
J Evid Based Dent Pract. 2016 Jun;16 Suppl:59-67. doi: 10.1016/j.jebdp.2016.01.017.
Basic preventive oral services for children can be provided within the medical home through the collaborative care of medical providers and dental hygienists to expand access for vulnerable populations.
Because dental caries is a largely preventable disease, it is untenable that it remains the most common chronic disease of childhood. Leveraging the multiple visits children have with medical providers has potential to expand access to early preventive oral services. Developing interprofessional relationships between dental providers, including dental hygienists, and medical providers is a strategic approach to symbiotically expand access to dental care. Alternative care delivery models that provide dental services in the medical home expand access to these services for vulnerable populations. The purpose of this article is to explore 4 innovative care models aimed to expand access to dental care.
Current activities in Colorado and around the nation are described regarding the provision of basic preventive oral health services (eg, fluoride varnish) by medical providers with referral to a dentist (expanded coordinated care), the colocation of dental hygiene services into the medical home (colocated care), the integration of a dental hygienist into the medical care team (integrated care), and the expansion of the dental home into the community setting through telehealth-enabled teams (virtual dental home). Gaps in evidence regarding the impacts of these models are elucidated.
Bringing preventive and restorative dental services to the patient both in the medical home and in the community has potential to reduce long-standing barriers to receive these services, improve oral health outcomes of vulnerable patients, and decrease oral health disparities.
基本预防口腔服务可为儿童提供在医疗家庭通过医疗服务提供者和牙科保健师的协作护理，以扩大弱势群体的获得途径。
由于龋齿是一种可以预防的疾病，它仍然是儿童最常见的慢性疾病，这是不可接受的。利用儿童与医疗服务提供者多次就诊的机会，有可能扩大早期预防口腔服务的机会。在牙科提供者（包括牙科保健师）和医疗服务提供者之间建立专业间关系是一种协同扩大牙科护理获得途径的战略方法。提供在医疗家庭中提供牙科服务的替代护理提供模式为弱势群体扩大了获得这些服务的途径。本文的目的是探讨 4 种创新的护理模式，旨在扩大牙科护理的途径。
描述了科罗拉多州和全国目前在医疗提供者提供基本预防口腔健康服务（例如氟化物漆）方面的活动，并将其转介给牙医（扩大的协调护理），将牙科保健服务纳入医疗家庭（联合护理），将牙科保健师整合到医疗保健团队中（综合护理），以及通过远程医疗支持团队将牙科家庭扩展到社区环境中（虚拟牙科家庭）。阐明了这些模式对影响的证据差距。
在医疗家庭和社区中将预防和修复牙科服务带给患者，有可能减少接受这些服务的长期障碍，改善弱势群体患者的口腔健康结果，并减少口腔健康差距。
