The Impact of an Interprofessional Oral Health Curriculum on Trainees.

PURPOSE: Despite the prevalence of oral disease, the subject of oral health historically has been absent from medical education. We have developed an interprofessional curriculum in collaboration with our school of dentistry to teach oral health in the primary care setting to physician assistant (PA) students. The goal was to create and assess the impact of a curricular model that would be adaptable to various academic settings. METHODS: A blend of classroom, clinical skills lab, observations in the dental clinic, and observed structured clinical examinations was used to teach oral health to first-year (didactic year) PA students. The objectives were created in collaboration between the medical and dental faculties and included topics on general oral health, oral cancer, geriatrics, pediatrics, and fluoride varnish. RESULTS: A total of 12 hours of instructional time was delivered to 23 students over 3 semesters from 2014 to 2015. Pretesting and posttesting demonstrated long-term knowledge retention that was 14% better than baseline at 8 months (P < .001). Student surveys demonstrated that satisfaction levels were high and that the students felt better prepared and motivated to incorporate oral health into their practice of medicine. Analyses of students' write-ups of the history and the physical examination demonstrated that the students incorporated oral health concepts. CONCLUSIONS: A significant impact on trainees can occur after a short, focused amount of instructional time in oral health. Students demonstrate enthusiasm and begin using oral health skills early on. A focused interprofessional oral health curriculum can likely be successfully integrated into various academic settings with a positive effect on learning and improved patient care.

Oral Health for Older Adults: An Interprofessional Workshop for Medical Students.

INTRODUCTION: Because many older adults lack dental insurance and have limited or no access to dental care, it is essential to train future physicians to conduct brief oral health assessments on them. Likewise, interprofessional educational experiences are crucial in teaching medical students the skills necessary to provide comprehensive, team-based care to complex and vulnerable populations. Thus, this workshop was designed to increase fourth-year medical students' knowledge and confidence in performing oral health examinations on older adult patients using an interprofessional and hands-on approach. METHODS: The curriculum includes an online presession self-study module followed by a 75-minute workshop. The workshop is comprised of a brief introduction (5 minutes), a lecture about the impact of oral health on older adults (30 minutes), a hands-on skill session practicing a focused oral exam led by dental students (30 minutes), and a large-group debrief and wrap-up (10 minutes). RESULTS: A pre-/postsurvey assessed learners' knowledge, attitudes, and confidence in oral health skills. The results were compared to a lecture-only format that was in place prior to the implementation of the workshop. In comparison to medical students who received the lecture-only format, those who participated in the workshop showed a greater increase in confidence and skills over time. The medical students also expressed interest in more frequent opportunities for collaborative learning experiences with dental students. DISCUSSION: This workshop was successful in introducing an interprofessional experience to medical students in order to ensure more comprehensive and coordinated care for older adult patients in the future.

Oral Health and Interprofessional Collaborative Practice: Examples of the Team Approach to Geriatric Care.

Oral health for the older adult patient is vital for function, comfort, and communication and is a critical component of overall health. Oral diseases such as dental caries, periodontal disease, and oral cancer may lead to pain, functional limitations, and decreased quality of life. Optimal oral health outcomes are often owing to effective interprofessional collaboration between and among health care providers, in conjunction with patient family members and caregivers. This article highlights 2 cases illustrating how interprofessional team dynamics can affect patient outcomes.

Introduction of an interprofessional oral health curriculum.

PURPOSE: Physician assistants can incorporate a variety of oral health services into their practices, but many physician assistant programs do not dedicate adequate time to oral health education. Our goal was to develop a novel and interprofessional oral health education curriculum model for our physician assistant students that could be adopted by other physician assistant programs and dental schools in the United States. METHODS: Curricula were created collaboratively and taught by dental school faculty with a focus on the primary care setting. Prewritten and postwritten tests were administered along with a clinical skills examination. Student and faculty evaluations were administered for pedagogical evaluation. RESULTS: Pretests and posttests demonstrated a 25% increase in knowledge acquisition (paired t test: P < .001). Physical examination skills testing achieved a 95% completion rate. Student and faculty evaluations demonstrated high satisfaction rates with the curricula delivery. CONCLUSIONS: Initial evaluation of this novel interprofessional curriculum for physician assistant students demonstrates that it was successful. It was well-received by the students and the faculty members and resulted in measurable knowledge acquisition. This model could feasibly be reproduced in other institutions for oral health education.

Oral health disparity in older adults: dental decay and tooth loss.

Progress has been made in reducing dental caries and edentulism in older adults, but disparities continue to exist related to race, ethnicity, socioeconomic level, and sex. Lack of training in treating medically complex patients, economic factors including absence of coverage for oral health services in Medicare and as a required service for adults in Medicaid, and attitudinal issues on the part of patients, caregivers, and providers contribute to barriers to care for older adults. In addition to the impact of oral health on overall health, oral health impacts quality of life and social and employment opportunities.

An oral health study of centenarians and children of centenarians.

OBJECTIVES: To determine whether oral health is better in centenarians than in a published birth cohort-matched sample and to compare oral health in centenarian offspring with a case-controlled reference sample. DESIGN: Observational cross-sectional study. SETTING: New England Centenarian Study (NECS). PARTICIPANTS: Seventy-three centenarians, 467 offspring, and 251 offspring generation-reference cohort subjects from the NECS. MEASUREMENTS: A self-report questionnaire was administered to measure oral health in all three groups, with edentulous rate as the primary outcome measure. The NECS made information on sociodemographic characteristics and medical history available. Centenarian results were compared with published birth cohort-matched results. Data from offspring and reference cohorts were analyzed to determine differences in oral health and associations between oral health measures and specific medical conditions. RESULTS: The edentulous rate of centenarians (36.5%) was lower than that of their birth cohort (46%) when they were aged 65 to 74 in 1971 to 1974 (according to National Center of Health Statistics). Adjusting for confounding factors, the reference cohort was more likely to be edentulous (adjusted odds ratio (AOR) = 2.78, 95% confidence interval CI = 1.17-6.56), less likely to have all or more than half of their own teeth (AOR = 0.48, 95% CI = 0.3-0.76), and less likely to report excellent or very good oral health (AOR = 0.65, 95% CI = 0.45-0.94) than the centenarian offspring. CONCLUSION: Centenarians and their offspring have better oral health than their respective birth cohorts. Oral health may prove to be a helpful marker for systemic health and healthy aging.