Select State Initiatives on Integrating Oral Health and Chronic Disease

Objectives: The relationship between oral health and chronic diseases is well-documented in literature, however, there still exists a gap in integration of the two domains. The objective of this study was to evaluate accomplishments in medical-dental integration by state oral health programs and identify best practices that can be implemented within other oral health programs.
Methods: The Division of Oral Health at the Centers for Disease Control & Prevention in collaboration with the Association of State & Territorial Dental Directors supports 21 state oral health programs. Initiatives toward chronic disease integration were reviewed from all 21 states. Based on the diversity of the oral health-chronic disease collaboration, current status, and effectiveness of the program, select programs from five states– Iowa, Maryland, New York, Vermont, and Virginia were chosen to be comprehensively evaluated.
Results: Iowa collaborated with heart disease and tobacco cessation programs. Educational sessions on conducting blood pressure screening and tobacco counselling were provided to dental professionals. Maryland focused on integrating oral healthcare and diabetes. A conference was conducted to increase knowledge and skills of dental providers at recognizing prediabetes in patients and providing diabetes prevention resources. Programs educating dental students to use a glucometer to screen and identify patients with prediabetes were also initiated. New York and Vermont worked with state tobacco control programs to expand smoking cessation programs to dental providers. Vermont also conducted a medical-dental integration conference to explore how medical and dental professionals can collaborate to impact overall health. Virginia worked with community health workers and local area agencies on aging to improve oral health counselling skills and knowledge.
Conclusions: There is an increasing awareness of the importance of oral health and chronic disease integration. While various approaches initiated by select states have successfully integrated the two domains, steps should be taken to strengthen and further this collaboration nationwide.