Medical dental integration (MDI) is the practice of integrating oral health and primary care to address oral health as part of overall health.
There is a crisis involving access to care in oral health across the U.S. and in many middle- and low-resource countries around the world. In Maine, about half of all children are not receiving any preventive dental care, and even fewer are able to access care in a traditional dental home. This leaves families without the preventive and early intervention care they need to maintain oral health. Not only does dental disease contribute to several local issues, including pain and difficulty eating, but systemic health effects that correlate to dental disease are also a concern.
Oral health is overall health, and it is good practice to approach prevention of dental disease in the same way we approach prevention of other diseases, in the primary care setting. Moreover, families have far greater access to a medical home than a dental home, both earlier and more often.
MDI allows families to access preventive and early intervention services when it matters most, BEFORE the dental disease process begins.
Accomplishing MDI
MCD Global Health provides leadership for several Health Integration Action Teams (HIAT) MDI initiatives. In collaboration with partners, MCD has completed a planning process for the Dental Steps Program expected to be piloted in Maine in 2024. Dental Steps is a comprehensive integration of oral health into the well-child visits of children ages 0-5. Through a multi-pronged approach, including assessment, prevention, and education, into every well-child visit from birth to age 5, onsite prevention and early intervention dental services, and virtual connection to a dental home, Dental Steps gives families the early-and-often support they need for their children to realize a lifetime free of dental disease.
Planning efforts are also underway to establish an e-Consult pathway in Maine between pediatricians and dentists to support pediatricians in assessment, delivery of non-invasive caries therapies, and care coordination for oral health needs in their patients. Additionally, an adaptation of this model is being explored as a potential solution to the oral health crisis among children in Maine’s child welfare system.
There are many MDI models around the country. In Maine, the Children’s Oral Health Network of Maine (COHN)’s HIAT is exploring numerous ways to achieve MDI, as shown in their graphic below:
