Western Dental exec: Patients benefit when physicians talk to each other

Dental offices could become one-stop shops for patients' overall healthcare needs if one dentist's vision takes off.

John Luther, DDS, chief dental officer of Western Dental & Orthodontics, spoke with Becker's on April 29 to discuss the integration of oral and overall health.

Editor's note: Responses have been lightly edited for length and clarity.

Question: What would an ideal integration of oral and overall health look like?

Dr. John Luther: We should look at this as patient-centered integrated care. What that means is that all care, medical and dental, is centered around the patient to meet their specific needs. As opposed to what we have many times today where we may have six or seven physicians or dentists, none of which are talking to each other, and they don't really have an idea of the patient's total overall health or even the medications that they're taking. This is especially important for an organization like Western Dental because we treat a lot of underserved patients … that are challenged in a lot of ways in terms of taking off work time to see physicians or dentists or even transportation. So if they can get more done in one appointment, for example, that really increases access and boosts equity to care whether it's dental or overall healthcare.

Q: What has the timeline of that integration looked like in the past five years? Is the industry moving closer to that goal?

JL: I think so. It sounds simple but it's often somewhat complicated to bring care together in one setting. I think there is some progress being made in pilot programs. … All of it takes time. I see this first occurring in what I would call primary care settings, where we might see a primary care or family doctor in a building that may also have a dentist or pediatric dentists.

Q: What's currently standing in the way of making this a reality? What are the biggest obstacles?

JL: So it's very interesting, but when we think of the dentist we think of the dentist looking only at teeth. In a dental setting, the dentist not only does a complete dental examination but also should complete a complete medical history and take the patient's blood pressure, for example, if they're having some kind of surgical procedure. What that means then is that the dentist would refer the patient if they have an untreated medical problem to the appropriate physicians. That's one way that care is coordinated.

Another example would be for a pediatrician who would see a baby for their first Well-baby visit doing a cursory dental exam. It's called a knee-to-knee exam where they do an oral screening. For example, a child that has been put to bed with a sweet drink to put them to sleep may have a lot of cavities in their mouth. That physician then can refer that to the dental setting.

One interesting thing that Western Dental is doing around care coordination is we're now piloting eye care in the dental setting. In our margin or offices we are piloting having an optometrist who may provide eyeglasses for patients in the same facility. These are things that haven't been tried routinely, but it's one step closer to getting patients the care they need in one location.

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