Integrating Oral & Physical Health Part 4

A growing number of clinics are integrating an expanded practice dental hygienist (EPDH) into their clinic. Expanded practice dental hygienists can provide select treatments without having a general dentist present, making it easier to offer dental treatment in a medical setting. This includes:

  • Dental assessments
  • X-rays
  • Oral hygiene instructions
  • Dental Cleanings
  • Fluoride varnish
  • Dental sealants
  • Dental treatment referrals

Capitol Dental Care employs expanded practice dental hygienists, and since 2014, Samaritan Health Services has been collaborating with Capital Dental Care to offer dental services in primary care homes.  Below are some of the benefits we have observed and lessons learned. (Miller, J. & Whitley, K. (2014). Oral health co-location project [PowerPoint slides]. Retrieved from

Benefits of Co-location 

  • Enhances the care that patient centered medical homes can offer by including oral health services
  • Allows for onsite coordination between medical and dental practitioners for target populations such as pregnant women, children, and patients with chronic diseases
  • Increases access to service, which is especially important for some rural areas that may not have an oral health provider
  • Removes barriers, such as transportation, time off from work and child care, for people by allowing them to have their medical and dental needs cared for in a single visit
  • Emergencies can be triaged and patients directed to ambulatory settings, potentially avoiding higher costs of care in emergency departments

Lessons Learned

  • Expanded practice dental hygienist should be involved  in clinic staff meetings
  • Clinics should identify an oral health champion
  • All clinic staff should be aware that the clinic has an expanded practice dental hygienist
  • Expanded practice dental hygienist should have a dedicated space to work
  • If dental service is offered, clinics should advertise that it is available
  • Identify how many days per week the expanded practice dental hygienist is needed at the clinic
  • Medical providers should stress the importance of dental treatment to their patients

If you are interested in adding an expanded practice dental hygienist into your clinic or would like more information about integrating oral health programs and services in your clinic, please contact us and let us know you would like to be connected with one of our dental coordinators. 

Next Issue: Introducing the Smiles for Life Program 

Next month, we will feature the national Smiles for Life program, as we continue to explore how oral and physical health are related and the opportunities primary care clinics have to integrate and coordinate dental services. 

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