Team approach to primary care includes dentists
Poor oral health has been linked to a host of health woes, such as heart disease and diabetes, yet too many New Mexicans fail to receive routine preventive dental care.
UNM and community health providers have teamed up to address this problem by incorporating oral health into a team-based primary care setting.
Patients receiving an exam at the El Pueblo Health Services Clinic in Bernalillo, NM, are seen by a primary care physician, a dentist and a nurse practitioner, says Dr. Peter Jensen, director of UNM’s Advanced Education in General Dentistry residency program.
“We’re finding it’s a good dynamic to have all of the practitioners in the room,” Jensen says. “We’re really starting to feed off one another as we focus on wellness checks for diabetics, pregnant moms and kids.”
The program, implemented with the help of a grant and faculty from the College of Nursing and the School of Medicine’s Department of Dental Medicine, relies on CAMBRA (Carries Management by Risk Assessment), a tool dentists use to assess cavity and gum disease risk.
“CAMBRA is becoming part of our physicals, regular exams, wellness checks and so forth,” says Rick Adesso, El Pueblo’s executive director. “So we have our primary care physicians and nurse practitioners looking closer for oral health problems.”
El Pueblo is a private non-profit clinic in Bernalillo, 15 miles north of Albuquerque. Anyone is eligible to receive services, and no one is denied due to their inability to pay. “We’re not building a dental clinic within a health clinic,” says project director Dr. Barbara Overman. “This is an effort at integrating two historically independent health care services.”
El Pueblo patient Connie Welsh said the experience has been eye-opening. “I’d been going to the emergency room for the pain in my mouth,” Welsh says. “I definitely learned more about what’s happening, and have been going to Pima Medical Institute for more regular cleanings and work.”
Making better oral health care more readily available to New Mexicans is likely to pay off in the long run. More than 37 percent of the state’s third graders have untreated tooth decay, while only 64 percent of state residents have had their teeth cleaned in the past year.
Six months into the grant, this diverse health team has developed an unexpected symbiosis. “This is an exciting approach to improving patients’ overall health,” Overman says. “We’re developing these collegial relationships among professionals of differing disciplines, and we’re all expanding our knowledge base. We want to improve our patients’ care and train others to do the same. We have an opportunity to put out the best care possible.”
The team hopes its work will become a model for rural areas where dental services are in short supply. They’re also incorporating it into curricula in the College of Nursing, says Dean Nancy Ridenour, the project’s principal investigator. “As frontline practitioners begin to integrate oral care into their services, they’ll have yet another part of the body that speaks to patient health,” she says.