Interest in Accessing Integrated Dental Services in Primary Care Among Patients with Low Dental Care Utilization

Abstract

Purpose Medical-dental integration models in primary care settings offer opportunities to increase access to oral health care, particularly for vulnerable populations. The purpose of this study was to assess dental care utilization and measure patient interest in accessing integrated dental services within the primary care setting, among patients attending a primary care practice participating in MassHealth’s Accountable Care Organization program.

Methods Convenience sampling was used to recruit participants from a safety-net health care system serving the greater Boston area. A 10-item survey was used to collect data on dental care utilization and measure interest in accessing integrated dental services at one primary care practice. Descriptive statistics, in addition to bivariate and multivariate logistic regression models were used to characterize the sample and explore dental care utilization associations.

Results A total of 149 individuals participated, with over half (52%) reporting dental care utilization in the past year. Participants with public insurance were less likely to have seen a dental provider compared to those with private insurance (OR=0.35, 95% CI [0.12, 0.99]). Most patients (77.2%) expressed interest in accessing both in-person appointments with dental hygienists and teledentistry appointments with dentists (63.8%). When asked to choose between the two services, integrated dental hygienist appointments emerged as the more popular option for a majority of respondents (83.9%) Interest in accessing teledentistry appointments was higher among non-English speakers (OR=2.76, 95% CI [1.19, 6.40]).

Conclusion Patients with low dental care utilization showed high interest in accessing integrated dental services at a primary care practice that participates in MassHealth’s Accountable Care Organization program, supporting moving forward with pilot initiatives to evaluate implementation strategies.