Why Cooperation Between Departments is Good News for You

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We get it: remembering school picture day and when to get an oil change is hard enough. Regular doctor and dental visits on top of that feels impossible. But these visits are crucial for patients of all ages. Fortunately, San Fernando Community Health Center’s doctors, nurses, and dentists are now working together to help you and everyone in your family.

Doctors + Dentists: Better Together

The advantages of mingling medical and dental services may seem intuitive. But San Fernando’s Chief Dental Officer, Dr. Antonio Alfonso says only “in the last few years…there’s been a lot of attention given to this whole medical-dental integration. A lot of studies are ongoing to further that because it’s still fairly new.” It’s a trend he’s “one thousand percent” behind, pointing out that referrals between departments lead to more preventive care. And more preventive care results in fewer emergency visits.

Dr. Anastasia Williams, San Fernando’s Medical Director of Pediatrics, elaborates that preventive care is easier for patients when they’re comfortable with their provider. Starting that relationship early is an important step, but it can be difficult for busy families. “Getting in to see the dentist every six months starting at age one is what we at the American Academy of Pediatrics recommend…But asking families to do that in addition to the one-year-old checkup, fifteen-month checkup, eighteen-month checkup, two-year-old checkup, and three-year-old checkup – it’s a lot.” 

When medical and dental providers make sure patients receive each type of service, it results in better preventive care. Each department can affirm the other’s recommendations. For example, a pediatrician will advise against letting babies sleep with a bottle to avoid tooth decay. When a pediatric dentist reiterates that same advice, parents are more likely to listen. Public school enrollment requires regular checkups to help ensure preventive care for children. But integrating dental checkup requirements into these visits, Dr. Williams says, would lower the number of children, often poor and underserved, who still get missed.

Why Care Providers Worry

It may seem hard to believe, but even today, even with all we know, people still don’t get enough preventive care. Far too many patients end up in the emergency room with conditions that could have been prevented if they’d been caught earlier:

• Diabetics should see their dentist regularly because they’re three times more likely to develop gum disease. 
• Regular dental visits can reveal damaged teeth from an amphetamine addiction. 

Unfortunately, many poor and underserved people have never been to a health clinic at all.

Aura Veliz, a women’s health nurse practitioner at San Fernando, says many women don’t see a regular doctor enough—or ever—until they become pregnant. Early and regular medical and dental visits are important for both new moms and their babies. 

• If a woman develops diabetes, her children are more likely to as well.
• Diabetes, poor cardiac health, and gingivitis are all conditions that can pass harmful bacteria to a growing fetus or a newborn through nursing.
• Gingivitis bacteria can increase a hormone that causes premature contractions and potentially preterm labor. This is important especially for the Hispanic community, where Veliz says flossing is less common.

Veliz remembers one young woman who hadn’t had a physical exam since childhood. When the woman came for her first prenatal exam, she was found to have advanced thyroid cancer.

Veliz says that first prenatal exam can reveal everything from hypertension and diabetes to behavioral health issues and undiagnosed STDs: “Prenatal care is almost like opening the door to their overall wellbeing.” So how can that door be opened earlier? 

Working As a Team

The care providers at San Fernando now ask patients about dental services as part of their medical history. Next, they educate patients, filling in the gaps in their understanding about these services. Dr. Williams and her team encourage proper use of fluoride toothpaste early and recommend dental fluoride treatments as early as one year old. Veliz finds that many pregnant women are afraid to get dental x-rays out of concern for the baby, especially in the Hispanic community. She promotes dental checkups in the first trimester and assures future moms that wearing a lead apron during x-rays protects the fetus.

If necessary, patients can be referred to San Fernando’s dental department – in the very same building! Dr. Alfonso says this is hugely helpful in increasing preventive care. He continues that many health centers, hospitals, and dental service organizations (Western Dental, for example) are also merging departments into single buildings to make access easier for their patients. San Fernando’s dental office then follows up with patients about their referrals. In this way they provide backup for the primary provider and make sure those patients are seen. “It helps us to affirm one another,” Dr. Williams raves, “and it helps the patients and the families stay on schedule. It’s been awesome.”

San Fernando is also creating a new position, to be called an Oral Health Coordinator or Patient Navigator, to coordinate patient referrals between departments and keep patient documents up to date. They’ll also be available to answer patient questions. The health records themselves are being modified to help providers know which questions each patient should be asked. San Fernando is also active in California’s Comprehensive Perinatal Services Program. The CPSP provides access to all areas of care for future and new moms.

San Fernando’s departments joining forces has already received a positive reaction from all sides. “We know that people are responding,” reports Dr. Alfonso, “they’re taking on our recommendations.” Dr. Williams agrees: “My patients that get their dental care here are very happy. They’re really doing a great job.”