Environmental Scan of Oral Health

This resource is an environmental scan on emerging models of behavioral and oral health integration, as well as an overview of barriers and facilitators to adopting coordinated or integrated care models.

In the past decade, the health care delivery system in the United States has moved toward an increased focus on value, most often defined as health outcomes achieved per dollar spent. Unfortunately, oral health has largely been left out of the value equation. The American public, policymakers and providers tend to view oral health as separate from general health, even though oral health is a key contributor to overall health and well-being. Further, there has been less focus on the specific connections between oral health and behavioral health — which includes both mental health conditions and substance use disorders — even though the two are very closely related. Health policy experts have also projected that the coronavirus pandemic will contribute to a significant increase in the number of individuals with behavioral health conditions due to increased rates of unemployment, depression, grief, anxiety, domestic violence and/or substance use.

Lack of access to oral health has been amplified due to coronavirus; at times during the pandemic, dental care has only been available for urgent and emergency care. At the same time, significant oral health disparities exist for many racial and ethnic groups, in part because access to oral health is often determined by socioeconomic status and geographic location. Dentists also frequently treat patients who have experienced trauma, such as child sexual abuse or domestic violence, which can interfere with delivery of oral health services, including preventive care. Models of care that are coordinated and integrated can more effectively account for patients’ past experiences and conditions, and have the potential to reduce costs, improve outcomes and improve patients’ access to and experience of care.