Can physician assistants help address oral health needs?

2018 05 23 18 22 3051 Doctor Woman Girl Child 400

More than 60 million people live in areas of the U.S. with limited or no access to dental care. Seeking to address this issue, an organization of physician assistants (PA) began a program in 2010 to promote oral health in PA education and practice.

The American Association of Physician Assistants (AAPA) found that strides had been made in incorporating oral healthcare into PA education and practice in the first six years of the program, and researchers reported the results in a poster presentation at the organization's 2018 annual meeting in New Orleans.

"[Physician assistants] and PA students are increasingly integrating recognized oral health competencies, knowledge, and skills," noted Denise Rizzolo, PhD, PA-C, and co-authors. Rizzolo is on the faculty at the Kean University School of Nursing in Union, NJ.

Improving access

Recognizing a crisis in oral healthcare access, the AAPA started the PA Leadership Initiative in Oral Health in 2010. The ongoing program brings together physician assistants, organizations, and interprofessional champions to promote oral health in PA education and practice.

“Efforts to integrate oral health into PA curriculum are working.”
— Denise Rizzolo, PhD, PA-C, and colleagues

For their AAPA 2018 presentation, the researchers collected qualitative and quantitative measures over a six-year span from 2010 to 2015. Physician assistant educators, clinicians, and students have worked with those who set accreditation and certification standards to develop strategies, including tools and workshops, to build oral health competencies.

In the first six years of the initiative, more than 500 PAs participated, the researchers reported (there are more than 123,000 certified PAs in the U.S., according to the poster). The percentage of PA academic programs providing instruction in oral healthcare to their students had more than doubled from 33% in 2008 (83 programs) to 78% in 2014 (125 programs).

"Efforts to integrate oral health into PA curriculum are working and educating a new generation of providers to view oral health as an integral part of health," the researchers wrote.

They also found that overall almost a third (32%) of practicing PAs reported encountering oral disorders weekly in 2015. PAs in emergency departments see more oral disorders than those who practice in a hospital setting, as the table below shows.

Setting and percentage of PAs who see oral disorders weekly
Practice setting Percentage of PAs
Hospital medicine 32%
Internal medicine 38%
Family medicine 42%
Pediatrics 71%
Emergency medicine 75%

While the data suggest strides are being made by PAs toward improving oral health in the patients they serve, there is still room for improvement, the researchers noted.

"Such efforts are essential to maintain existing gains and foster continued integration as the number of educational programs and certified PAs grows," they wrote.

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