Integrating Dental Hygienists into Medical Care Teams: Practitioner and patient perspectives

Purpose: The Colorado Medical Dental Integration (MDI) project explored ways to leverage medical visits with the goal of expanding access to dental services through the integration of dental hygienists (DH) into medical practices. The purpose of this study was to explore the perceptions of DH and patient participants in the MDI project. Methods: A concurrent, mixed-methods approach was used. Qualitative key informant interviews were conducted with MDI DHs. A quantitative survey was administered to patient-participants who had received MDI care 18-24 months into the practices’ participation in the project. Interviews explored DH’s perceptions of working as an integrated DH, factors impacting MDI implementation, the level-of-Integration into the medical team, and how ways to access to dental services were expanded through the MDI. Interviews were recorded, transcribed, and analyzed for recurring themes using an iterative process. A patient-participant survey, available in English and Spanish, assessed perceptions regarding MDI care. Descriptive statistics were used to analyze the data. Results: A total of 17 dental hygienists, across 15 MDI practices, agreed to participate. Generally, participants endorsed working in MDI practices and identified factors that were facilitators and barriers to MDI care. A total of 390 patients were surveyed for a response rate of 33%; one half (52%) had attended > 1 MDI visit. Most (95%) were extremely satisfied with MDI care and very few barriers to MDI care were reported. Conclusions: Integrating dental hygienists into medical practices was generally endorsed by both the DHs and patient-participants. Dental hygienists reported various challenges to the MDI approach, however most were surmountable.