Status of Oral Health Training in U.S. Primary Care Programs: A Qualitative Study to Define Characteristics and Outcomes.

With increasing recognition of the important relationship between oral and systemic health, non-dental health professions schools and programs are now teaching their students about oral health in various ways. This study built on surveys of medical schools, primary care residency and fellowship programs, and other health professions programs conducted by the authors in 2017, which found some had made significant progress in integrating oral health into primary care training, while others lagged behind. The aim of the current study was to better understand the characteristics and climate of oral health education in non-dental health professions schools by conducting interviews with leaders of programs who had self-identified in the surveys as having a robust oral health curriculum. Hour-long interviews were conducted between October 2017 and March 2018 with 31 program directors or deans of medical specialty and allied health professions programs using a semi-structured interview guide. These interviewees were from 13 health disciplines. The coding of interview transcripts identified seven major themes: motivations to develop an oral health curriculum; rationale for curriculum topics covered; best aspects of the curriculum; evaluation and assessment strategies; relationships with dental providers and residents and dental hygienists; barriers and challenges; and advice and lessons learned. The interviewees reported a strong belief that oral health is an important health topic. Key elements that interviewees identified as helping them build robust oral health programs in their primary care curricula were the following: having an oral health champion; having some funding; building relationships with dental professionals; using local, state, and national resources; using curricular materials from existing sources; incorporating skills-based sessions; taking an IPE approach; and making oral health part of what the program already does. These findings should be useful for primary care schools and programs that are beginning to add oral health to their curricula and those seeking to improve their existing oral health education for their students.