Making Connections: How a Community Clinic Is Integrating Dental and Overall Care

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March 13, 2024

A Federally Qualified Health Center (FQHC) in southern California noticed an alarming statistic last year: Only about 22% of their pediatric medical patients were also going to their dental department. 

“We really wanted to promote the one-stop-shop, under-one-roof, collaborative care with the medical providers and really dig into why they weren’t seeking dental care at all or . . . were going elsewhere,” says Rebecca Cornille, DDS, the chief dental officer at Vista Community Clinic (VCC). 

The FQHC had hired an integration coordinator for patients with diabetes in 2021, and Cornille, along with project manager Rajni Lopez, says that inspired the idea of hiring an integration coordinator for their pediatric patients. 

“What we were looking for is someone acting somewhat behind the scenes of the actual direct care team to make the connections between these parts of the body — from the medical care to the dental care,” Cornille says. 

dental hygienist looks inside child's mouth
 A dental hygienist at Vista Community Clinic cleans child's teeth

The organization didn’t have the budget for the position, so VCC applied for — and received — a $125,000 CareQuest Institute of Oral Health grant as part of the Institute’s Community and Care Transformation initiative.

“I think it’s a great partnership,” says Rajni Lopez, the project manager of VCC. “It’s great to have an organization like CareQuest Institute who is willing to fund programs like this that are innovative.” 

The Benefits of an Integration Coordinator 

The pediatric integration coordinator started in December and benefited from the integration structure — built around diabetes — that was already in place at the organization. Cornille says when it comes to treating patients who have diabetes, medical physicians are often busy managing the condition, and they may give an optometry referral to rule out diabetic retinopathy. 

“But dental — that piece was just missing,” she says. 

Diabetes can increase a person’s risk of developing periodontal (gum) disease by 86%, and it is more severe than for people without diabetes. So VCC members were challenged to figure out how to make sure patients who were diagnosed with diabetes were also getting the oral health care they needed. 

“What I’ve learned in health centers is that everybody’s working at their maximum capacity, and if you add another thing to their list, you can get a lot of pushback and folks can border the line of burnout,” Cornille says. “The [integration coordinator] can act as the facilitator to get those appointments scheduled and reach out to those patients as another layer of the care team.”

Patients have already experienced the benefits from that extra layer of care, as evidenced by several testimonials the organization has received. 

“I have been going to VCC for regular checkups,” reads one testimonial. “I have prediabetes, and thanks to my VCC provider, [I’ve] been able to keep my blood sugar levels low. Today when I came in, I met Maria, diabetes patient navigator, and she educated me on the importance of dental checkups for diabetic patients. I was hesitant at first because I have had bad experiences with another dentist. With Maria’s encouragement, I agreed to be seen by a VCC dentist at VCC, and I’m glad I did, because I had a great experience.” 

Child in dental chair gets his teeth examined by dental hygienist
A child gets teeth examined by dental hygienist at Vista Community Clinic

Helping the Community Through Care

 At VCC, most of the patients are on Medicaid. 

“I think more than 60% of our patients are female. A lot of our patients are Hispanic or Latino — some only speak Spanish,” Lopez says. “We also have a large group, about 15% or so, that are either migrant farm workers or homeless. And about a third of our patients are children.” 

Both Cornille and Lopez say that even though it has only been a few months, the new pediatric integration coordinator, Juan C. Lopez, is already making connections between patients’ oral and overall health. 

“I am happy to be a part of a team that is willing to help out families that aren’t aware there are services to assist them and help get the coverage they need,” he says. 

Dental hygienist gives gift to patient
 A dental hygienist at Vista Community Clinic gives a child a gift after his cleaning

“Now we’re able to target those pediatric patients with [Juan], who physically is embedded in the pediatric department and can talk with the parents, provide education, and facilitate warm handoffs,” Cornille says. “I think last week or the week before, we had about 45 kids that he was able to coordinate right into dental, which is amazing. And that’s probably 45 kids that wouldn’t have made it otherwise.”

As for the long-term plan for the integration coordinator, Cornille says she’s hopeful it proves to be a financially sustainable and recognized position within the care team. 

In the meantime, she says she’s appreciative of CareQuest Institute providing that sustainability with their grant. 

“This is the first time that that we’ve been funded through CareQuest Institute, and it has been amazing because our work was great, but it was struggling without the financial backing,” Cornille says. “It has really been able to help us move the needle forward on our objectives.”

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