Keys to Collaborative diagnosis in the Dental Wellness Center

The line separating dentistry and medicine is beginning to blur. As the evidence of crossover between medical and dental conditions continues to emerge, collaboration of the communities will change the way both types of providers diagnose, treat and evaluate outcomes of patients. In the ADA’s opinion it is the dental community’s responsibility to lead the way in bridging the disciplines. Subsequently more and more dental teams are adopting the role of Wellness Center in order to provide the type of comprehensive service patients’ need, while using models of care that their colleagues in the medical community recognize.

Why collaborate?

Just as the mouth is not separate from the body, oral disease is not independent of systemic health issues. Dental professionals cannot treat part of a person without knowing what is going on with the whole body, and medical doctors need to know of a patient’s oral disease in order to do the same.  Successful collaboration relies on communication between the medical practitioner and the dental provider; relaying information regarding a patient’s health history, diet, medications and current disease management protocols. Cooperative diagnosis requires both communities to be knowledgeable regarding the oral-systemic link and actively engaged with one another during the treatment process.

How to collaborate successfuly

Electronic Health Records are emerging as “the bridge between medicine and dentistry.”  Currently oral surgeons are leading the way in this endeavor. EHR helps the practitioner “manage data, streamline patients’ visits and communicate with referring doctors.”[i] If EHR is not in part of the wellness center, utilizing a simple medical evaluation request form in office is a start.  Additionally, actively seek partners in the medical field, as well as educate patients on the importance of reporting oral disease on medical forms.

Wellness Center providers must also be trained in billing medical insurance by identifying the medical necessity of procedures or treatments.

Diagnostic tools

Diagnostic tools in the wellness center play a vital role in the process of cooperative diagnosis and treatment. The following are diagnostic tools that can and should be utilized in a wellness center:

• Saliva Testing
• CT Scans
• Oral cancer screening 
• Oral DNA testing

Saliva testing is currently being used in many states as part of key diagnostics for patient pharmaceutical compliance, substance abuse and disease monitoring. Some EHRs provide space for results within the laboratory sections.  It allows providers to see correlation between drug dosages or treatments. 

CT scans are considered standard as they show as their imaging provides a clear picture to inform clinician’s analysis and treatment recommendations.

Oral cancer screening including a comprehensive risk factor checklist as well as chemiluminescent device provides the most accurate and judicious ways to detect and diagnose oral cancer.

Oral DNA testing helps medical and dental professionals in all healthcare settings and their patients to obtain “precise evidence about periodontal disease and oral HPV, allowing more accurate diagnosis and, in the case of periodontal disease, more effective treatment.”[ii]

Utilizing these diagnostic tools assists the wellness practitioner in correctly diagnosing the patients prior to recommending treatment. Once these tools are adopted in a wellness program dental teams will be able to determine a medical necessity for each patient. The utilization of diagnostic codes on both medical and dental forms streamlines reimbursement.

Benefits:

The benefit of adopting a medical model of diagnosis in the wellness center is demonstrated in the capacity for dentists and medical doctors to use a common approach in the treatment of their patient. This translates into the EHR and will allow both doctors to have the most accurate medical and dental histories, drug profiles and interactions, and laboratory results, thus vastly improving patient safety and treatment effectiveness. It will also provide access to vital information, like how third party carriers reimburse.  Lastly it may positively impact the resale value of the wellness practice.

For more information on becoming a Wellness Center, contact Christine Taxin at www.links2success.biz