Welcome to the IOH Toolkit! The chapters to follow will walk you through the process of integrating oral health into health professions courses and programs at your institution. To get you acclimated, this chapter outlines the reasons for creating this toolkit and some guidelines for its use. You’ll learn about:
Note: The teaching strategies provided in this toolkit have been pilot tested and improved based on evaluative feedback from faculty and students. These resources are intended to assist faculty with integrating oral health into existing health professions curricula. However, this toolkit is not intended to be an exhaustive curriculum on all aspects of oral health.
This toolkit is designed to help faculty and administrators at schools and academic health centers advance IPE through the integration of basic oral health competencies into courses and programs across the health professions. This curricular innovation has two aims:
Health professions educators who want to advance IPE will find that oral health integration programs offer students from across the health professions an overlooked opportunity to learn about interprofessional collaborative care. The connections between oral and overall health suggest a wide range of opportunities for this kind of collaboration.
This toolkit will be useful for oral health and IPE advocates interested in integrating oral health in other health professions curricula at the course, program, or institutional level.
Faculty champions. If you are an individual or group of individuals looking to start the ball rolling, you’ll find resources here to help you implement classroom-level changes that can link oral health to:
Program pioneers. If you are interested in making program-level changes at your institution, this toolkit has what you need. You can choose from a variety of programming options.
Each of these options stands on its own so you can pick and choose the topics and formats that fit your programming requirements.
System-wide change agents. If you are looking to make institutional-level changes that integrate oral health competencies across health professions programs, this toolkit will be of use to you from the first step to the last. From raising awareness and assessing your institution’s readiness, to training faculty and educating students, chapters will walk you through the process, giving you valuable tools for turning your vision into a reality.
The mouth resides in the body, and the two interact in myriad ways, yet a separation has persisted between professions that provide care for the body and professions that provide care for the mouth. Oral health integration ensures that primary care and dental providers work as a team to deliver integrated care that recognizes both the oral and the systemic needs of their patients.
From an educational perspective, oral health integration refers to the inclusion of oral health competencies in the curricula of other health professions. Why does this matter? Tooth decay is the most prevalent chronic disease in U.S. children and adults even though it is largely preventable. Further, oral health concerns disproportionately affect vulnerable and underserved communities. Equipping all health professionals with basic oral health competencies will reduce oral disease and promote health equity.
This toolkit advances IPE through programming and activities that:
Unlike programs designed for specific professions, settings, or populations, the IOH Toolkit has broad application. Whether you are an individual faculty member who wants to add an oral health dimension to your courses or an administrator seeking ways to embed IPE throughout the health professions curricula, this toolkit has resources you can use. It offers both high-level guidance and detailed step-by-step instructions for all phases of the integration process.
The IOH Toolkit also differs from other oral health toolkits in its flexibility. It includes activities for both entry-level and more advanced students and curricular modules suited to a range of settings and pedagogical approaches.
Chapters in this toolkit are based on the successful implementation of the Innovations in Oral Health (IOH) program at Northeastern University’s Bouvé College of Health Sciences. You’ll find step-by-step instructions, comprehensive lesson plans, and sample forms, worksheets, and assessments to help you create your own plan and put it into action.
At the launch of the IOH Program in 2013, organizers convened an Oral Health Summit where over 125 health professionals, funders, policymakers, faculty, students, and community leaders from across New England gathered to address systems change for improving oral health. Their collective wisdom was distilled into a core set of guiding principles that influenced the development of program activities and initiatives. Those principles included:
These principles, combined with the DentaQuest Foundation’s Oral Health 2020 vision to “improve lifelong oral health and eradicate dental disease in children,” served as common ground from which to advance interprofessional education and practice across health professions and promote medical-dental collaboration.
In the two years that followed, educators at the Bouvé College of Health Sciences implemented a series of programs and activities aimed at integrating oral health throughout the curricula within their college. The IOH Toolkit is the culmination of these initiatives. It provides a roadmap for engaging all health care providers in oral health surveillance and strengthening educational resources to support oral health integration across the health professions.
This toolkit promotes a team-based approach to care that brings together students from multiple health professions to learn from and about one another’s roles and responsibilities while also learning to improve oral health across the lifespan. Educators will find a variety of teaching strategies, including online, simulation, case-based, and service learning as well as cooperative education. Where appropriate, these strategies are accompanied by ready-to-use instructor’s guides focused on diverse aspects of oral health integration.
The IOH Toolkit relies on the third edition of Smiles for Life: A National Oral Health Curriculum as a curricular foundation for its educational programming. The combined elements of flexibility, low cost, and accessibility make this online educational platform a powerful tool. But online programming alone cannot provide the interactive clinical and team-based experiences that characterize the best IPE. As a remedy, this toolkit uses a blended approach, incorporating online materials from Smiles for Life into classroom and clinical settings. In this way, students and faculty can reap the advantages of online education without missing out on the benefits of face-to-face, hands-on learning.
The Smiles for Life online curriculum undergirds programming described in the following toolkit chapters: Faculty Development, Simulation Learning, and Interprofessional Case-Based Learning.
Background. The Society of Teachers of Family Medicine Oral Health Group created the Smiles for Life curriculum to develop oral health competency in primary care professionals and faculty. This widely respected online program equips practicing health professionals with the skills they need to:
These competencies align with the Interprofessional Education Collaborative and the core competencies developed by HRSA as part of its 2014 Integration of Oral Health and Primary Care Practice initiative.
To learn more, see this Framework for Competency Development in Oral Health.
Content. Smiles for Life consists of eight self-paced online courses that cover oral health across the lifespan. Educators can access downloadable modules that include the course slides along with presenter notes, companion videos, an implementation guide, learning objectives, test questions, and a resource list.
Course 1. The Relationship of Oral to Systemic Health
Course 2. Child Oral Health
Course 3. Adult Oral Health
Course 4. Acute Dental Problems
Course 5. Oral Health and the Pregnant Patient
Course 6. Caries Risk Assessment, Fluoride Varnish and Counseling
Course 7. The Oral Examination
Course 8. Geriatric Oral Health
Access. Smiles for Life is available online and may be used free of charge. Faculty interested in completing Smiles for Life courses should register as individual clinicians.
Note: Registration is not required to view the courses, but it is required to receive continuing education credits. Those who wish to train others and download resources for classroom use must register as educators to gain full access to instructor materials.
Endorsements. Seventeen organizations have endorsed Smiles for Life, including:
Sustainability matters if you want to create lasting change. Without a sustainability plan, the programming you put in place and the outcomes you achieve could disappear over time. To make sure that doesn’t happen, you’ll need to think about how to sustain your changes, big and small, before they occur.
A systems approach to change is the best way to develop a plan that sticks. This means you should embed your program into the existing systems at your institution, so it will have the support and resources needed to remain in place over time.
A systems approach dictates that you consider multiple factors when you develop new programming.
Costs.
Environmental support.
Organizational capacity.
Partnerships.
Communication.
Evaluation.
Adaptation.
The extent of your oral health integration efforts will determine which of these factors to consider. Change at the program or institutional level can be challenging and involve all of these considerations, while integrating oral health into a single course may only require the support of one or two faculty members and incur few if any costs.
Specific challenges to your plan will depend on:
Note: In some states, regulations regarding the placement of fluoride varnish may also complicate the implementation of certain activities in this toolkit.
This toolkit devotes three chapters to issues directly related to sustainability.
These chapters will walk you through the steps of preparing your institution for a long-term commitment to oral health integration.
In addition, the toolkit’s curriculum-focused chapters employ teaching strategies that have been tested, implemented, and evaluated to provide a strong foundation on which to build a sustainable oral health integration effort. Evaluation results show each strategy achieves the intended lesson objectives and produces an overall increase in student knowledge, skills, and (where applicable) attitudes.
To ensure effective programming at your institution, you should continue the evaluation process. Encourage all faculty to seek feedback from students and colleagues to determine if modifications are necessary based on the needs at your institution.
Forms for evaluating programming are included in the appropriate chapters of this toolkit.
Throughout the toolkit, you will find links to additional resources intended to aid you in implementing various activities. These include:
Additionally, many government agencies, professional organizations, academic institutions, and independent entities have created a range of materials on oral health and IPE that can enhance your efforts.
Over the past two decades, several landmark reports have sparked a national conversation about the need to integrate oral health in comprehensive primary care, particularly for vulnerable and underserved populations.
More recently, several documents have articulated a compelling case for oral health integration.
To learn about other available resources and how to access them, see the following list of Web-Based Resources.