Increasing Access to Care By Way of An Interprofessional Dental Hygiene/Physician Assistant Curriculum

Shepherd, Kathi, Michelle Wheater, and Suzanne York

The State of Michigan 2010 Oral Health Plan states a 63% reduction in decay if fluoride varnish is applied when teeth first erupt and applied four times a year. As part of the Plan, the Michigan Department of Community Health encourages medical professionals to perform oral screenings and apply fluoride varnish to high risk 0-2 year olds and connect them to a dental home. In order to address this recommendation, the University of Detroit Mercy (UDM) School of Dentistry and the UDM Physician Assistant (PA) Program have developed an interprofessional dental hygiene/physician assistant curriculum. Objectives of the program are to prepare PA students to 1) gain knowledge of their role in assessing oral health of children and 2) apply fluoride varnish as a preventive tooth decay measure. A nine item pre test survey completed by a convenience sample of 34 first year physician assistant students (approval as an exempt study was obtained from the University of Detroit Mercy IRB prior to administration of the survey-IRB Protocol #1011-03) revealed that while 97% perceived referral of pediatric patients to dentists was their responsibility, 52.9% were not aware of their role in oral health assessment and prevention. 88.23% of the students felt instruction on performing an oral health assessment should be in their curriculum. Based on these results as well as other data obtained, a 90 minute lecture on the role of the physician assistant in performing an oral health assessment was provided by a dental faculty member. Physician assistant students also completed an online module addressing infant oral health and fluoride varnish application intended for medical professionals developed by the Michigan Department of Community Health. A fluoride varnish application instructional classroom session followed by a clinical session utilizing second year dental hygiene students as peer instructors was also provided for the PA students in October 2010. To ascertain perceptions and comfort level with fluoride varnish application upon completion of all instruction, a post test survey was conducted.  97% percent of the students indicated they were aware of the role of the PA’s responsibility in oral health assessment  and 94.1 %  felt that this instruction should be included in their curriculum. One hundred percent of participants felt they were either very comfortable (91.1%) or somewhat comfortable (8.9%) applying fluoride varnish upon completion of the curriculum. Program outcomes demonstrate an indication for a viable, sustainable program to be implemented each year. It is recommended that a future phase of the program include coordination of interprofessional delivery of care on patients in community outreach settings.