A community dental health coordinator program in an FQHC improved diabetes control for rural patients with uncontrolled type 2 diabetes.

Background

Diabetes is a significant risk factor for periodontal (gum) disease, which in turn may contribute to uncontrolled diabetes and poor disease management. Coordinated care between medical and dental providers is important to support individuals who have or are at risk of developing diabetes. This study evaluated a community health dental coordinator program at a New Jersey federally qualified health center, which provided community-based prevention, care coordination, education, and patient navigation. The program targeted rural adults with uncontrolled type 2 diabetes and assessed outcomes including hemoglobin A1c (HbA1c) levels and participation in dental care.

Findings

The program enrolled 154 patients with uncontrolled diabetes; 103 (66%) participated in dental care and 37 (24%) completed periodontal treatment. Among those completing treatment, 46% improved A1C levels, with an average reduction of 1.8, and 40% moved from uncontrolled to controlled diabetes. Among all patients with follow-up A1C measures, 70% showed improvement regardless of dental treatment participation. Compared to non-participating sites, a higher proportion of patients improved A1C levels and achieved diabetes control. Additional outcomes of the program included increased referrals to the health center’s pharmacists and nutritionists, as well as reduced no-show rates for appointments.

Program/Policy Takeaways

Providing dedicated staff and services to promote oral health care amongst individuals with type 2 diabetes can improve disease management and reduce associated risk factors. Health care organizations and providers can use insights from this program to support connections to oral health services for their patients, which can increase follow-up, reduce barriers, and improve overall disease management.