Dominiquea Rosario sees a dentist regularly for debilitating jaw pain, but at her last two dental appointments at Virginia Commonwealth University she also saw a nurse practitioner who checked her blood sugar and blood pressure.
In a new practice model, dentists and nurse practitioners at VCU are teaming up to see patients together, with goals of increasing access to care, better understanding the connection between oral health issues and disease elsewhere in the body and lowering health care costs.
“It’s a new model … so that you can have sort of one-stop shopping,” said Nancy Langston, professor and dean of the VCU School of Nursing.
“Dentistry has always been about health promotion and disease prevention. Nurse practitioners have been about early recognition, risk reduction and health promotion. We are putting them in the same environment to see if we can truly matter in reducing risk and increasing health promotion,” Langston said.
The new VCU Neighborhood Partners Practice is being provided primarily to patients enrolled in VCU’s Virginia Premier Health Plan, a managed care plan for Medicaid enrollees.
The combined practice is located in the oral medicine suite in the Wood Memorial Building on the MCV campus.
“We’ve found when we have been looking at the literature that a lot of patients who visit the dentist haven’t seen a primary care provider in about three or four years,” explained nurse practitioner Judith Parker-Falzoi.
“There are a lot of chronic health problems that come up in the course of a dental exam that can impede the progression of their dental treatment plan,” she said.
The combined practice project is modeled after a New York University partnership in which dentists and nurse practitioners work together. VCU nursing professor Debra Lyon, chairwoman of VCU’s Department of Family and Community Health Nursing, is overseeing the VCU project.
The dental visit is the entry point.
“We are using the well-established, prevention-oriented delivery system of dentistry to see if we can harness that to apply to other disease,” said David C. Sarrett, dean of the VCU School of Dentistry. “So that patients who are coming for dental care, and if they also have other chronic issues, we can encourage them or facilitate them to pay some attention to those other things.”
At Rosario’s visit to the combined practice Tuesday, she saw dentist Bhavik Desai, an assistant professor of oral medicine and temporomandibular joint disorder, about the jaw pain and then went down the hall to see Parker-Falzoi, the nurse practitioner.
Parker-Falzoi checked her overall health, Rosario said. One item that did get red-flagged this time was her fasting blood glucose level. It came back a little high.
“I didn’t know I might have diabetes,” Rosario said later. “I had gestational diabetes a couple of years back when I was pregnant with my son,” said Rosario, whose children are ages 2, 3 and 4.
“And I was feeling … where I was craving salt, a lot of water and using the bathroom a lot.”
Rosario is scheduled for a follow-up visit with her regular primary care doctor next week.
Langston said the combined practice also promotes a more holistic look at health in training.
“Another piece of this is teaching nurses to do better assessments of the oral cavity and teaching our dental students and future practitioners to look more holistically at the human being in their chair and not just the mouth. So we will be doing some cross education,” she said.
Source: Times Dispatch