P0786 - Better Together: Enhancing resident education with interprofessional oral health partnerships

Background: Since 2003, the American Academy of Pediatrics (AAP) has developed a policy to support pediatric oral health practices which prioritize fluoride varnish application for caries prevention (2014) and oral health risk assessments in the pediatric medical setting (2015). Although AAP has provided a dense set of resources, pediatric resident physicians receive limited oral health practices training during their education. Systemic oral health connections are rarely discussed, which hinders resident physicians’ comfort to address oral health-related cases in practice. On many medical campuses, the relationship between medical and dental providers are under-utilized even though this partnership can improve patients’ access to care. The purpose of this study was to explore interprofessional oral health practices, improve pediatric resident physicians’ knowledge, and increase comfort to deliver oral health preventive services through the novel development of skills-based efficacy training.

Methods: Core quality improvement principles were used to systematically improve interprofessional oral health practices among pediatric resident physicians. An interprofessional team of pediatric residents and attendings, oral health and public health researchers, and pediatric dental providers was established. The team developed a longitudinal skills-based efficacy training for pediatric resident physicians including: categorical, primary care, combined medicine-pediatrics, and child neurology. Pediatric dental residents and attendings led didactic and skills training sessions during designated education times. The training focused on core areas such as: fluoride varnish application, dental emergencies, dental referral management techniques, and policy development. Pre- and post- training surveys were given to pediatric resident physicians (n=35). Data was compiled and simple descriptive analyses were run using SAS (version 9.4). Open-ended questions were analyzed for thematic analysis.

Results: Thirty-five pediatric resident physicians participated with each year of the residency program represented. After completing the oral health skills training, 95% of residents indicated oral health practice to be important and only 22% of residents were not comfortable providing oral health practices. Additionally, 20% more residents believed pediatricians should be responsible for oral health risk assessments. Over half of the residents were unfamiliar with oral health services in resident clinic, and all residents found the skills-based training to be useful. Future topic suggestions were dental care for cardiac patients, integrating oral health risk assessment in routine visits, and defining “good” oral health for caregivers.

Conclusion: Pediatric resident physicians are interested in prioritizing oral health for their patients and desire to be more comfortable delivering preventive oral health services. Pediatric resident physician programs should adopt interprofessional oral health skills-based training to support resident competencies, which can reduce barriers in their future practice. Future interventions should incorporate formal inclusion of skills-based training for oral health integration within physician resident programs and clinical protocols to reinforce skills and applied knowledge of interprofessional oral health practices.