Designing and incorporating integrated oral health care pathways for pediatric and adult patients: touchpoints in a dental setting

Background

Maintenance of oral health, prevention, and health promotion stand as primary competencies for dental graduates. Consequently, it is necessary to promote such an approach in dental schools, which are traditionally focused on treatment, to improve the attitude and practice of students in the field of prevention, the final result of which is the reduction of oral and dental diseases in patients. The study aimed to design Integrated Oral Health Care Pathways (IOHCPs) for adults and children referred to Tehran University of Medical Sciences (TUMS), School of Dentistry.

Methods

The study was carried out in the clinical departments of the School of Dentistry during 2022–2023. The design process involved utilizing the NHS dental care pathway template and developing the initial model for the IOHCPs. Qualitative methods, including semi-structured interviews with adult patients, parents of pediatric patients, and selected members of the interdisciplinary team (including researchers, experts, and policymakers), were employed to assess existing conditions, needs, and available facilities. The Delphi method was utilized to finalize the care pathway.

Results

Four Integrated Oral Health Care Pathways were formulated, covering dental caries, periodontal diseases, pre-cancerous lesions, and TMJ problems for adults, along with one IOHCP addressing dental caries for children aged 6 years and older, referred to the School of Dentistry. The design of these integrated care pathways was based on the primary prevention of oral diseases. Details, including risk assessment, follow-up times, related home care, and preventive interventions that should be conducted by dental students, were included in the care pathways.

Conclusions

This study focused on designing care pathways based on primary prevention for child and adult patients in dental settings, aiming to enhance patients' oral health by integrating prevention with treatment. The care pathways, designed according to the needs and facilities of the School of Dentistry of Tehran University of Medical Sciences, allow for continuous monitoring of the patients' oral health status and can be considered as a suitable initial model for other educational centers.