Here's how Michigan providers are improving whole-body health by integrating dental and primary care

By Estelle Slootmaker


Good dental health is about more than just preventing cavities – and Michigan health care providers are increasingly recognizing that by integrating dental care into their primary care practices.


"Studies have shown long-term that patients with gum disease have more premature births and low birth weight babies and heart disease. Tooth loss is a risk for coronary artery disease and is connected with diabetes. Cardiovascular disease has been linked to periodontal disease," says Dr. Timothy Hill, Cherry Health's director of dental services and interim chief oral health officer. "The reality is dental care is important for whole body health care, not just for the toothache and difficulty eating."



The negative effects of poor oral health extend into all elements of patients' lives. Oral pain and missing teeth may limit people's ability to get or keep a job, do well in school, or interact positively in relationships. And all these effects occur disproportionately in those Michiganders who are already among the state's most vulnerable. According to the 2020 Michigan State Oral Health Plan, 55.3% of Michiganders with household incomes under $20,000 did not visit a dentist in 2014, and Latinx and African-American children have much higher rates of untreated dental caries.


However, Michigan providers including Cherry Health, Grace Health, and HUDA Clinic have introduced integrated oral health models to begin addressing the issue. Here's how they're improving health and reducing disparities from the dental chair.



HUDA: Free dental care for uninsured and underinsured adults


Ten years after establishing its medical clinic, Detroit's HUDA Clinic began offering dental services in 2014, based on the needs of the clinic's client population.


"We decided to integrate dental care into our community health clinic along with our other services to create a one-stop shop for healthcare," says HUDA Clinic executive director, Eman Altairi. "A unified, comprehensive approach helped our patients with their health outcomes. When they come for physical care and realize we offer dental care, that prevents them from waiting (until a dental emergency occurs.)"


HUDA also provides primary care, mental health, podiatry, and ophthalmology services with no copays or fees. Its dental services include cleanings, X-rays, extractions, and restorative fillings. When patients have oral health issues beyond that scope, HUDA refers them to the University of Detroit Mercy School of Dentistry for low-cost treatment. HUDA also helps patients obtain dentures affordably.


"Funding is an issue, but we are always looking for ways to broaden opportunities for our clients," Altairi says.


While some of HUDA's hygienists are paid, all its dentists are volunteers. All funding comes from donations and grants.


"When it comes to oral health issues … pain might lead to neglect of other health issues. Oral health, a lot of times, is neglected till the last possible moment, when there's excruciating pain," Altairi says. "Emergency dental care is important, but we also educate patients about their oral health. Dental care is very hard to access in an underserved community."


Clinicians provide nutritional advice to dental patients and invite them to take fresh vegetables from the clinic's community garden.


"We don't know if they will come again, so we make the most out of their visit as far as oral health education," Altairi says.


HUDA hopes to include dental health as part of its outreach to children at local schools and is seeking more dental professionals to volunteer with the program.




This article is part of State of Health, a series examining integrated care and its potential to improve Michiganders' health. It is made possible with funding from the Michigan Health Endowment Fund.


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