Oral Health Initiatives Help PAs Make a Difference for Patients

Join PAs for Oral Health

March 5, 2018

By Eileen Denne, CAE, APR

Denise Rizzolo, PhD, PA-C

Oral health can be a neglected part of overall healthcare for children and adults because it is often taken for granted. The lead PA for AAPA’s special interest group PAs for Oral Health describes why it is important to address this issue.

“Patients should understand that oral health is intricately connected to overall health,” says Denise Rizzolo, PhD, PA-C, Associate Professor, Kean University, in Union, NJ.

Rizzolo has been a PA for almost 18 years and advocates that PAs discuss oral health with their patients. “For starters,” she says, “Oral cancer rates have not shown improvement and we are seeing more cases of HPV positive oral cancer. When we examine the mouth, we often depress the tongue, which conceals the borders. The lateral borders of the tongue are the most common location for oral squamous cell carcinoma and often we can miss early lesions. Additionally, we may believe patients receive oral health information from dental providers, when in fact, they have not seen a dentist in years. It becomes imperative that we not only examine the entire oral cavity but also counsel patients on the oral systemic connection. Patients should understand that oral health is connected to overall health.”

Rizzolo recommends that PAs integrate basic oral health questions into their Electronic Health Records.

“Within my medical record, I personally ask ‘When was the last time you have seen the dentist?’. From there, if I see they have not received recent dental care, I explain the importance of oral health and hygiene. Given the oral systemic link, I spend more time talking to my patients who have chronic diseases, discussing the importance of good oral health.”

AAPA developed the Oral Health Initiative several years ago to increase PA awareness and knowledge about oral health and to provide resources to educate patients. Some questions to consider when incorporating oral health into practice:

  • Are you aware of the link between oral health and systemic disease?
  • Do you understand different oral health concerns throughout the life span?
  • Can you recognize and identify oral lesions that present a risk of cancer or other diseases?
  • Do you incorporate oral health screening into your patient physicals?
  • Did you know that dental caries is the most prevalent childhood disease?

Rizzolo says Smiles for Life has an excellent free curriculum to use as a refresher for all PAs and healthcare providers. In addition, AAPA is a member of the Patient Centered Primary Care Collaborative which includes a National Interprofessional Initiative on Oral Health that has tools for PAs and other providers. The National Oral Health Conference will be held April 16-18, 2018, in Louisville, KY.

AAPA also has a policy regarding oral health: HP-3300.1.5 AAPA encourages all PAs to take an active role in the screening, prevention, management, and referral of patients for oral health disease. [Adopted 2011, reaffirmed 2016].

Rizzolo says she started working with the PAs for Oral Health special interest group because, “At some point, the mouth became disconnected from the body.  Given the time constraints in medicine, it is easy to think that our patients are seeing a dentist regularly and seeking oral care. Oral health is interconnected with overall health. The oral cavity can show signs of systemic illness and many systemic illnesses can be exacerbated by poor oral health.”

The group also has a Facebook page and is open to new members and new ideas. If interested in joining, Rizzolo says PAs can contact her. “We have annual meetings at AAPA’s Annual Conference and we would love to have the support of any PAs who are interested. We welcome anyone that has an interest in oral health to join us!”

Eileen Denne is director of corporate communications for AAPA. Contact her at communications@aapa.org.