Overcoming challenges to integration of oral health into geriatric primary care

The Age-Friendly Health System movement has been a unifying factor in caring for older adults at the University of Utah Health. Despite progress, challenges to efficient healthcare collaboration exist, particularly between geriatric primary care and oral health. This manuscript presents four of those challenges (lack of communication between medical and dental providers, the distance between medical and dental services, patient discomfort with the inclusion of oral health in primary health care, and provider discomfort in requesting oral health information in medical encounters) with the solutions derived at the University of Utah Health. Leaders at University of Utah Health developed five interventions to address these challenges (participation in the development of EPIC Wisdom©, a fully integrated oral health record in the electronic health record (EHR), co-location in new centers and oral health consultation in existing centers, implementing a geriatric health assessment that included oral health, widespread adoption of the 4 Ms framework). Applying the lessons learned from these challenges can benefit all older adults and may help prevent the conditions associated with periodontal disease.