Integration of dentists into primary care teams in underserved areas: a qualitative study

Abstract Background Integrating oral health into primary care is increasingly promoted to enhance coordinated, patient-centred care, particularly in underserved areas experiencing workforce shortages. In France, multiprofessional primary care teams organised under the Société Interprofessionnelle de Soins Ambulatoires (SISA) framework aim to strengthen collaboration across professional boundaries. However, dentists’ participation in these structures remains limited. This study examined how dentists’ integration into primary care teams is perceived in underserved territories by comparing the perspectives of dentists and other primary care professionals. Methods We conducted a qualitative study using semi-structured interviews in three French departments in which potential accessibility to dentists was below the national average. Data were collected in two sequential phases: first, interviews with non-dental professionals (2024), followed by interviews with dentists (2025), for whom the interview guide was informed by the themes developed in the first phase. All eligible structures and the professionals working within them were approached. Interviews were audio-recorded, transcribed verbatim in French, and analysed using conventional qualitative content analysis in both phases. Data collection and analysis were conducted concurrently, and sample size was appraised using the concept of information power. Categories were refined through iterative team discussion. Results Eighteen professionals (nine dentists and nine non-dental professionals) participated. Three interrelated dimensions shaped dentists’ integration: (1) organisational arrangements, which were perceived differently across professions and not always conducive to dental participation; (2) divergent professional perceptions regarding dentists’ roles in coordinated care; and (3) structural constraints related to workforce shortages and sustained clinical demand in underserved areas. While non-dental professionals consistently considered dental expertise essential to coordinated care, dentists frequently questioned the practical relevance and feasibility of their involvement. Formal coordination tools were often described as focused on medical priorities, leaving limited space for oral health. Structural overload further constrained dentists’ capacity to engage in multidisciplinary activities. Conclusions In underserved territories, limited dental participation in primary care teams appears to be driven less by a lack of interest and more by structural constraints, organisational misalignment, and differing professional perceptions. Policies aiming to strengthen the integration of oral health into primary care should address workforce pressures, adapt coordination mechanisms to dental practice, and reinforce interprofessional training. These findings contribute to a better understanding of how primary care workforce and system factors shape the integration of oral health within coordinated care models.