"Learning about the integration of primary care and dentistry in our dental school setting has been an unparalleled experience. Seeing patients who have previously undiagnosed chronic conditions receive the medical attention they need sheds light on how important it is to increase collaboration between the medical and dental worlds."
~ Yassee E. Pirooz, DMD18
The Nurse Practitioner & Dentist (NPD) model, piloted since 2015 at the Harvard School of Dental Medicine in collaboration with Northeastern University, promotes interprofessional practice and education by integrating primary care services provided by a nurse practitioner into an academic dental practice environment.
In this innovative model, nursing and dental students work in interprofessional teams and are jointly responsible for providing primary care and dental services to patients. During supervised clinical rotations, students learn how each profession formulates diagnoses, implements preventive interventions, and makes referrals within their scopes of practice. Students develop interprofessional plans of care under the direct supervision of NP and dental faculty. Older adults (>65 years of age) living with one or more chronic health conditions, particularly diabetes and hypertension, constitute the target population.
The HSDM clinic, where faculty dentists, graduate students, and predoctoral dental students provide dental care to more than 5,000 patients each year, proved to be an ideal location for the model’s pilot. The clinic serves many older patients who have chronic conditions and may not see a primary care provider on a regular basis.
"Our research increases the evidence base for integrating oral health and primary care, and demonstrates how the full partnership of nursing and dentistry can improve health outcomes. The model holds promise for improving health for populations across all age-groups. The next phase of our research will test the efficacy of the model with younger adults.”
Other academic institutions, including Indiana University, University of Louisville and Temple University, are experimenting with collaborative nursing and dentistry programs. Several, such as UNC Chapel Hill, are interested in replicating the NPD model developed by Harvard and Northeastern.
To encourage more educational institutions and private practices to adopt the NPD model, the project team recently released a guide and webinar that provide a framework for planning and implementation. The guide includes templates for developing timelines, resource requirements, quality measures, curriculum design and operational workflows. Both are available online at no cost.