Claudia Guillen, DNP, MSN, AGPCNP, an adult gerontology nurse practitioner, is the facilitator of the Nurse Practitioner/Dentist Model for Primary Care at the Harvard Dental Center–Longwood. This unique and integrative arrangement, a pilot study supported by CareQuest Institute for Oral Health and Henry Schein Cares Foundation, makes certified nurse practitioners available to dental care patients at the clinic to facilitate easy, convenient primary care.
What is the integrated dental and primary care model at the Harvard Dental Center?
The main aim for the model is to integrate a professionally educated nurse practitioner alongside dentists to offer primary care to the clinic’s adult dental patients who are living with chronic diseases. The goal is to have patients who are coming in for dental care to be seen for any other medical problems at the same time so that patients don’t have to see multiple providers.
It's a wonderful model because it can take a long time for an individual to get in to see their primary care provider (PCP)—and many of our patients don’t even have a PCP to schedule an appointment with. If we have nurse practitioners here working with the dentists, patients can see them right away and they can help tackle their problems more quickly.
How do dental students benefit from this unique model?
The dental students who work in the Dental Center benefit by collaborating with the nurse practitioners and looking at the patient in terms of chronic problems, such as high blood pressure or diabetes with uncontrolled blood sugar. By learning this primary care perspective, they learn how to look at their patients’ health in a more holistic and integrative way.
What is next for the NP/Dentist Model for Primary Care?
Phase 1 of the model was getting it up and running; now in Phase 2, we’re working to allow patients to use their medical insurance for these services. HSDM is credentialed by the Massachusetts Department of Public Health to provide medical services and the NPs are credentialed with the medical insurance companies to provide medical services at HSDM. We are testing the financial viability of the integrated model.
Why is integrating medical care with dental care an important part of holistic healthcare?
This program is designed to close gaps in care and to make care more convenient. In healthcare, patients often get sent to many different providers and specialists for different issues, and it can be difficult to navigate—especially when there’s a language barrier or they don’t have access to a PCP in the first place. Traditionally, the medical system relies on patients to do that legwork, but this model helps them in an immense way by allowing us to do continuity of care while they’re here at the Dental Clinic instead of sending them away to more doctors.
Overall health starts with the mouth, but the medical and dental worlds are separated in many ways. Bringing them together can be a question mark for people who’ve never seen it before, but it’s very cool and saves time. Imagine going in for your dental cleaning and getting your flu vaccine at the same time or having a follow-up about your diabetes or hypertension. We want to help close that gap between medical care and dental care for the benefit of our patients.