Primary Care Integration into Postdoctoral Dental Curricula: A Cross-Sectional National Survey

Dental providers frequently deliver care for individuals with chronic medical conditions (CMCs) such as hypertension, diabetes mellitus, and obesity and should be prepared to address their oral and systemic health needs. The goal of this study was to assess the current integration of CMC education into advanced education in general dentistry (AEGD) and general practice residency (GPR) curricula.

A 46-question cross-sectional survey was sent electronically to all 265 U.S. AEGD and GPR program directors (PDs) in February 2019. The survey consisted of multiple-choice questions about CMC curricular content, mode of delivery, barriers to teaching the content, evaluation technique, and competence of residents upon graduation. The survey was adapted from relevant literature and prior validated surveys. The data were analyzed using univariate statistics such as frequencies and percentages to describe all survey items.

Of the 265 programs surveyed, 42% of PDs responded (N = 111). Most agreed that it was important for residents to receive training to identify diabetes (88%), hypertension (90%), and obesity (78%). However, only 62% of PDs taught their residents to identify obesity compared with hypertension (90%) and diabetes (85%). Regarding health assessments, nearly half the PDs reported that their residents do not collect body mass index for obesity, while only 12% and 4% were not collecting HbA1c values and blood pressure, respectively. In addition, among residents being evaluated, 65% of PDs agreed that their residents were competent in knowing health system resources for obesity compared with hypertension (78%) and diabetes (76%).

While most programs are teaching their residents to identify diabetes and hypertension, greater focus on obesity is needed. Increased efforts should be devoted to closing this gap in dental training so that residents are comfortable not only discussing medical conditions with their patients but also with performing regular chairside examinations, providing counseling, and making appropriate referrals.Knowledge Transfer Statement:The results of this study can be used by educators charged with creating and revising curricula for postgraduate dental residency programs. Knowing the current status of the integration of primary care topics into such programs can assist in the identification of existing curricular gaps and solutions to barriers. This could lead to the development of better integrated curricula, which will result in more comprehensive care for patients.