Medical-Dental Integration in Community Health Centres: An Environmental Scan of British Columbia

Medical-dental integration (MDI) is increasingly recognized as a promising approach to preventing disease and reducing oral health disparities. Although integrated care delivery is central to community health centres (CHCs), limited knowledge exists on how CHCs in British Columbia integrate medical and dental services. We conducted an environmental scan with the aim of describing the current state of MDI practices and strategies employed by CHCs in British Columbia. Methods A cross-sectional environmental scan approach combining passive conditioned viewing and active searching modes was used. Data were collected through an Internet search of organizational materials, an online survey of CHC representatives and clarifying telephone conversations. We included BC CHCs that addressed oral health through referrals or direct service provision. Descriptive statistical and content analyses were conducted. MDI practices and strategies were categorized as relating to workforce, information sharing, evidence-based care, and measuring and monitoring.

Among the 23 CHCs included in the study, approximately half provided on-site dental services through co-located clinics (n = 9, 39%) or embedded dental hygienists (n = 3, 13%), whereas others relied on referrals (n = 9, 39%), and a smaller subset (n = 2, 9%) partnered with local private and nonprofit dental practices to provide off-site care. Implementation of integrating processes was limited overall. Less than one-quarter of the CHCs reported processes for information exchange, referral tracking and standardized screening protocols. Few reported using dedicated personnel, training resources or interoperable technology to support integration.

Our findings established a baseline understanding of MDI in BC CHCs, revealing significant gaps in the implementation of integrating processes. Further research is needed to explore these gaps and to build on lessons learned from other jurisdictions.