Methamphetamine Information: Integrating Oral Health with Primary Care
|9299||December 18, 2012||8|
This teaching module is based on the results of separate assessments of dentists and physician assistants practicing in Kentucky and West Virginia and subsequent training resources developed to meet their reported need for practical information on Methamphetamine. Illegal Methamphetamine (MA) is on the rise in the U.S. while dentists, physician assistants and other health care providers may be unaware of the percentage of their patient population using MA. Uncertainty about the appearance of early stages of "Meth Mouth" and what can be done for these patients has led to lack of care and referrals for further treatment and prevention. Unfortunately, advanced cases rarely result in optimal care due to lack of patient interest and/or lack of awareness and timely intervention. This resource provides current evidence to support the need for updated information on MA, its oral manifestations and brief video approved by the Kentucky Board of Dentistry for 1 CEU and is intended for practitioners in dentistry, medicine, nursing and other professionals who may play a role in the early recognition, intervention and referral for users of MA. This information has been useful for physician assistant students as part of their orientation to oral health as an integral part of a health promotion and disease prevention course. The purpose of this module is to encourage interprofessional interface in the recognition and referral of patients suspected of MA. The BOHC Competencies related to this module include:
- General Oral Health Screening- Apply foundational knowledge of oral health to perform basic assessment screening and diagnoses.
- Public Health - Work with health professionals and community partners to emphasize health benefits and effective disease and injury prevention strategies.
- Medical Dental Interface - Optimize oral health and treatment outcomes through effective outreach and collaboration with dental professionals.
In some states and rural areas, anecdotal reports and evening newscasts suggest more alarming increases in the numbers of users with horrific effects on the individuals, families, and especially their children as well as its effects on neighbors and the larger community. The expressed need continues for updated information about MA and their interest in gaining clinical skills to screen, intervene and refer users for further care. The first-ever Report of the U.S. Surgeon General on Oral Health (May, 2000) and more recent Report of the Institute of Medicine (July, 2011) emphasize the need for integration of oral health and primary care with an emphasis on the education of non-dental professionals including basic oral health screening assessments as part of the patient's medical evaluation. Toward that end my work (University of Kentucky Physician Assistant graduate training program) has included a series of regular guest lectures, clinical laboratory sessions on conducting the oral exam, and oral cancer screening, and end of rotation (clinical clerkships) seminars across all three years of their training program. feedback from students has been very positive as reflected in standard teacher and course evaluations (TCEs) on file in our Department. Regularly, students will send a follow-up note from their clerkships to share their clinical experiences in diagnosing an oral problem and successfully referring to the dentist for care and/or more recently, following up on the oral cancer screening resulting in an early diagnosis of a suspected cancerous lesion.
As well, several peer-reviewed presentations and workshops have been offered at the national level for practicing physician assistants through the professional organization, American Academy of Physician Assistants (AAPA) and to the faculty attending the national educators group, Association of Physician Assistant Programs (APAP) and later at the Physician Assistant Education Association (PAEA) covering the need for integration and medical-dental collaboration among providers and for the training of their students and residents. These practitioners and educators realize that it is essential for physicians to be prepared in the basic oral health content and exam skills since physicians supervise the practice of physician assistants. Over the last several years, these courses have also been approved as Category One CME for the physician assistants and their supervising physicians. The course evaluations are on file in our department and reflect very high satisfaction levels with the presentation content and delivery, with averages well above the mean. The PAEA Education Committee Chair (Savanah,2008) stated in her summary letter that, "Evaluations were overwhelmingly positive. Ninety-five percent of respondents rated the conference as "good" to "excellent" and your presentation contributed significantly to the success of the forum." Information on this topic was also presented in a peer-reviewed poster session, "Methamphetamine Information: Identifical Studies Assessing Kentucky and West Virginia Dentists", sponsored by the National Rural Health Association (New Orleans, 2008) for which the co-authors (Skaff, Crout, Harrision, Wearden, Walker and Cassis) received the Research Poster Award.
In summary, the need is great for updated information on Methamphetamine Information as oral health is integrated with primary care. Students, faculty, practicing dentists, physician assistants and their supervising physicians may benefit from a heightened awareness of the need for integration and clinical updates related to their patients who may be using, producing and sharing Methamphetamine in their homes and neighborhoods.
Skaff K, Crout R, Blackwell C. Methamphetamine information: integrating oral health with primary care. MedEdPORTAL Publications. 2012;8:9299. http://dx.doi.org/10.15766/mep_2374-8265.9299
- To optimize oral health and treatment as part of overall well-being for of illegal methamphetamine through informed outreach and collaboration among healthcare professionals.
- Early recognition, intervention and referral for suspected users of illegal methamphetamine and other illegal substances.
- To integrate knowledge and standards of care for users of MA seeking oral health care.
- To identify oral health problems associated with MA in a basic oral health assessment/screening.
- Illegal Methamphetamine Users, Effects of MA, Early Recognition and Referral, Building Oral Health Capacity (BOHC) Collection, Multidisciplinary Teamwork
This information is made available under the Creative Commons license.
Authors & Co-Authors
Dr. Karen Skaff, RDH, PhD
University of Kentucky College of Health Sciences
Dr. Richard Crout, DDS, PhD
West Virginia University School of Dentistry
University of Kentucky
Sponsorship or Funding Source
This project is also sponsored in part by funding from the Health Resources and Services Administration/Maternal Child Health Bureau grant #U44MC20223.