Linking medical and dental records in health information exchanges could improve dental patient safety, preventive care, and treatment outcomes

Dental professionals require access to each patient’s complete electronic health record – including laboratory test results and current prescriptions – so they can provide the best care possible; care that is safe for the patient, promotes preventive management and improves dental treatment outcomes.

This unprecedented access would aid all types of dental professionals, including general dentists, oral surgeons, periodontists, prosthodontists, endodontists, hygienists and others. A new multi-study project from the Regenstrief Institute and Indiana University School of Dentistry has determined that information from patients’ medical records is generally not available to oral health practitioners in either an easy-to-use or timely manner.

The dental informatics researchers confirmed that requested medical information typically is faxed from a medical facility to the dental office. Faxes, sometimes unreadable when received, often are scanned into the patient’s dental record. The researchers found that, typically, the faxed information arrived in 7 to 10 days, although in the study, 30 percent took even longer.

“Oral health practitioners may need to confirm a list of medical considerations; for example, that there is no contraindication to a patient sitting in a chair for a lengthy procedure or whether a patient is taking any medication that could put them at risk for excessive bleeding during a tooth extraction or other procedure,” said senior author and study leader Thankam P. Thyvalikakath, DMD, MDS, PhD, director of the Regenstrief and IU School of Dentistry Dental Informatics program. “In this day and age of electronic data transmissions in banking, shopping and other commercial fields, should health professionals still be relying on inefficient, paper-based methods for sharing patient information?”

Demand for advanced dental care is increasing due to people living longer with chronic diseases like HIV and the growing number of older adults with natural teeth. For these patients, information from their medical file may be especially critical to appropriate dental treatment.

The researcher-clinicians found that the medical information most frequently requested by a dental office to finalize treatment decisions and procedure timing were patient diabetes status and history of blood sugar levels. Knowing this information helps oral health professionals rule out any contraindication to undergo dental treatments, determine outcomes of a surgical procedure or assess options for implant placement and calculate risk for gum disease. For example, if blood sugar numbers are high, there is a greater probability that an implant may fail.

“Retrospective Study of the Reasons and Time Involved for Dental Providers’ Medical Consults” is published in the peer-reviewed journal Frontiers in Digital Health. Authors, in addition to Dr. Thyvalikakath, who is the senior and the corresponding author, are Shuning Li, PhD, IU School of Dentistry; Karmen S. Williams, MBA, DrPH, Regenstrief Institute and IU Richard M. Fairbanks School of Public Health, IU School of Dentistry and City University of New York; Jayanth Kuman Medam, BDS, M.S., IU School of Dentistry and ELLKAY LLC; Jay S. Patel, BDS, MS, PhD, IU School of Dentistry and Temple University and Theresa Gonzalez, DDS, IU School of Dentistry.

The study was funded by IU School of Dentistry and the National Library of Medicine.