While there has been an increased push and awareness for the integration of oral and overall healthcare, the integration with dentistry is still behind other medical areas.
Rita Bilello, DDS, became the new clinical director of the NYU Dentistry Oral Health Center for People with Disabilities in October.
Dr. Bilello recently connected with Becker's to explain why integrated healthcare is crucial to overall health and the role a dentist has in addressing a patient's total well being.
Editor's note: Responses were lightly edited for clarity and length.
Question: What is the importance of connecting dental and oral healthcare with overall healthcare?
Dr. Rita Bilello: The mouth is the gateway to the body. It's the body's first line of immune response and the first location where you can see something in general health is askew. The body, as complex as it is, is fairly simple in that it does not discriminate; processes like diabetes and hypertension will show signs and symptoms everywhere, including and especially in the mouth. Therefore, not only is oral healthcare important in detecting signs of systemic disease, but good oral health is important in fighting systemic disease. Oral diseases such as periodontal disease and caries also lead to decreased ability in getting adequate nutrition, which will hamper general health, and oral pain leads to things like mental health struggles and sleep issues.
It is incomprehensible to think that oral health and systemic health are not part of the same conversation. In my opinion, you cannot address one without addressing the other. As a dentist, I need to not only review my patient's overall health but I need to work with their medical team to appreciate and highlight the impact that their medical conditions, prescription medications, etc. have on their oral health, as well as advocate for when medical interventions may be having adverse effects on their oral health.
Q: Do you have any big predictions for the dental industry in 2025?
RB: I have great hopes and aspirations that the industry will continue to move forward in valuing all of the patients that dentists are serving. I hope that my fellow dentists recognize that still, in 2025, there are disenfranchised groups of individuals that sadly cannot find providers to treat them, and that as a profession, we have a responsibility to address the barriers that exist.
Q: Are there any other trends in the dental and/or healthcare industries that you are keeping up with?
RB: The trend that I watch the most closely is the concept of integration in healthcare. On the medical side, there is a tremendous push to make sure that there are interdisciplinary integrations, particularly between primary care and mental healthcare, because there are known improvements in both quality health metrics and outcomes for the patients, as well as fiscal and operational gains for the providers.
Unfortunately, this push for integration has not crossed the tremendous divide that exists between medicine and dentistry. Separate systems in terms of physical systems, payer models, etc., make it almost impossible for medicine and dentistry to integrate in meaningful ways. This has, in my opinion, led to a devaluation of dentistry and oral health in the overall picture of health. Dentistry is an afterthought in terms of health funding. For example, why is health insurance mandated but dental insurance is not? If oral health and general health are integrated, it would be impossible to separate one from the other; they would be parts of the same whole. I am hopeful that one day in the future, the improvements in health outcomes in integrated models of care will bridge the divide between medicine and dentistry so that truly comprehensive healthcare could become a reality.