Care convergence: 5 proven strategies to elevate dental care and patient outcomes

The dental industry is evolving rapidly, driven by advancements in technology, a shift toward personalized care, and the growing recognition of the link between oral and systemic health. As the concept of care convergence gains traction, dental practices have a unique opportunity to integrate medical and dental care without significant additional investments using solutions already on the market.

Understanding care convergence

Care convergence refers to the integration of medical and dental care, where patient management involves understanding overall health profiles, not just oral conditions.¹ This approach emphasizes multidisciplinary collaboration and information sharing to provide holistic care.

For example, dentists can use routine chairside tests to assess C-reactive protein (CRP), glucose, and HbA1c levels during a dental examination to identify broader health risks such as cardiovascular disease or diabetes.

Why convergence matters for dental practices

Convergent care models improve patient outcomes by addressing underlying conditions that could impact oral health. They also create a competitive edge for practices by offering differentiated services and new revenue streams that align with the macroshift toward outcomes-based care.

For example, a patient with a family history of diabetes and high HbA1c levels may require more aggressive periodontal therapy to mitigate risks of progression.² Conversely, treating the periodontal disease of a diabetic patient would also improve the patient’s A1c and overall glycemic levels.³

Dentists who are successful in integrating oral-systemic health solutions in their practices tend to deploy a combination of the five strategies listed below. They shift their approach from doing more to doing things differently, which allows them to tweak existing workflows without additional burden on their already strained teams.

No. 1: Leverage existing diagnostic tools for broader health assessments

Successful dental practices maximize the use of existing diagnostic tools to incorporate systemic health assessments into routine visits. For example:

• Oral-systemic health screenings: During routine cleanings, dentists could screen for conditions such as sleep apnea by observing oral signs of tongue scalloping or large tonsils. Solutions already on the market provide fully integrated workflows to administer screening questionnaires, connect to a network of sleep specialists, and provide administrative support for the dental practice for seamless diagnosis, treatment, and payment across medical and dental plans.
• Chairside blood tests: Incorporating chairside blood tests for markers such as CRP and HbA1c can help identify inflammation and glucose control issues, allowing for tailored treatment plans. This approach adds value to routine checkups without requiring significant new equipment.
• Salivary diagnostics for disease markers: The use of chairside salivary diagnostic tests for periodontal pathogens or inflammatory biomarkers, for example, could provide actionable insight into patients’ current disease activity and guide the dentist in tailoring treatment plans, follow-up care, and collaboration with medical providers if systemic conditions are detected. In the future, affordable, point-of-care diagnostic tools would also be able to reliably diagnose the most common oropharyngeal cancers. In the near future, affordable, point-of-care diagnostic tools would also be able to reliably diagnose the most common oropharyngeal cancers using both genomic and protein markers, offering noninvasive, real-time solutions chairside.

No. 2: Enhance collaboration across specialties

Convergent care thrives on collaboration with medical and dental specialists. Here’s how innovative practices tend to integrate this into their existing workflows:

• Cross-referrals with medical professionals: Establish partnerships with local physicians, endocrinologists, and cardiologists. For instance, patients with high CRP levels, a marker of systemic inflammation, can be referred to a cardiologist for further evaluation. In turn, these providers can refer patients back to the dental practice for periodontal care, fostering a two-way relationship that enhances patient care. To minimize the barrier of cross-disciplinary referrals for patients with chronic conditions, many practices are using telehealth platforms for consultations with specialists, such as nutritionists or endocrinologists. Virtual collaborations are cost-effective, save time, and ensure coordinated care without the need for physical referrals.
• Cross-referrals with dental specialties: Integrating orthodontic and periodontal care offers a practical example of convergence across dental specialties that enhances outcomes with minimal changes to existing workflows.⁴ Dental practices can adopt a collaborative approach by coordinating periodontal evaluations before and during orthodontic treatment. This ensures that potential periodontal issues such as gingival recession or plaque buildup are managed early, optimizing both the esthetic and health outcomes for the patient. Similarly, leading prosthodontists already collaborate with periodontists for oral rehabilitation (e.g., implant-supported crowns, bridges, or dentures).

No. 3: Streamline processes and information sharing

Digital tools can make care convergence more accessible by enabling streamlined communication between dental and medical providers and liberating clinical teams from repetitive administrative tasks in at least three ways:

• Augmented teams: AI is a powerful enabler of convergent care both in assisting clinical teams to analyze and visualize diagnosis as well as automating processes such as billing, inventory management, and care coordination.
• Electronic health records (EHR) integration: Where possible, use publicly available APIs (application programing interfaces), such as FHIR (Fast Healthcare Interoperability Resources), to integrate EHR systems that allow dentists to share critical health data with a patient’s primary care provider. Even without a full-scale EHR integration, existing digital solutions can facilitate the exchange of reports and referrals, reducing administrative barriers to continuous care. Recognizing that there might be some technology investment in the short term, over time, these integrations would become bundled as a standard feature for most leading patient management systems.
• Patient management systems: Utilize patient management software that includes space for tracking nondental health metrics such as blood pressure or glucose levels. These data can be shared with patients, payers, and medical professionals as part of a comprehensive care plan that tracks clinical outcomes and total cost of care, not only procedures.

No. 4: Integrate preventive care into routine appointments

Dental practices can adopt care convergence by expanding the focus of routine visits to include preventive measures that influence overall health:

• Use noninvasive treatments to prevent and manage early carious lesions. In this case, dental teams would apply fluoride varnish to the whole mouth during regular dental cleanings for adults at high risk of caries, and treat incipient lesions on smooth surfaces and in areas that are hard to reach using traditional methods, such as between teeth, using innovative solutions like Curodont Repair Fluoride Plus. Noninvasive treatments like this enable targeted remineralization of “watch areas” before more invasive procedures are needed. These types of solutions extend beyond prevention into restorative care, preserving patients’ natural tooth structure and allowing practices to free up chair time for more complex cases.
• Educate patients on oral-systemic links. Dental professionals tend to have two to three times more time with patients than their medical counterparts. This becomes a valuable opportunity to educate patients on how oral health impacts conditions such as heart disease, diabetes, and pregnancy outcomes. Simple, informative conversations can enhance patient awareness and encourage adherence to oral care routines, and lead to higher acceptance of treatment plans, ultimately improving outcomes.⁵

During regular appointments, for example, a dentist might notice signs of tobacco use in a patient’s oral health (e.g., staining, leukoplakia). By incorporating a brief conversation about the risks of smoking and pointing to available resources, the practice contributes to reducing the patient’s risk of oral cancer and other health issues. For patients with frequent cavities or signs of erosion, a discussion about the risks of sugary drinks and acidic foods, and the importance of key nutrients such as vitamins D, C, B-complex, and calcium, can help prevent further damage and elevate the role of dentists as oral health physicians, an integral part of the patient’s overall health-care team.^6,7

All of this is highly dependent on the patient’s needs and the specific context for their visit. For example, a patient with acute pain or severe anxiety would not be receptive to any information until their immediate needs are addressed. Ultimately, it’s up to the dentist and their team to assess what is appropriate as they build a relationship with that patient over time. Not all dental visits are well suited for convergent care.

No. 5: Focus on value-based care to drive long-term success

At scale, care convergence requires broader adoption of value-based care payment models and dental benefit designs that encourage prevention and cross-disciplinary treatment plans. As these payment models still lag in adoption, the value to the patient and the dental practice from convergent care models holds true even in fee-for-service settings. In the short term, this means private pay practices leading the way in educating and empowering patients to take agency for their own health and to opt for treatment and benefit plans that enable care convergence. As benefit designs and insurance plans catch up, dental practices could offer complementary services that prioritize patient outcomes and demonstrate value in multiple ways:

• Bundled care packages: Offer care packages that include routine dental cleanings and health assessments for conditions such as diabetes, hypertension, cancer, or life milestones such as healthy pregnancy, longevity, etc. Bundling dental services makes it easier for patients to access comprehensive care while ensuring continuity between oral and systemic health management.
• Outcome tracking: Measure patient outcomes through follow--ups and surveys. For example, track changes in periodontal health among patients with diabetes over time to demonstrate the benefits of convergent care. Positive results can help practices market their unique value to patients and insurers.

The future of dental care lies in integration

The operating model of care convergence is not about doing more; it’s about doing things differently. Augmented by technology, dental practices can lead the way in integrating medical insights into existing patient workflows across the five categories discussed above. This approach enhances patient outcomes, fosters stronger relationships with other health-care providers, and positions dental practices as integral to the broader health-care ecosystem. With this strategic shift in mindset, leading dentists are already embracing care convergence as a powerful tool for practice growth and patients’ overall health, reminding us that those who care, converge.

Editor's note: This article appeared in the January 2025 print edition of Dental Economics magazine. Dentists in North America are eligible for a complimentary print subscription. Sign up here.

References

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3. Chien WC, Fu E, Chung CH, et al. Type 2 diabetes mellitus and periodontitis: bidirectional association in population-based 15-year retrospective cohorts. J Clin Endocrinol Metab. 2023;108(11):e1289-e1297. doi:10.1210/clinem/dgad287
4. Alsulaimani L, Alqarni H, Akel M, Khalifa F. The orthodontics-periodontics challenges in integrated treatment: a comprehensive review. Cureus. 2023;15(5);e38994. doi:10.7759/cureus.38994
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6. Zelig R, Honeywell S, Touger-Decker R. Nutrition and oral health. In: Hogue CM, Ruiz JG, eds. Oral Health and Aging. Springer; 2022. doi:10.1007/978-3-030-85993-0_3
7. Sugue M. Statistics on the impact of diet on oral health. NewMouth. Updated July 22, 2024. https://www.newmouth.com/oral-health/diet-statistics/