​Jim Crall is a professor and chair of the Public Health and Community Dentistry division at the UCLA School of Dentistry and principal investigator of the Dental Home Project. He is also the co-author of a new study about the importance of locating dental and primary care services together at community health clinics, which serve low-income populations. In this brief interview, Crall discusses "dental homes," the barriers to having dental and medical services in one place, and the current lack of "dental capacity."

Q: Can you explain the concept of a dental home and the advantages of co-locating dental services and medical services in one setting?

​A dental home is a place where a patient sees a dentist or dental care team for regular, comprehensive oral care, as opposed to only seeking dental care when he or she has a toothache. Patients should start having dental checkups by 12 months old at the latest. Ongoing dental care should include exams of the teeth and mouth, education on oral health care and habits (such as discussing the use of pacifiers with parents), preventive services (such as applying fluoride and sealants), and referrals to dental specialists, if needed.

As far as co-locating oral care and medical services, it is more convenient for patients, many of whom are from low-income households and lack cars, and it is efficient for the medical and dental staffs, as far as sharing patient records and recordkeeping.

Q: Why don't all community clinics have oral health services on-site?

​Several reasons. First, the community health center has to be willing to recognize the importance of oral care in overall health, which wasn’t a priority when many older clinics were established. Second, dental equipment is expensive ― putting in a few dental chairs costs hundreds of thousands of dollars ― it's not like putting an exam table in a room. Third, centers have to add oral health staff -- dentists and hygienists ― which is another cost. Grants and other financial incentives are available to community health centers to help cover some of the costs, but the centers have to consider these financial decisions carefully.

Q: Your study says one-third of California community health centers do offer oral health care on site, but they have low dental capacity ― what does that mean?

​Many co-located sites have only part-time dental staff available and only a few dental chairs, which means few patients are seen. And it's more likely those limited dental hours are spent putting out fires -- emergency extractions, treating toothaches, filling cavities and so on. Increased investments by community health clinics in dental staffing levels and facilities would allow for greater delivery of preventive care, which would improve health and save money in the long run.