Role of Patient Navigators in Linking HIV+ Patients to Dental Care

Issues: Project TEETH, a 5-year HRSA-SPNS funded grant, was designed to increase the number of HIV+ patients referred to and utilizing dental services at ten Montefiore Medical Group (MMG2) sites. One objective is to design and implement an integrative model of oral health (OH) care by integrating Patient Navigators (PNs) into three sites with existing dental facilities on/near site. Description: The bilingual PNs are liaisons between medical and dental care. They educate HIV+ patients on the essentials of maintaining good OH, assist with the dental appointment process, and perform follow-up activities. The PNs create an environment in which the patient may feel more comfortable speaking to someone who can relay the information in layman's terms. Patients receive services which makes them feel like they're receiving client services and educational tools unlike that of routine clinical visits thus improving their perceptions of the facility. PNs prompt patients to initiate conversations with the dentist thus addressing communication barriers in the patient/dentist relationship. PNs help to ease patients' anxieties by suggesting techniques that can be used during the dental exam. Lessons Learned: To date, PN referrals have come from PCPs (78%), HIV care team members (13%), other staff (9%), with a 3.75% refusal rate to meet with the PNs. This preliminary data shows that integrating PNs into the existing medical and dental services is a promising strategy to expand HIV+ patients' comprehensive care packages and to raise awareness of OH issues among the HIV population. Recommendations: PNs may be useful in other settings.