Oral health clinicians tend to organize their schedule in a one-size-fits-all manner. We tend to schedule appointment times based on the type of treatment or personal skill level: one hour for dental cleanings and fillings, with additional time for more complex procedures [Bannister et al., 2023]. Scheduling this way helps us to maximize our day and hit our daily production goals; however, it is questionable whether the standardized timing is best for our patients.
Dental anatomy is unique to each person, as is the consistency of their microbiome and its waste products. Some calculus is easy to remove, while other calculus seems to turn dental professionals into construction workers for several hours. Additionally, patients have varying levels of anxiety and dental fears. If dental professionals focus only on time constraints, they cannot slow down to address patients’ emotions, which increases dental trauma [Zeegers et al., 2022].
The Precision Medicine Initiative is an emerging approach that considers each patient’s genetic variability, environment, and lifestyle before deciding on the exact treatment and the time allotted for appointments [MedlinePlus, 2020]. It is the opposite of the one-size-fits-all approach and allows dental professionals to develop schedules based on patient needs [Zeegers et al., 2022]. It reduces patient anxiety by increasing the dental professional’s empathy scale and allows for reduced risk of treatment complications [Zeegers et al., 2022 and MedlinePlus, 2020]. Other benefits of using Precision Medicine to better understand disease risk level include increased disease prevention, accurate diagnoses, better pain management, integrated primary care, and better treatment outcomes in oral health settings [Malcangi et al., 2023 and Steigmann et al., 2024].
Like what you’re learning? Consider enrolling in the Herman Ostrow School of Dentistry of USC’s online, competency-based certificate or master’s program in Community Oral Health.
There are many ways dental professionals can integrate precision medicine into their practice. Involving patients in treatment planning not only gives dental professionals more information but also gives patients a sense of autonomy. This leads to better patient engagement, increased understanding, confidence, and satisfaction [Steigmann et al., 2024]. Additionally, implementing tests such as salivary analysis and monitoring the oral phenotype helps to identify risk factors and allocate resources accordingly, leading to more efficient scheduling and better treatment outcomes [Steigmann et al., 2024]. The initiative allows shorter chair times for patients who are regularly monitored and gives patients with more advanced disease more time to receive the necessary treatment [Steigmann et al., 2024].
From a public health perspective, precision medicine is particularly relevant to oral health, given the uneven distribution of disease burden. Dental caries and periodontal disease disproportionately affect low-income populations, people with disabilities, older adults, and individuals with limited access to care [Centers for Disease Control and Prevention, 2024]. These disparities are influenced by social determinants of health, including access to preventive services, diet, health literacy, and chronic stress. By using precision medicine to assess individual risk and tailor prevention and treatment strategies, dental professionals can better allocate time and resources to patients who need them most. This approach supports earlier intervention, reduces disease progression, and aligns clinical care with broader public health goals of prevention, equity, and improved access to oral health services [Zeegers et al., 2022].
Barriers do exist for this type of practice, including limited reimbursements for an increased number of appointments and specific diagnostic tests [MedlinePlus, 2022]. This results in patient burden and financial strain and can limit who has access to this type of care. There can also be logistical challenges with connecting to primary care providers, legal and ethical challenges with personal health information, and limited data storage capabilities [MedlinePlus, 2022].
Precision medicine is an effective approach to patient-centered care. The barriers can be broken down over time with policy advancement and improved integration of medical and dental care. Working together to promote this initiative and taking small steps to focus on patient care rather than production will lead to increased accessibility and a better overall healthcare system.
Earn an Online Postgraduate Degree in Community Oral Health
Do you like learning about a variety of issues while focused on the unique needs of community health dental programs? Consider enrolling in the Herman Ostrow School of Dentistry of USC’s online, competency-based certificate or master’s program in Community Oral Health.
References
Bannister, C., Anwen Louise Cope, Karki, A., Harper, P., Peddle, S., Walters, B., Allen, M., & Ivor Gordon Chestnutt. (2023). Time to complete contemporary dental procedures – estimates from a cross-sectional survey of the dental team. BMC Oral Health, 23(1). https://doi.org/10.1186/s12903-023-03671-y
Centers for Disease Control and Prevention. (2024, May 15). Health disparities in oral health. U.S. Department of Health and Human Services. https://www.cdc.gov/oral-health/health-equity/index.html
Malcangi, G., Patano, A., Guglielmo, M., Sardano, R., Palmieri, G., Di Pede, C., de Ruvo, E., Inchingolo, A. D., Mancini, A., Inchingolo, F., Bordea, I. R., Dipalma, G., & Inchingolo, A. M. (2023). Precision Medicine in Oral Health and Diseases: A Systematic Review. Journal of Personalized Medicine, 13(5), 725. https://doi.org/10.3390/jpm13050725
MedlinePlus. (2020, September 22). What is precision medicine?: MedlinePlus Genetics. Medlineplus.gov. https://medlineplus.gov/genetics/understanding/precisionmedicine/definition/
Steenen, S. A., Zeegers, M. A. J., van Wijk, A. J., Al-Zubaidi, S., Jethu-Ramkrishan, M., Loddin, A., de Lange, J., & de Jongh, A. (2022). Dentist Empathic Accuracy Is Associated With Patient-Reported Reassurance. International Dental Journal, 73(1). https://doi.org/10.1016/j.identj.2022.06.009
Steigmann, L., Željka Perić Kačarević, Khoury, J., Nagy, K., & Feres, M. (2024). Integration of precision medicine into the dental care setting. Frontiers in Dental Medicine, 5. https://doi.org/10.3389/fdmed.2024.1398897
MedlinePlus Genetics. (2022, May 17). What are some of the challenges facing precision medicine and the Precision Medicine Initiative? U.S. National Library of Medicine. https://medlineplus.gov/genetics/understanding/precisionmedicine/challenges/
