Since the beginning of modern healthcare, medicine and dentistry have existed as separate healthcare domains. One pathway of care is oral healthcare for the oral cavity and certain associated structures – commonly called dental care (and less commonly stomatognathic care) and is delivered by dental providers. A distinct pathway of systemic health care delivers care to the rest of the body – called medical care and is delivered by medical providers.

While this separation appeared to serve well for many years, significant changes in healthcare have occurred and this separation is now obsolete and may be harmful. This artificial division of care into organizational silos ignores the fact that the mouth is part of the body.

The growing understanding of how oral health affects overall health, and vice versa, suggests that continuation of this separation leads to incomplete, inaccurate, inefficient and inadequate treatment of both medical and dental disease. As healthcare in the United States enters the era of accountability and moves toward achieving the “Triple Aim,” focus on oral and craniofacial health as well as its connection to systemic health, research and education will significantly increase to close the siloization between Medicine and Dentistry.

To enable the integration of medical-dental care, research and educational initiatives, and to assure the highest quality of care and safety for the patients and the communities, Marshfield Clinic Research Institute (MCRI), Marshfield Clinic Division of Education (MCDE) and Family Health Center of Marshfield, Inc. (FHC), took a leadership stance by establishing the singularly unique Center for Oral Systemic Health (COSH), unparalleled in the nation.

"For too long, dentistry and medicine have operated in separate silos. We know connections exist between gum disease and chronic illnesses such as diabetes and kidney disease, but we're only scratching the surface," said Dr. Amit Acharya, the founding COSH director. "Through research and new informatics tools such as the Clinic's integrated medical-dental record and clinical decision support systems, we're going to bridge that gap."

Core Priorities

  • Create access to dental care for disadvantaged populations;
  • Integrate medical and dental care to improve overall health;
  • Focus on population/public health and prevention through community collaborations;
  • Facilitate oral-systemic and other supportive translational research;
  • Train next generation dental providers, educators, and researchers in the new integrative model.