You Are What You Eat: Integrating Dentistry and Dietetics at NYU College of Dentistry

Katie Schepps, a dietetic intern and nutrition graduate student at NYU Steinhardt, discusses the sugar contents of popular beverages with a mother and son at the NYU Pediatric Dentistry Clinic.

10/09/2018

Research shows a clear link between nutrition and oral health, including dental caries and gum disease. Nutrition also plays a key role in other health conditions such as obesity, diabetes, and heart disease, which have important implications for oral health.

Given their frequent contact with patients—people may see dentists more often than any other health professional, particularly when they are not sick—dentists can play a critical role in engaging their patients about health promotion, including healthy eating.

"Pediatric dentists, in particular, have a unique opportunity to discuss dietary choices with children and their families," said Amr Moursi, DDS, PhD, professor and chair of pediatric dentistry at NYU College of Dentistry. "These interactions could prevent a child from having health problems later in life."

Recognizing the importance of nutrition in oral health, nationwide efforts have incorporated nutrition into dental education. NYU College of Dentistry covers nutrition and health promotion in its curriculum as early as the fall of dental students' first year.

But traditionally, dental and nutrition students have had little opportunity to work together. In 2005, NYU College of Dentistry decided to address this: it began a collaboration with NYU Steinhardt's Department of Nutrition and Food Studies to integrate dietetic interns into the care provided at NYU's Pediatric Dentistry Clinic.

"It's clear that nutrition and oral health professionals should be working together. We have so much in common between these two fields because what you consume affects your health," said Lisa Sasson, MS, RD, clinical professor of nutrition and dietetic internship director at NYU Steinhardt. "For example, sugary beverages and foods are the main cause of pediatric obesity, but they are also one of the main causes of dental caries."

Currently, all NYU nutrition students complete a one-week internship in the Pediatric Dentistry Clinic. The dietetic interns collaborate with dental students and pediatric dentistry residents to provide patients and their families with on-site nutrition education and counseling.

Dental students and residents invite dietetic interns into their appointments to talk with children and their parents or caregivers about healthy eating. The dietetic interns may offer healthy snack ideas or spot dietary patterns that could be problematic, such as a young child drinking juice all day long and constantly exposing their teeth to sugar.

In addition to providing nutrition education in the clinic, dietetic interns join NYU College of Dentistry in outreach visits to Head Start programs in New York City. There, they teach preschool-age children about oral hygiene and how different foods affect their oral health through fun activities.

The collaboration is based on a model where learning goes both ways—dietetic interns learn about oral health in the classroom and through hands-on experience in the clinic, and dental students and residents learn about nutrition through interacting with the dietetic interns and nutrition-focused seminars led by the interns. One dental student noted that the experience encourages future dentists to look at a patient as a whole person—and not just a mouth with teeth.

The NYU Dentistry and NYU Steinhardt faculty involved stress the important of health professionals working together across disciplines. Once the nutrition and dentistry trainees graduate and are practicing independently, they can draw on this increased knowledge of oral health and nutrition and can refer their patients to other professionals as needed. For instance, a pediatric dentist may treat a child at risk for obesity and suggest they see a dietitian, or a dietitian working with someone with an eating disorder may refer them to a dentist to address tooth decay.

"Multidisciplinary and interprofessional care is the future of health care," said Sasson. "I think this type of collaboration should be in every dietetic internship and every dental program."

Interprofessional education is a growing focus at NYU College of Dentistry. Lauren Feldman, DMD, clinical assistant professor in the Department of Pediatric Dentistry, was recently awarded a $1 million grant from the Health Resources and Services Administration (HRSA) to develop a formal interprofessional curriculum around pediatric dental education at NYU, including integrating primary care, nursing, and nutrition into students' learning. In addition, the NYU College of Dentistry has hired a nutritionist to help educate dental students and residents, creating more opportunities for collaboration around nutrition and oral health.

"This unique collaboration really helps connect the dots for both the nutrition intern and dental student in recognizing the oral-systemic link: our mouths affect our body, and our bodies affect our mouths," said Jill Fernandez, RDH, MPH, director of pediatric outreach and prevention programs at NYU College of Dentistry.