A community-based approach to dentistry | Selina Asante | TEDxBowdoinCollege
today I'll be speaking to you on the um challenges that I've experienced in public health dentistry and navigating these challenges specifically I'll be speaking on some of the barriers to oral health care and um the role that I believe the Community Dental Health coordinator can play in mitigating some of these barriers um I'll start by introducing myself a little bit I was born here in the US but when I was about five or six years old I moved to Ghana and I lived in Ghana West Africa for about 10 years I moved back to the US and applied to this wonderful college and I spent the next four years in bronswick Maine my experience was fabulous because he basically set the trajectory for my current um professional experience um there was a class in sociology that I took that really helped me think about health in a different way prior to taking this class I had always thought about disease as being caused by a virus or bacteria but in this class I recognized that um as the public health field would describe it there are social determinants of Health that also impact our um Health um economic instability um distance from the health um Care Center finances lack of insurance all these things have an impact on our health and this was something that um really stood out to me and made me really curious about health care in this sense the other experience that I had while I was enrolled at the school was my experience during an internship a summer internship that I took over the summer it was an internship that allowed us to experience different Health Care professions medicine Dentistry nursing prior to this experience to tell you the truth I had no idea about Dentistry I actually had never been to a dentist before so it was in this experience that I really got to understand the dental profession and after looking at and watching over the female dentist that was practicing I thought hm this looks like something I could do so between my experience in the internship in this one class that I took at Bodin and obviously being infused with this sense of offering something good to the world the common good as we all call it I have my Superman Capon I'm like I'm ready to Jet out and save people's teeth so there was out in the world I went through dentl school and um basically started the practice of Dentistry um Dentistry is not just about teeth though it's about entire our health it's about our mouth it's about our entire our facial region it helps us express our smiles when you have a tooi as I'm sure many of you have experienced it is not cool um you may not be able to show up to class or work because of pain in your mouth oural Health Care is so important to me and yet I feel that it's not talked about enough in the mainstream we all know the importance of mental health we all go on diet and exercise because we understand how important it is to keep our bodies healthy but what about our mouth what about our teeth um it is it will be quite a shame to not be able to show up to class or go to work because of a toothache so I'm on a mission to make sure that our health care is at the Forefront of our discussions just like all the other professions in healthcare So currently I work for two nonprofits because I'm that desperate um I work for a Community Dental um well a community health center it's a federally qualified Health Center that basically provides services for underserved communities um we have medical doctors in our practice um Behavioral Health Pharmacy um different divisions of healthcare um and I work there to provide services to these um underserved communities I also work in a mobile Dental van and I go to different schools to make sure that students also have access to our health care so while Public Health Dentistry is excellent um it does have its limitations and those are some of the things I'll be describing today and some of the ways that I believe we can mitigate some of those barriers um in my practice so far one of the challenges that I find I run into are time constraints unlike Private Practice a lot of dentists and private practice are able to offer full dental Rehabilitation to a lot of their patients they can spend an hour or two just with one patient restoring their oral dental health Health that is not quite the case in public health Dentistry if we're trying to reach a lot more people and so we have to continue to find ways to be a lot more efficient for us to have the reach that we're looking to have um another constraint that I feel I've ran into in public health Dentistry is um the anxiety that comes with d Dentistry um as a dentist most the time when I run into my patients they usually talk about how young I look what's going on with my accent when was the last time that I got out of dental school but truthfully the most interesting comment that I get is the one patient that sits in my chair stares me right in the face and says I hate the dentist I don't even know why I'm here and I say okay that's cool schol no beef there because I understand I understand that Dentistry precedes local anesthesia so there's a lot of horror stories even in the movies about people's experience at the dentist I understand because when I look on my tray I just see a hand piece an anesthesia maybe a forcep for an extraction but what a patient sees is a needle some PL tiers and then a high pitch um drill I get it because I wouldn't want pliers in my mouth either I would rather Reserve that for a plumber or a mechanic but that is the nature of our profession and so these Dental fears are real some patients may have um had these fears due to their childhood experience some patients may have had these fears based on their experiences and as adults or Guardians that may have had poor dental experience and transferred those fears to their children there are other people that may have had just distressing experiences in life unfortunate things like abuse or violence and may project these fears in the dental um Arena as well so these fears are real and um the other barrier that I find that I run into are just the logistics of access to care patients that lack Transportation patients that um don't have money lack of insurance language barriers can all in inhibit a patient from getting the dental care that they need so while I was so excited to fix teeth after I got out of boing and thinking I'm going to go out there and just just fix all these people's teeth and I'm working for different offices I find that there are these very real barriers that really prevents um me from being able to see that everyone has access to oral health care so how do we mitigate some of these challenges and in my experience so far I want to talk about the role of the Community Dental Health coordinator I may abbreviate this sometimes and say cdhc because try saying Community Dental Health coordinator 10 times and after a while it just sounds like gibberish so um the Community Dental Health coordinator um it's a role that was introduced by the American Dental Association in 2006 and it was really meant to mitigate some of these barriers that I just described um in order to be a Community Dental Health coordinator you could be a dental assistant or dental hygienist and receive additional CER certification in this program the dental health um the Community Dental Health coordinator um basically is just your friend in your dental office a little removed from the dentist and the dental staff but their role really is to speak to patients about you know access to care if they're having issues with Transportation if they really need to um have better understanding of their oral health to help educate them um you can imagine that if you are having fears about going to see the dentist but you had this other person that was also in your community that can really express to you what takes place at the dentist maybe give you some recommendations or referrals to where you can get dental treatment from I I think just in that interpersonal connection that may help reduce some of the fears that patients may experience going to the dentist so I really want to speak to the role of this Community Dental Health coordinator unfortunately it doesn't have as much as a presence in public health Dentistry as I would like to see but hopefully with as we continue to have conversations about that specific role it will become more prominent in the dental field so the dentist and the dental staff are still not exempt to educating their patients speaking to them making sure that they um also see the importance and relevance of oral health care um and that's not to exempt them from those roles but especially in public health Dentistry when we're working with such Limited time when there are so many barriers that get in the way of patients gaining access to care I think that there needs to be an additional role just to help bridge that gap between our dentists and the patients that need the care so I looked online just to see different Community Dental um different community health centers and um the ones that incorporate Community d mental health coordinators into their practice um there's one such Health Care Center in New Jersey and their specific research was based on um diabetic patients and seeing the role that cdhc has in improving the oral health of diabetic patients as I may have mentioned earlier diabetic patients are more likely to have poor oral health based off of their condition so makes it even more important that their oral health is really regulated um and this Community Dental Health Center was able to increase the dental treatment among these patients by 40% so that's 40% of patients that have diabetes that may not have had their oral health taken care of had it not been for the um interjection of the Community Dental Health coordinator the Community Dental Health coordinator is basically almost like a social worker that um really helps bridge the gap and that's just a role that I feel is missing and needs more presence in our field so in to in to summarize basically uh I know I've been speaking a lot about the role of the community health dental coordinator and how I feel they have an they could have a very great impact in public health Dentistry but truthfully it's not really about the role it really is about the point of human connection and especially in the field of dens which is marred with so much fear and so much anxiety and so many barriers having that human connection would hopefully help us bridge that Gap to really see people um get the oral health care that they need human connection is so important just reflect on your own experience when you've had to make a reservation and you are punching numbers cuz some machine is telling you press one two versus actually being able to speak to an agent think about how much more um effective that is um there's a lot of conversation about trauma informed care and I think the Community Dental Health coordinator can really help mitigate some of these fears and anxieties and really talk to people about the fears that they have with um being at the dentist in summary I really hope that our health care is at the Forefront of our conversations and we continue to find ways to make sure that our health care is available to all thank you w