As dental hygiene students we learn to care about our patients as individuals. We tailor fit our recommendations to make a noticeable and lasting impact on their oral and systemic health. If we are good at that, we see change. Perhaps they come to a recall visit with no bleeding sights, praise us for the advice, the awesome job we did, how gentle we were, or the distinct change they have noticed after using a product or technique. We call those wins, we celebrate those moments, and we should.
What about the members of the community we never touch or see? How do we reach them? How do we make a larger impact? How do we care about our patients as members of a community? How do we translate our passion for progress, health, and prevention to a larger group? Short answer: Advocacy.
I began working in a federally qualified health center in May of 2014 and could immediately see a difference in case presentation compared to private practice. I was no longer talking about whitening. My new patients needed basic care. Pain relief and therapeutic intervention became the focus. Mary Otto, author of Teeth: The story of Beauty, Inequality, and the Struggle for Oral Health in America explains it like this:
Nobody wants to do the low-end stuff anymore. Of course there is a lot more
money to be made with some of these really high-end procedures. But on
the other hand there’s this vast need for just basic basic care. A third of the
country faces barriers in getting just the most routine preventive and restorative
procedures that can keep people healthy.
My patient population falls into that third. They are suffering and I can help them when they are in my chair. Their problem is getting to us. The barriers facing our nation’s poor are sometimes insurmountable. According to the ADA, approximately 45% of the adult population ages 19-64 does not have dental coverage. The patients that do have dental insurance may not have a provider near them that accepts their plan, and if they have Medicaid the likelihood of finding a participating dentist decreases more.
Any hygienist working in a public health setting knows the need is vast. There are not enough clinicians, not enough chairs, not enough hours in the day. Having been on mission trips abroad, I was shocked to see that people in our country could be suffering at the same level or worse. I started looking for ways to improve the oral health of the community, not just appointed patients.
My state Oral Health Coalition became a soft place to fall. The mission statement seemed simple and appropriate: improve the oral health of all the people of Kentucky. This was a collaborative, inter-professional group of stakeholders working towards a common goal. I was impressed to see Dentists, Hygienists, Public Health Administrators, Nurse Practitioners, and Educators all at the same table working on solutions together.
The coalition gave me an opportunity be a part of a larger network. I learned more about oral health as a social justice issue. Access to care is a systemic problem and will need policy change. This year was my first time attending an advocacy day at the state capitol. We met with our legislators and we had conversations about upcoming goals. It was a day of educating non-dental professionals about the conditions of their constituents. I was able to tell my patient’s stories and the concerns I have for their health. It was a different kind of win, another one with a celebration, because it has the opportunity to make an impact for many in the future.
We know our patients. We know their clinical presentations, but more than that, we know their stories. We have a responsibility to be their voice and demand change, big change, the kind of change that stops the bleeding, the kind of change that brings health to a community. Advocate for change RDH. It comes naturally.