Dental/dental hygiene trainees discuss access to care, trust, health literacy, patient fears, bias, and social determinants of health. (2023)
I also have a similar patient experience: several patients that have come from underserved backgrounds. And I guess one patient in particular I can think of, just because I haven’t seen oral health this badly in a patient before, and it’s also very early in my career. But basically most of all of his dentition is gone, most of his teeth are gone, just necrotic. And when I’ve gotten to know him, and this is a patient that was transferred to me, so I didn’t see him in that, we call it screening clinic, as [another trainee] mentioned earlier. But after seeing something like that, in addition to [. . .], we were focused on getting [a] diagnosis and clinical data, but I just asked him, “Why now? Why are you here now to start treatment, and what got you to this state?” And not [in] an intrusive way, but just to simply ask how did you get here and what do you want to get done? What is your teeth plan eventually, is the conversation you have. He explained, he’s like, “I grew up on the Southside of Chicago. I was homeless for a long time, and when you live in that type of environment, you’re not handing each other toothbrushes, and you’re not necessarily getting proper nutrition. It’s not the first thing on your mind, your first thing is survival.” So in that way, I got to know a lot about him, and what he wanted later on. But over time our relationship has changed, and the communication, and getting him motivated and understanding processes, and getting [a] primary care physician, just establishing his health in general, was a huge process. Because I thought this was a baseline knowledge for a lot of people, but it really isn’t. We actually worked together for one of his extraction appointments. And sometimes, I think patients generally that don’t have access to the same levels of access that people do to health services, have distrust in healthcare professionals. So a lot of times we have to take a step back and make it feel safer when we’re explaining things. We can’t get angry. We can’t be irritated. He came in with lots of preconceived notions and information from the internet and videos that he watched, of people getting their teeth pulled and this and that. And there’s misinformation out there, but it’s our responsibility to, I don’t know, be gentle.