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Addressing Oral Health Disparities: Access and Quality Care for All

Conference Summary:

The Dallas area and the State of Texas are composed of very diverse communities. Many of these communities do not have adequate access to dental care, and, thus are dentally underserved.

On Saturday, March 29, 2014, 3 experts in this field came together to discuss these issues with a large audience at A&M Baylor College of Dentistry during the 2nd annual Center of Excellence Oral Health Conference.

The purpose of the conference was threefold:

  1. To discuss barriers to dental care in underserved communities;
  2. To provide an update of the diagnosis and treatment of more common oral diseases, especially those that are more common in underserved groups; and
  3. To explore the psychosocial aspects of patient treatment.

Presentation Videos

The presentations of all three presenters in the conference were recorded, and are available for viewing here on this page.

If any TAMBCD faculty, residents or students need to study the presentations in detail, and require a more sophisticated method of navigating the content of each, they may find the presentations in the appropriate formats on the TAMBCD local Intranet. 

The presentations are made available courtesy of the college's Media Resources department. 

Course Presenters:

Dr. GimpelNora Gimpel, MD

Dr. Nora Gimpel is assistant Professor of Family and Community Medicine, and Chief of the Division of Community Medicine in the Department of Family Medicine at UT Southwestern.

Dr. Gimpel is a family physician originally from Argentina with significant experience teaching evidence-based medicine, working with underserved communities, and teaching and performing community-based participatory research.

Dr. Gimpel's Presentation

Overview of U.S. health and health care disparities from A&M Baylor College of Dentistry on Vimeo.

Dr. Gimpel's Presentation Outline:

I. Overview of U.S. health and health care disparities. 

    1. Disparities in health/and the burden of disease.
    2. Disparities in access to and quality of healthcare.
    3. Oral health disparities in context of overall health and family/community medicine.
    4. Major barriers to health care among underserved populations.

II. Expanding access to oral health care.

    1. Policy issues (e.g., Medicaid reimbursements; Medicaid/CHIP underutilization).
    2. Educational issues: community service learning opportunities to raise awareness among medical and dental students and to give them experience in working with underserved communities.
    3. Promising approaches to improved access (e.g., physician/dentist collaboration; multidisciplinary work, public health prevention initiatives; school-based programs).

Dr. Wright

John Wright, DDS

Dr. John M. Wright is Regents Professor and Chairman of the Department of Diagnostic Sciences, Texas A&M Health Science Center, Baylor College of Dentistry in Dallas, Texas.

Wright is an oral pathologist and a Diplomate of both the American Board of Oral and Maxillofacial Pathology and the American Board of Oral Medicine. He received his dental degree from West Virginia University and oral pathology training at Indiana University.

He has contributed over 100 publications to the scientific literature, as well as 15 book chapters and three textbooks, and is a past President of the American Academy of Oral and Maxillofacial Pathology, the American Board of Oral and Maxillofacial Pathology and the International Association of Oral Pathologists.

Dr. Wright's Presentation

2nd Annual Center of Excellence Conference - Video #1: Oral Pathology Update from A&M Baylor College of Dentistry on Vimeo.

Dr. Wright's Presentation Outline:

Pathology Update with a Focus on Oral Health Needs of Underserved Populations

The lecture provides a review and update on the more common pathologic diseases/conditions affecting patients. It includes conditions more common in the underserved but any underserved patient with a pathologic lesion in their mouth has an oral health need for diagnosis and management. Strategies for access are discussed.

William F. Wathen, DMD

Dr. Wathen

Dr. William Wathen is a faculty member at the Texas A&M University Baylor College of Dentistry Department of General Dentistry in Dallas. He teaches a web-based course on psychosocial skills and provides clinical supervision for D4 and DH2 clinics.

Dr. Wathen graduated from the University of Kentucky College of Dentistry in 1967 and went to Texas for a general rotating Air Force Internship. He began private general practice in Fort Worth in 1970, where he practiced for the next 37 years.

Dr. Wathen's Presentation

Psychosocial Aspects of Dental Practice from A&M Baylor College of Dentistry on Vimeo.

Dr. Wathen's Presentation Outline

Synopsis: The practice of dentistry has three major components: Social sensitivity, biologic orientation, and technical capability. Most dental schools today focus on the biologic and technical aspects while largely ignoring the very foundation of patient care: powerful interpersonal relationships.

Standard curricula tend to follow a surgical model of ‘find holes and spaces to fill and gums to scrape or cut’. Today’s model of comprehensive dental care follows the medical model of education, in this sequence:

    1. Recognition and management of systemic and acute issues in the presenting patient;
    2. helping patients accept their individual responsibility to control their diseases and maintain that control over time;
    3. continuously monitor disease risk factors to definitively determine whether patients are getting better, worse, or maintaining the status quo;
    4. develop and implement definitive treatment plans specific to each patient’s current needs and abilities; and
    5. implement an appropriate active maintenance plan.

It is increasingly important that health care today involve helping patients manage conditions whose outcomes can be greatly influenced by lifestyle or behavior change.

Psychosocial understanding presents powerful tools to enhance communication with patients and guide them in making choices to improve and maintain their oral health, from weight loss to exercise and smoking cessation, to medication adherence and safer sex practices.

Engaging dialogues and vignettes bring to life the core skills of motivational interviewing (MI) and show how to incorporate this brief evidence-based approach into any health care setting.

The ultimate oral health related goals of patients boil down to 6 factors:

  1. dental teams that care about patient interest ahead of their self-interest;
  2. absence of pain, whether inflicted or incurred;
  3. optimal appearance;
  4. good chewing function;
  5. teeth that last a lifetime; and
  6. ‘reasonable’ lifetime dental costs.

This lecture outlines some psychosocial practice strategies to help patients achieve and maintain healthy mouths. The reward for the dental team is the achievement of balanced and rewarding professional lives.

Last edited by: aupton 12/15/2014

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