Editorial

Hugh Silk, MD, MPH

TWENTY years ago, I pondered the plight of my patients’ mouths as a young family medicine resident at Hahnemann Family Health Center. Why did so many children and hospitalized patients have poor oral health? The articles presented in this themed edition of Worcester Medicine on Oral Health focus the lens on answering that question about the origins of challenging oral health issues for so many in our region. I am honored to be the guest editor for this edition, as oral health affects so much of our systemic health and our overall wellness – heart disease, diabetes, and also job prospects and the ability to smile and show pride. I am proud of the authors herein who challenge us all to do more to help our patients and our neighbors to have better overall wellness through better oral health. Oral health matters; oral health is health.

In the first article, I worked with Vanessa Villamarin, UMMS Class of 2021, to explore the origins of local disparities and their effect on oral health. Vanessa researched her piece during a 4th year oral health elective. She shares her own personal experiences and reveals the ugly truth about the “why” behind local disparities.

Dr. Lynda Young, a longtime advocate for oral health in Worcester and Massachusetts, has written a review of the history of Worcester’s complicated history around community water fluoridation. Such a promising public health intervention that has been the victim of misinformation and our infatuation with liberty over communal benefit.

Addressing oral health is a team sport; Brian Genna, Christine Dominick, and Stacy Hampson prove this point with their three-part article. Dr. Genna leads off paying homage to the role of the community health center in addressing local unmet needs using interprofessional care and outreach to meet people where they live. Christine Dominick explains the role that dental hygiene students can play in our community and how they have adapted to COVID-19 in their many community-based clinics. And finally, Stacy Hampson shares the unique role of the dedicated members of her team on the UMass Care Mobile serving school children and those without dental insurance around the city. Each set of providers filling important gaps and creating a tapestry of essential dental care.

The Worcester District Dental Society is the sister organization to the Worcester District Medical Society. Drs. Christina Shaw and Pooja Gupta give us a brief history of the Society and the important role local dentists play in tackling our oral health challenges especially during the pandemic. Dentists and dental hygienists are at the highest risk of contracting the virus – kudos for your dedication!

I have a special affinity for Shari Harding’s piece on the role of nursing for those with mental health disease. I provide primary care in Leominster to those with significant mental health issues. Their teeth and mouths, as Shari points out, are severely affected by the side effects of their medications, tobacco, and the uphill battle to address dental hygiene. Her call to us as medical providers to do our part is long overdue!

Anna Morin continues this theme with her insightful pharmacist’s perspective on oral health and medications. She reminds us that the pharmacist is part of the oral health team and can offer advice on everything from tobacco cessation and oral cancer prevention to relief medications for canker sores. I applaud her emphasis on the role of xerostomia from medications as a major cause of caries.

Six UMass students from the class of 2023 spent two weeks during their Population Health Clerkship closely examining the oral health issues faced by our most vulnerable populations. They worked with other student groups which culminated in a presentation to their colleagues and this article delving into the inequities faced by the homeless, veterans, Latinx, the uninsured and underinsured, those living with disabilities and the black population in Worcester. They offer up hope with a plea for better integrated care.

Many of us have worked hard over the years to build a more comprehensive oral health curriculum at UMass Medical School. Olivia Nuelle, UMMS 2022, talks about her perspective on the curriculum and the role she herself has played in evolving it. It is clear that she is using the newly acquired oral health skills in her clerkships!

Like Dr. Jane Locherie always notes – I encourage everyone to read the Society Snippets. Dr. Dale Magee has managed to find some historic references on community water fluoridation, and I offer an added plug for the As I See It section which includes a message from Dr. Charles Steinberg, a dentist and the President of the Worcester Red Sox, about bringing baseball to Worcester with oral health messaging from the mascot and team!

Hugh Silk, MD, MPH Professor, University of Massachusetts Medical School, Department of Family Medicine and Community Health and Instructor, Harvard School of Dental Medicine and Harvard Medical School