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Oral Health – The Community Health Center Perspective

Brian Genna, DMD

Dentistry in a community health center setting has provided me with a fulfilling career. I work with people from many different ethnic and cultural backgrounds. What I used to take for granted, like the simple task of brushing your teeth, has taken on new meaning when caring for patients that have viewed dental and medical care as a service used only for acute issues.

Our mission is to help people live healthier lives. The objective is to provide high quality care and promote wellness via many different disciplines working together for the benefit of the patient. There is an interdisciplinary participation by physicians, dentists, nurses, community health workers, and other health disciplines. This model serves to provide the patient with a central health home that addresses all their health care needs under one roof.

I will illustrate this concept of collaboration between departments using our pregnant population. It is common knowledge that dental education should start early. The objective is to be proactive rather than reactive; to prevent caries rather than treat caries. To emphasize this message, we have worked closely with our medical colleagues. We have established a gateway for perinatal patients to obtain a dental appointment during their medical prenatal visit. Our medical colleagues can provide immediate scheduling for their patients in the dental department. This preventative appointment is an opportunity to emphasize oral preventative care during pregnancy and carry it forward to their newborn. We review fluoride and its benefits; gingival changes during pregnancy; timing of meals and snacks; tooth brushing and flossing, teething, oral care products, and re-call schedules for children. And continuity of care extends to the newborn as we emphasize dental visits as soon as the first tooth erupts or before age one.

This interdisciplinary relationship carries to other groups of patients with underlying medical conditions, such as those with diabetes. We have provided a pathway, working with our medical colleagues, to ensure that those patients are seen regularly in the dental department too.

Community health dentistry has come a long way. A common misconception is that only extractions are performed. We provide dental procedures from root canal therapy, to removable dentures, and implant restorations. We cater to all ages and emphasize restoration of teeth rather than removal; our goal is not only a healthy mouth but a healthy lifestyle.

Brian Genna, DMD Dental Director, Edward M. Kennedy Community Health Center

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