Eastern Shore Rural Health System (ESRHS) patients can receive dental care at local schools; this photo taken at Metompkin Elementary and courtesy of the ESRHS public webpage.

Of the many services offered by Eastern Shore Rural Health System (ESRHS), the dental program- currently available at 4 out of the 7 ESRHS community health centers and via traveling clinics- is central to the organization’s mission to “enhance the quality of life for people on the Shore, by providing accessible, comprehensive and affordable health services”. In fact, oral health is not only an ESRHS priority, but a national focus, as evidenced by the U.S. Department of Health & Human Services’ recent commitment of $156 million to improve oral health access and outcomes for patients at federally qualified health centers. A portion of this federal grant, totaling $350,000, was awarded to ESRHS during the first week of June 2016.

It is yet to be seen how all of this funding will be used, but under the direction of ESRHS chief dental officer Dr. Scott Wolpin DMD, who boasts extensive experience optimizing the oral health literacy of medically underserved populations living on the Shore, we may expect this to be a target area. For the area’s migrant community in particular, the concept of literacy takes on various meanings, as the majority of these patients are Spanish-speaking, often cannot read or write, and are typically not ‘health-literate’, in the sense that U.S.-trained medical providers are accustomed to.

Faced with these obstacles, Dr. Wolpin emphasizes the critical role that interpreters, community health workers, and adequately trained dental professionals can have in changing the status quo when it comes to oral health literacy. For instance, at an Institute of Medicine-sponsored roundtable on health literacy in February 2013, Wolpin shared his success in deferring to a savvy interpreter; she was able to identify a widespread, cavity-causing practice of putting infants to sleep with a bottle of sugary juice or honey, which had until then eluded the dental staff. From this anecdote, student interpreters, such as myself, can glean that quality work is not based solely on correct vocabulary, but must also be drawn from the cultural, sociologic and anthropologic knowledge we have learned throughout our semesters at The College.

Atlantic Community Health Center is the newest addition to the Eastern Shore Rural Health System (ESRHS) network of sites along the peninsula. Senator Tim Kaine sent video remarks for view at the ribbon-cutting ceremony on 11 June 2013. (video courtesy of ESRHS marketing)

Since beginning my internship this past week at Atlantic Community Health Center, I have already witnessed a deliberate focus on oral health by ESRHS. Providers routinely ask when a patient was last seen by a dentist, encourage oral hygiene by providing free toothbrushes, and arrange for specialist follow-up when a complex dental procedure is necessary. However, a concurrent reality also struck me, upon seeing a child from a migrant family with over a dozen cavities definitely requiring an outside provider’s expertise, and no means of payment. As the referral specialist received one more negative response via telephone, from the last pediatric dentist whom she could think of to accept the case, I cringed imagining the remaining options for this individual.

While I do not have a best-case-scenario-ending to conclude this post with, or even any additional information on this patient’s case (s/o to HIPPA!), to me it demonstrates why efforts to truly connect with patients, though often frustrating or discouraging, are critical. This migrant child’s unmanageable amount of dental decay could have been prevented by better tooth-brushing habits, combined with healthy drink choices.  Though the seasonal nature of the Shore’s migrant population does not lend itself well to comprehensive preventative care, ESRHS does not balk at the challenge. The aforementioned traveling dental clinics visit local schools, where children are already present as participants in the migrant summer program, as their parents spend the daytime at work.

Thanks for reading and stay posted for an insider look at traveling clinics and other in-the-field experiences. Also, feel free to contact me with any topic requests or feedback.

Ciao for now!