Essay on Dental Care in the United States and the Dominican Republic

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Oral health is defined as “a state of being free from chronic mouth and facial pain, oral and throat cancer, oral infection and sores, periodontal disease, tooth decay, tooth loss, and other diseases and disorders that limit an individual’s capacity in biting, chewing, smiling, speaking, and psychosocial wellbeing.” (WHO, 2019) Unfortunately, access to oral health care in America is in a crisis and oral health is completely overlooked for most. Through articles and documentaries, I’ve learned about the current state of oral health care in America as well as the importance of oral health for one’s overall health.

The Frontline PBS documentary “Dollar and Dentist” provides a look into the limited world of dental care in America. It examines the long-lasting tension between the need of Americans for dental services and the lack of services available under the current system. The documentary emphasized the maldistribution of dentists in rural communities and its effects on many Americans. Low-income families who are the most vulnerable to oral problems have become the population that is the most neglected. In my opinion, dental care has become a luxury and one that most can’t afford or obtain. Although I was somewhat conscious of the current dental care situation in our country, I was saddened to see how to cooperate chains have turned dental care providers into sales representatives, making unjust decisions based off monetary incentives. It was very unsettling to watch doctors try to provide over-treatment to children. I believe it goes against the ethics and oaths we take when we decide to become healthcare providers. The vulnerable population that lacks of access to oral health care can result in delayed diagnosis, untreated oral diseases and conditions, compromised health status, and even death. An odontogenic infection is an infection that originates within a tooth or in the closely surrounding tissues and can spend through spaces and become increasingly dangerous in patients who are very young.(Bali, Sharma, Gaba, Kaur, & Ghanghas, 2015) Children are extremely vulnerable due to their dependency of a caretaker. The parents of these children typically work numerous hours just to make ends meat and do not have any oral health literacy. Furthermore, they are unable to equip their children with the information and tools need to practice good oral habits. This along with no dental care gives rise to early childhood caries, dental infections, pain, speech impairment, difficulty chewing, sleep disruption, and school absences. Children of the vulnerable population may develop the long-term effects of malocclusion, nutritional problems and dental anxiety of fear.(Bersell, 2017) Oral hygiene habits are developed early in life, it is very important that from day one children create and practice good oral hygiene habits to avoid the many effects of bad oral hygiene.

Dental care in my home country of the Dominican Republic is pretty similar to the one here in the United States. Where there is wealth there are dentists. In more rural areas of the Dominican Republic, you will not be able to encounter a dentist and or dental office. Therefore, poor and lower class don’t receive any dental care and are not educated one bit on oral home care. From my standpoint, since a young child, I’ve visited the dentist regularly for checkups and cleanings. Growing up close to the city I never had an issue with finding dental care which is why I was astonished when I learned that some Americans did not receive dental care because the services were not locally available to them. Furthermore, while discussing this topic with my classmates I learned that in Romania, a country in east central Europe dentistry is cheap but there is no preventive care. My classmate stated when she came to America she had no understanding of what a scaling, root canal or filling was because all they provide in her country are extractions and crowns. My other classmate shared how she is from Nigeria and she has never been to the dentist because in her country dentistry is almost nonexistent. After watching the documentary “Dollar and Dentist,” reading the article “Access to Oral Health Care: A National Crisis and Call for Reform,” and listening to my classmates share their stories and experiences my opinion on access to oral health care has definitely changed. I am now aware how difficult it is for people all over the world to have access to good quality preventive care or any type of oral care at all. I believe oral health is important to everyone’s overall health and should be more prevalent in all countries.

The factors that contribute to problems with access to oral health care are numerous and complex. These include social, cultural, economic, structural, and geographic factors, among others.(National Academies Press, 2011) Solutions to improving the dental care situation in America may be to place dentists in hospitals so that dental professionals are readily available to provide emergency services. Ultimately solving the issue of the maldistribution of dentists would give more Americans a chance to receive oral health care. Dental hygienists can contribute to improving the current dental care situation by lobbying together and gathering evidence to try to change policies to expand the spectrum of responsibility given to dental hygienists. Expanding the scope of care for dental hygienists can help decrease the vulnerable population of oral health.

Oral health literacy has been identified as a major internal barrier and personally, I would like to help break that barrier. I would like to start a blog to help educate our country on how important home care is to help disrupt the bacteria formation in the oral cavity and to help clarify any perceptions and/or misconceptions about preventive dental care. I would also like to inform parents on how they can instill good oral hygiene habits in the lives of their children. Ultimately, I would like to inform and educate everyone about oral health care in hopes that the information can steer someone in the right direction when it comes to oral health choices and potentially save a life.

Although Rome wasn’t built in a day I believe small changes and gestures can help our country rebuild our oral health care system so everyone has access to it. Oral health is not just important for the health of the oral cavity but the body as a whole. Everyone’s life can be improved by having access to oral care and knowledge about oral home care. Oral health care is not a privilege but a right and necessity for everyone and it can’t remain an optional extra in our health service.

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