Jeffrey Jackson and Amanda Kilburn Kerns are thinking big.
By focusing on the critical link between an expectant motherâs oral health and the pre- and post-natal health of her child, the two Schweitzer Fellows and University of North Carolina School of Dentistry students are building bridges between their local dental and medical communities.
In partnership with the University of North Carolina OBGYN Clinic, Jackson and Kerns â whose Fellowship is funded by Blue Cross Blue Shield of North Carolina Foundation
â are recruiting and training medical students and residents to screen
pregnant women for oral health issues, and refer them to the schoolâs
dental clinic for prenatal dental care and education.
âI hope the project will help to create a generation of providers who
are able to recognize the need for prenatal dental care, and who are
ready and willing to work together to help care for pregnant women
during this critical time,â Jackson says.
ASF: Why did you decide to develop your particular project?
Jackson: Despite the best efforts
of many hard-working pediatricians and pediatric dentists, it seems the
dental profession cannot reach children early enough to prevent the
onset of oral diseases like early childhood caries.
Additionally, despite the current recommendations,
many dentists refuse to treat pregnant womenâwhich puts those women
(and, ultimately, their children) at risk.Â We wanted to address
misconceptions and move upstream to help address oral health issues
before they even begin.
Kerns: My mom has been a nurse in the Neonatal
Intensive Care Unit (NICU) for almost 30 years. She was shocked when I
told her that current national guidelines recommend that a child have
his or her first dental visit by age one.
This worried me: if my momâan educated nurse passionate about helping
her patients and the mother of a daughter in dental schoolâwasnât aware
that kids needed to get to the dentist by age one, then how was the
average parent going to know this?
After meeting with Dr. Rocio Quinonez, our Schweitzer mentor,
we realized how receptive pregnant women are to health education
issues. We decided that since the mother is often the main caregiver for
her family, working with pregnant women would be a perfect opportunity
to maximizing our impact on our communityâs oral health.
ASF: What do you hope will be the lasting impact of your project on the community it serves?
Kerns: Not only will we be directly helping the pregnant women who
receive dental treatment as a result of our project, but we are also
hoping to motivate them to find a long-term dental home for themselves
and their families.
In addition, we expect that the experience the fourth-year dental
students at the dental clinic receive in triaging and treating these
pregnant women while in dental school will increase their comfort level
treating this populationâand in turn, increase the likelihood that they
will continue treating these patients post-graduation and in private
Ultimately, we are working toward an entire systems change for
collaboration between the dental and medical communities, as is
supported by the goals of Healthy People 2020.
Jackson: Our ultimate goal is to
create a community of communication and collaboration in which medicine
and dentistry work together provide a means for overall health (both
oral and systemic).Â Greater collaboration is needed between the two
fields in order for health professionals to provide the best possible
care.Â I hope the project will help to create a generation of providers
who are able to recognize the need for prenatal dental care, and who are
ready and willing to work together to help care for pregnant women
during this critical time.
ASF: What do you think is the most pressing health-related issue of our time, and how do you think it should be addressed?
Jackson: I believe that the most
pressing issue a health care provider can face is being able to provide
health care for everyone. Through our Schweitzer project, we connected
with a segment of the population that was essentially ostracized from
the dental system due to many misconceptions and myths.Â We felt the need
to find a way for them to receive care and work towards a culture shift
to try to permanently alleviate this issue.
Kerns: Perhaps not the most pressing, but certainly a
health issue that needs to be addressed, is the lack of collaboration
between the fields of dentistry and medicine. Many people see their
dentist more often than they see their doctors, so dentists are trained
to watch out for conditions such as undiagnosed heart disease or
diabetes, or suspicious skin lesions.
One of the goals of our project is to motivate Ob-Gyns to incorporate
dental messages into the medical messages that they are already giving.
For example, as they discuss hormonal changes and how this may affect
the way a woman is feeling, Ob-Gyns have a perfect opportunity to
discuss pregnancy gingivitis and how it can be treated.
Our goal isnât to add additional work into the already jam-packed
prenatal care curriculum; itâs to remember that the oral cavity is the
portal to the entire body, and thus, medicine and dentistry really go
ASF: What has been the most surprising element of your experience as a Schweitzer Fellow?
Kerns: I never cease to be amazed by the pregnant
women I work with in the clinic. Many of them are struggling with
serious health issues, juggling multiple small children, language
barriers, and limited resources, yet they are active participants in our
discussions on oral health for themselves and their families.
Oftentimes, they put their childrenâs needs before their ownâso when
they learn that there are links between the oral health of a mother and
her infant, they begin to prioritize their own oral health, in addition
to that of their children. These mothers want what is best for their
families, and it is inspiring to see how selfless they are when it comes
to the needs of their children.
Jackson: I think the thing which
has shocked me the most is the willingness and lengths the pregnant
women with whom we are working will go to ensure a better outcome for
their children.Â Some days, we work in the high-risk clinic, which has
patients dealing with serious issues like diabetes, drug addiction, and
spousal abuse.Â To see these patients stop, think, and put their unborn
child before their own selves time and time again has been amazing.
ASF: What does being a Schweitzer Fellow (and ultimately a Schweitzer Fellow for Life) mean to you?
Jackson: It means that I have a responsibility to work
to address arising health needs in my community, and to work towards
bringing a solution to these needs.Â It also means that I have the
support of Fellows in other allied health fields to make large-scale
Kerns: Being a Schweizter Fellow for Life is truly
an honor for me because it provides me with a consistent network of
leaders within my community who are working to make a difference. The
busier I get in life, the easier it is to forget that the world is
larger than my lecture halls and clinic operators, and that there are
other causes worth fighting for besides the ones I immediately identify
with. I love staying connected with what the other Fellows are working
on and having the opportunity to help them, and have them help me.
To learn more about the North Carolina Albert Schweitzer Fellows Programâs work to create change and improve health, click here.