Jeffrey Jackson and Amanda Kilburn Kerns are thinking big.
By focusing on the critical link between an expectant mother’s 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 — whose Fellowship is funded by Blue Cross Blue Shield of North Carolina Foundation — are recruiting and training medical students and residents to screen pregnant women for oral health issues, and refer them to the school’s dental clinic for prenatal dental care and education.
“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,” 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 women—which puts those women (and, ultimately, their children) at risk. 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 mom—an educated nurse passionate about helping her patients and the mother of a daughter in dental school—wasn’t 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 community’s 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 population—and in turn, increase the likelihood that they will continue treating these patients post-graduation and in private practice.
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). Greater collaboration is needed between the two fields in order for health professionals to provide the best possible care. 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. 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 isn’t to add additional work into the already jam-packed prenatal care curriculum; it’s to remember that the oral cavity is the portal to the entire body, and thus, medicine and dentistry really go hand-in-hand.
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 children’s needs before their own—so 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. Some days, we work in the high-risk clinic, which has patients dealing with serious issues like diabetes, drug addiction, and spousal abuse. 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. It also means that I have the support of Fellows in other allied health fields to make large-scale changes possible.
Kerns: Being a Schweitzer 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 Program’s work to create change and improve health, click here.