Download a PDF of the fall 2012 edition - UBC Dentistry - University ...

12 FALLFALL12From left to right: Matthew Gustafson, Ellen Park, Paul Mikhail, Les Campbell, Robert Mills and Michelle Brown.· Age-appropriate school curriculum: UBC Dentistryhas created and integrated educational materials intoyear-long core curriculum for grades one through 12.Content ranges from brushing techniques to foodchoices and the impact of smoking.· A rewards system: Students at local Haida Gwaiischools collect points on a card for healthy activitiesand practices and have the chance to enter a raffleto win a bicycle, reinforcing a healthy lifestyle.· An after-school mentorship program: Career-mindedHaida students in grades 10 through 12 watchdentistry in action and learn about general andchair-side dentistry, infection control procedures,surgical procedures and front-desk reception.Structured conversations address dentistry within ahealth-and-sciences context, enabling First Nationsstudents to consider a dentistry career (a facultystrategic goal) or one in medicine, nursing or otherhealth-related fields.· Training of auxiliary staff: A training program inHaida Gwaii, started by UBC Dentistry, enableslocal First Nations people to become dentalreceptionists and dental assistants. Two currentdental receptionists went through this program.· Effective medical model of triage management:Education of community members enables healthcare professionals to better triage dental patientsto the right treatment areas or triage themselvesearlier, because they recognize that they havedental disease, says Zed. “They don’t think it’sgoing to heal all by itself. Therefore, their dental IQhas gone up.”Cutting-edge research· Oral health and fitness: A current study of the localpopulation examines how mouth disease relates toobesity and other diseases.· Fish oils and oral health: UBC is investigating thelinks between the Haida’s fish-laden diet anddental health. This will help determine how theirhealth and diet compare to that of people in theBC Lower Mainland.Zed has two measurements of ultimate success forthe Haida Gwaii model. With a program morefocused on health promotion and disease prevention,he envisions “less disease coming through the door,”reinforcing the positive impact of preventiveeducation. He’d like to see the model inspire Haidalocals to come to UBC for dental training, then returnto their community to practise dentistry.Zed would like to add a student rotation under UBCDentistry’s Professionalism and Community Service(PACS) program, which combines classroomlearning with community-based outreach initiatives.In addition, he plans to introduce technology anddistributive (distance) learning models, which wouldenable students in Haida Gwaii to learn corecurriculum offered at UBC’s Point Grey campus. Zedbelieves that these opportunities will be availablewithin two years.The following factors have enabled UBC’scommunity service model in Haida Gwaii to gain theacceptance of local people and create an effectivecross-cultural approach, says Dr. Christopher Zed:Communication: mutual respectand trust· a willingness to ask many questions like “What,specifically, do you feel that you need? How canwe reduce the no-shows?”· clarity on how treatment and care decisions aremade; for example, whether via the extendedfamily, Haida chief or First Nation band· enough humility to say: “Here’s where we’restruggling, and here’s where we’re failing”Collaboration: local engagementand buy-in· ongoing partnerships and an excellent relationshipwith key First Nation decision-makers, such as thelocal band councils and the health director· school principals and teachers who champion theoral health curriculum provided by UBC DentistryCultural competencies:understanding values and beliefs· an awareness of how parents’ own attitudesand fears about dental practices influencetheir children· an appreciation of the differences in how peopleaccess and believe in their dental careWhat do students andstakeholders say about theirHaida Gwaii dentistry experience?Dr. Matthew Gustafson, general practiceresident (January-February 2012): A teenagepatient struck in the face while playing roadhockey would likely have lost his teeth withoutthe specialist care he received, says Gustafson,who repositioned the youth’s teeth and gavehim a dental splint. Later during his 10-weekrotation, Gustafson removed the patient’ssplint and restored some chips in his frontteeth. “What left the biggest impression on meduring my rotation was the chance to provideservice to a group of isolated people whowould otherwise not have access to treatment.”Gustafson saw patients ranging in age from11 months to 80-something. Besides doingmultiple fillings, he did preparations forcrowns and bridges, partial and completedenture fabrications, cleanings, root canalsand extractions. He also worked with threespecialists: a pediatric dentist who usedoral sedation on children with behaviourmanagement problems, an oral surgeonwho extracted difficult wisdom teeth usingintravenous sedation, and a periodontist whodid soft tissue grafts and implant placement.The Haida Gwaii rotation provides an excellentopportunity to learn from specialists, honeyour technical skills and see a large numberof patients with a wide range of treatmentneeds, Gustafson says. Culturally, the rotation’sapproach stresses the importance of beingmindful of the customs of patients, he adds.Dr. Ellen Park, endodontic resident (one-weekrotation, September 2010): Ending a work daywith a kayak trip through spectacular scenery,and a campfire, is “exquisite,” Park says. “I wasimpressed to see a thriving and well-appointeddental clinic in such a beautiful natural setting.”When not helping students perform rootcanals, Park says, she learned a lot from UBCDentistry faculty, who provided practical tipsand tied them into ongoing research.The local community was quick to welcomethe students: “Artists stopped by with their artwork. The proprietor of the local coffee shopsteered us toward incredible hikes and lent ushis kayaks. Everyone was quick to chat and sayhello. The clinic patients I met were friendlyand full of character.” She definitely wants togo back for another rotation.Dr. Paul Mikhail, a 2012 UBC Dentistry grad(two-week rotation, April 2012): A militarydentist in Ottawa for the federal government,Mikhail now does recall exams more efficientlythanks to his rotation in Haida Gwaii.Then a fourth-year DMD student, he alsoperformed emergency work on a crackedtooth and watched the pediatric dentist workwith the general practice hospital residents.He appreciated the opportunity to see howa public clinic operates.While on the islands, Mikhail hiked on trailsand went clam digging. “It’s beautiful outthere. We loved the environment and liked thepeople a lot. It’s a very relaxed kind of life.”Dr. Les Campbell, UBC endodontics gradstudent (July 2012): From a panoramic viewatop Tow Hill to eating freshly caught salmonat a waterfront home, Haida Gwaii is “reallyincredible,” says Campbell. “The view isunaffordable anywhere else. The place is magical.”When he wasn’t supervising general practiceresidents, dentistry graduates or undergraduates,Campbell was catching salmon and halibut andexploring the islands, which he has visiteda handful of times on his own.He says that he found his role as mentor at theSkidegate clinic fun and satisfying. The newlyminted grads saw endodontic challenges theyhad never encountered and asked questionsthat prompted him to rethink the foundationsof his training. “Being a teacher, you’re alifelong student,” he says.Robert Mills, chief councillor, Skidegate BandCouncil: His 14-year-old autistic daughter,whom he describes as low functioning, receivedphenomenal treatment at the Old Massettclinic. With great patience and interaction,the dentist got her accustomed to using atoothbrush and had her teeth cleaned with the“air-powered tool.” “I was very surprised,” hesaid. “Usually, I have to take her to Children’s[Hospital] and generally, they knock her out.”Mills calls the clinic service “awesome” and sayshe hasn’t heard any negative remarks aboutit. The education program at the elementaryschool and the display booth at the annualSkidegate Days summer event, which offers oralcare information and free toothpaste, floss andsugar-free gum, have been a success, he says.“Overall, our community members have betteraccess to dental care.”It can still take months to get into the clinic,he adds, but not if you ask to be put on acancellation list. Mills has one complaint: Toomany off-reserve people and Old Massettresidents are coming to the Skidegate clinic.Michelle Brown, health administrator, HaidaHealth Centre in Old Massett: It would be awfulif UBC Dentistry wasn’t working in Old Massett,she says. “The closest dentist is a hundredkilometres away in Skidegate. Nobody would go.”With no orthodontist on the island, her17-year-old son has received help with hisbraces at the Old Massett clinic. (UBC’sgraduate orthodontics program plans to startrotations in Haida Gwaii soon to providesuch service from a specialist.) He has alsolearned about flossing at school, as have histwo younger siblings. Pictures of gum disease,along with sessions on cancer prevention andgood oral hygiene, have helped promote betterhealth in the community, she says.16 UBC DENTISTRY IMPRESSIONSUBC DENTISTRY IMPRESSIONS 17