Bringing
Care to People rather Than People to Care – SEM approach
Watching the video of “the name of the disease” and mentoring
the bad health conditions, through my dental experience, in the developing
countries, triggered my memory back to my first patient in the pediatric
dentistry clinical class when I was a fourth year dental student. I recall how
shocked I was when I saw this kid whose teeth were badly mutilated although he
was only 6 years old. Back then; I wondered, as a dentist, what my role is
towards this kid. Should I only fill his cavities, extract his badly broken
down teeth and apply the artificial appliances? I still remember my professor
who told me then “A successful dentist is not only treating teeth, but rather
is treating PATIENTS having teeth”. These words became the base of my
professional career, since then.
Having this background makes me agree completely with Dr. Neiderman
in his article Bringing care to people rather than people to care, that
the role of a dentist is far beyond to drill, fill then bill. The statistics
that was clarified in his article showed that the incidence and prevalence of
untreated caries remained unchanged from 1990 to 2010, and this sounds the
alarm that focusing on surgery is not the solution for dental caries as a major
public health problem. I like how the author presented the concept of the delivery
of preventive dental care via three levels; patients (through brushing
and flossing), non-dentist community health workers and school systems (through
provision of oral health facilities), and community wide programs and
improved infrastructure capacities (through community water fluoridation).
However, I believe that the role of the dentist is mandatory along with these
levels not only through tertiary prevention (by providing dental care and
rehabilitation) but also via oral health education, counselling and orienting
patients’ minds towards adopting new healthy behaviors.
Although
adopting a new healthy behavior is a long process which is not that easy, it is
not impossible. In my opinion, it can be tailored according to individual
variations in age, psychological and cognitive development. However; these
steps won’t be successful without making the environment more conductive to
facilitate, support and maintain that behavior. Such an approach supports the
concept of the complementary role of (the community, individuals, experts,
public health professionals and governments) which is a classical
representation of the socioecological model (SEM). I believe that all should
work together towards improving health conditions among populations especially
developing ones that are struggling under various extreme harsh conditions.
References:
“The name of the disease” video – (MIT Poverty Action Lab)
Niederman, R. (2015). Bringing care to people
rather than people to care. American Journal of Public Health, 105(9),
1733.
Excellent reflections!! we not only treat the disease but treat the patient having the disease and thats more important. I think education plays a big role here specially in countries where chewing tobacco, smoking cigarettes are huge problems. Much is related to lifestyle though as there is a huge practice of people to subject the teeth to abuse. Take for example, the practice of drinking coffee here all through the day or having Sugar sweetened beverages (SODAs). The teeth suffer a lot. Models like SEM make a lot of sense in these conditions.
ReplyDeleteSalma, great post! Your ideas had me lost in the literature on SEM and the various disciplines in which it has been adopted in research, very applicable to my own research interests such as maternal nutrition and maternal health literacy- thank you so much for that!
ReplyDeleteDentistry and oral health has been undermined in my opinion, even in North America in terms of what it can tell us about a patient's overall physical health and even the environments in which they live in. After reading your post and searching various ways in which SEM has been used in dentistry, I came across an article by Newton & Bower (2005) and their examination of ways to approach such a complex system that is made up of interrelated parts. The article is well worth the read and is a fascinating perspective; I provided the link below as I think you would be interested in the full article as well. They explain that traditionally, research often approaches oral health outcomes as being made up of linear relationships between certain factors, using the example of social class, environment, psychosocial stress, and oral behavior as determinants of oral health when in fact, not enough has been done to explore the cross-ways between each. Each of these four factors they use as an example need to be explored as their own being and understood as complex systems in and of themselves. It is only when this is done in research that effective public health programs can be developed. I think oral health is a great place to start in assessing not only an individual's overall wellbeing but also a given population.
Full Article:
Newton, J. T. & Bower, E. J. (2005). The social determinants of oral health: new approaches to conceptualizing and researching complex causal networks. Community Dentistry and Oral Epidemiology, 33: 25–34.
http://onlinelibrary.wiley.com/doi/10.1111/j.1600-0528.2004.00190.x/abstract
It seems an interisting article!
DeleteThank you Amy for posting that
Salma,
ReplyDeleteI really enjoyed your post! The quote about not just treating teeth but treating the patients is really great. I think that Doctors of all specialties should have this type of mindset. The six year old boy you mentioned in your post needed much more than just treatment of his teeth. If you just treated his teeth, you would care for his teeth as much as you could during that appointment and then he would go home practicing the same unhealthy habits. Getting to know you patients’ habits, and their parents in this case, and understanding their level of knowledge is very important. I agree that just like all preventable illness and disease, oral health also requires maintenance and preventative care. I think oral health is often overlooked, but like we said in class it is one of the first things other people notice about you.