Category Archives: 04: Clinical therapy

Union Gospel Mission – The Orchard

This past semester, I had the opportunity to develop and implement a preventative oral health program at Union Gospel Mission’s (UGM) Orchard Complex for my community rotation. UGM is a non-profit Christian organization that aims to transform communities by overcoming poverty, homelessness and addictions. The Orchard is a subsidized housing complex with 75 town homes, aimed to provide long and short term housing to new immigrants, refugees and low socioeconomic individuals. Similarly to Pioneer Community Living association, my role as a student dental hygienist was to provide preventative and non invasive therapeutic services such as dental hygiene exams, oral cancer screenings, debridement, fluoride administration and oral health instruction. Although the majority of clients are individuals living in the Orchard complex, we recruited new clients through the community health nurse, referrals from current clients and from a local church that is sponsoring two Syrian refugee families that arrived in February. At this community site, three dental chairs and two portable dental units were shared between four students.

This was a community site that helped me develop efficiency in my clinical skills. I was required to see an average of three clients per session, and my cultural competence was tested as the clients varied greatly in terms of culture and ethnicity. The two greatest challenges at this community site was the language barrier between the client and myself, and the fact that the majority of the new clients had not seen a dental professional due to poor access to oral health services in their home countries or financial restraints. These challenges were managed by speaking slowly, using hand gestures and pointing to the area of concern when explaining the client’s diagnosis and treatment plan. Overall, the community initiative was successful as we treated a total of 69 patients, 18 of which were new patients.  12969331_10156744948110384_1054235769_n

Ray Cam Community Clinic

Ray Cam Community Clinic stirred in me a great interest in the low socioeconomic population. Currently 1 in 7 Canadians live in poverty.1 Low income populations tend to experience greater health inequities such as poor access to health services, systemic health conditions (high blood pressure, obesity), and poor oral health.1 The low socioeconomic population face the double burden of having the highest level of oral health problems and the greatest barrier to oral health care.2,3 Cost of dental treatment remains to be a deterring factor for those struggling financially.1 Although, the Canada Health Act states “continued  access  to  quality  health  care  without  financial  or  other  barriers  will  be critical to maintaining and improving the health and well-being of Canadian”, there is a absence of a policy  attempting  to  achieve  “continued  access  without financial or other barriers” enacted for oral health care.2,3

The clinic was held in Ray Cam Community Centre, situated in Downtown Eastside in Vancouver, a region known as Canada’s poorest postal code. Many individuals who sought care from the clinic were predominantly elderly individuals of Chinese descent and had not seen a dental professional for 10 to 15 years. Working along side an experienced registered dental hygienist and two other dental hygiene students we managed to provide dental hygiene services to more than 30 individuals. This was also my first exposure to an individual with severe chronic periodontitis and an “wall to wall” calculus. This community initiative allowed me to use my the talents, skills, and knowledge I have acquired from my undergrad career to serve a marginalized population.

  1. The Canadian Academy of Health Sciences. Improving Access To Oral Health Care For Vulnerable People Living In Canada. 2014
  2. Provincial Health Services Authority. Towards reducing health inequities: a health system approach to chronic disease prevention. Vancouver (BC): Population & Public Health, Provincial Health Services Authority; 2011.
  3. Health Officers Council of BC. Health inequities in British Columbia: discussion paper. Vancouver (BC): Public Health Association of BC; 2008.

Pioneer Community Living Association

12987996_10153606686039226_588516374_n.pngMental illness is becoming increasing prevalent in Canada as statistics reveal that in any given year one in five Canadians experiences a mental health problem.1 Additionally, literature shows that people are more likely to visit their oral healthcare providers on a regular basis than their other primary healthcare providers.2 It is reported that adults aged 20-44 rarely visit their family doctors for preventive care, yet they visit their oral healthcare professionals at least once a year.2 Therefore, understanding this population`s barriers to oral health care can help clinicians managed this population and treat them with dignity they deserve. In addition to providing clinical services, my team and I held a table clinic to educate the population about the difference between healthy and unhealthy gums and showed them how to care for their oral health daily. The goal of the table clinic was to encourage the population to equip them with the basic knowledge and skills to care for their oral health daily.

Pioneer Community Living Association (PCLA) challenged me in the area of professionalism and client management as I provided treatment to a population living with multiple mental illnesses. I learned the importance of not labeling the residents by their condition, but instead understanding that they are people living with a chronic condition. During the meeting with the care manager of the facility, she stated that the residents “have enough20151202_102533 difficulty getting out of bed in the morning, more so caring for their oral health”. Keeping this in mind and having mindset of empathy, allowed me to understand the justification behind the poor oral health state of some of the residents. My community rotation at PCLA has equipped me with the skills to successfully create andmanage a community oral health program as my team and I were responsible for managing all aspects of the program including: assessing and diagnosing the needs of the population, developing a plan that catered to the needs, manage inventory of supplies, implement the plan, and evaluated the population.

  1. The Canadian Academy of Health Sciences. Improving Access To Oral Health Care For Vulnerable People Living In Canada. 2014
  2. Gordon JS, Albert DA, Crews KM, Fried J. Tobacco education in dentistry and dental hygiene. Drug Alcohol Rev 2009; 28:517–532.