Sealants!

So much can be taken away from the sealants rotation. An obvious item is that the experience allowed me to hone my hand skills as a clinician. I developed techniques to help with fine hand movements while working in limited space. But beyond the practical experience, this was a true opportunity to refine communication skills. The locations that our rotations took place were prime venues for young professionals to escape the comfort zone of the classroom and work with patients who were in a completely different state of mind, in so many ways. This program provided our class firsthand experience on working with inner-city children from the Cleveland Metropolitan School District. It was a moving experience that taught me how pivotal access to care can be in a community and confirmed the necessity of subsidized programs such as this one.

Before participating in sealants rotation, I believed that there was a large disparity in oral health status between children from rural areas versus those located in the inner city. I now know that this isn’t necessarily true. Although it’s the year 2012, there were children that informed my partner and me that they did not even own a toothbrush. This wasn’t as much an indication of low income but more a shocking perspective of priorities in areas of low social economic status (SES). I performed my own research before attending the rotation and made note that in order for schools to be eligible for the sealants program at least 50% of the children must qualify for free or reduced cost lunch (185% below federal poverty guidelines). Even this knowledge was not enough to prepare me for some of the mouths that I would work on.  There were many children with caries; some required urgent care and to my surprise didn’t register any discomfort during probing. It is one thing to hear statistics and another to see it.

There was one particular patient interaction that had an impact on me. Following our normal routine in the final week, my partner and I set up our station and grabbed a new patient. It was my turn to play doctor and I introduced myself to a very sweet second grader and asked her to take a seat for an examination. After opening her tiny mouth, it was immediately apparent that she had rampant decay in her adult molars, the worst I’d seen by far. I thought to myself, how could this already occur at such a young age?? So I asked her, “How often do you brush your teeth, Sweetie?” to which she responded, “I don’t have a toothbrush”. She informed me that none of her siblings owned a toothbrush; my heart broke for her family. There were some portions of her molars that were salvageable for placing sealants but this gesture would not be enough to save this poor child’s mouth in the long run if there weren’t serious changes at home.

                In the beginning of last semester we watched a movie called, Unnatural Causes. This movie did an excellent job describing the hardships faced by families of extremely low social economic status, and displayed obvious marketing schemes that continue to suppress these areas. There was a period in my childhood where my dad was a single parent with no choice but to raise my sister and me, in a flea ridden apartment in a low SES community full of corner stores and run down businesses. I felt for these children, but I wanted to do my best to convey to them that there are people out there that want to help them be healthy and successful.

Despite the difficult moments, I gained invaluable experiences. There were some children who had excellent oral hygiene to which I could only do my job and send them off without a care in the world. I enjoyed the challenge of working with these disadvantaged elementary students. For me, it wasn’t an issue of relating to their lives but more developing my communication skills with children. I am thankful to have participated in this program.