Heritage Snapshot: Part 238

LOMA LINDA>> The general public in China has been unaware of the need for, and value of, good oral hygiene. Even today, there are patients and even dentists who hold firmly to the notion that the act of cleaning teeth with dental hygiene instruments is detrimental to the teeth. As a result, periodontal disease is prevalent. Dental hygiene as a profession is not as present in today’s China. How to address this problem? During two visits in 2005, Dr. Les Arnett spent three evenings each week lecturing on periodontics and his wife, Linda, a dental hygienist, spent time during the day with two dental assistants who were initially providing coronal polishing for patients. This developed into further instruction in early instrumentation of the teeth to remove bacterial deposits from tooth surfaces. Little did Linda realize then that she was planting seeds that would germinate into Sir Run Run Shaw Hospital’s future Dental Assistant Hygiene Program (DAHP). A U.S. dental hygienist, Amy Joy Bergman, RDH, was invited to spend a year at the SRRSH Dental Clinic to promote this part of dentistry. During that year, she began to collaborate with Dr. Thor Bakland, and later with Dr. Les Arnett from LLUSD and his wife, Linda, to develop a pilot training program for dental assistants. The DAHP was based on the Loma Linda University Dental Hygiene educational program, but not to the same level. It would, however, be a first step toward incorporating dental hygiene into dentistry in China. Bergman worked to develop the details of such a program and received extensive educational support from Bakland and Arnett. The program started in 2009 with 15 students; they were dental assistants already hired by the clinic and they had some knowledge of dentistry, but at a minimal level. In 2009, Bergman completed her assignment and her position was taken over by Claudine Love Stephenson, RDH, MPH. According to Stephenson, there is a tremendous need for dental hygiene in China because more than 90 percent of the adult population has periodontal disease, also know as inflammation of the gums. The incidence of dental caries may even be higher. The recent increase in consumption of processed foods, sweets and other unhealthy foods over the past 20 to 30 years has coincided with an increased need for good oral health care. By promoting dental hygiene one can envision more opportunities to share “Loma Linda” health principles. Since dental hygiene has been low on the interest scale for both patients and dentists in China, dentists have not been enthusiastic about providing such care for their patients. The presence of the DAHP at SRRSH Dental Department, however, has sparked interest elsewhere in China and other dental institutions have now become interested in sending their assistants to SRRSH to be trained. According to Shirley Lee, RDH, Associate Professor of Dental Hygiene at Loma Linda University School of Dentistry, who has participated in the training and competency testing of the DAHP students, Chinese patients are more interested in oral health now as a direct result of chair-side education. Since 2009, these DAHP students have been making history as they change the lives of their patients. Lee further explains that previously, dentists would clean only the visible parts of the teeth. Dental hygienists clean below the gum line and thus improve the oral health of their patients. The SRRSH dental assistants who participate in the DAHP are hungry for information. They are anxious to learn: they are very receptive of their education and want to learn more. Patients also learn, according to Lee. An older gentleman arrived for a dental hygiene appointment. Because he had a lot of calculus buildup after not ever having had his teeth cleaned, he needed an additional appointment to finish the treatment. When he refused to make another appointment, the DAPH student asked Lee to help. In speaking with the patient, she learned that he was just nervous. She explained how the mouth impacts a person’s overall health and its relationship to whole-body care. This explanation helped him to understand the importance of this care, and he was now willing to return and have the same DAHP student complete the treatment. Lee said she told her students, “You have witnessed a miracle, by changing one life at a time.” The patient now understood the relationship between his oral care and his whole-body care. According to Lee, the importance of collaboration is significant: “We, as health-care professionals coming from Loma Linda, are helping to train the upcoming professionals in oral health care here, in the entire country. We are teaching them what we know and helping them to increase their skills, so that they can share those skills with their own people.” Lee acknowledged her own personal and professional growth from the experience. “I’m learning just as much from them. I’m learning to be a teacher in a different setting. I’m learning different cultures. I’m learning different ways of teaching—different ways of learning. It’s helping me to be a better teacher, as well. I want to see this as the premier dental hygiene program in the country of China. I think if we continue with the collaboration, it can have a huge impact,” she said.