Time and Compassion: Ingredients to Overcoming Healthcare Inequalities
As a paediatric dentist working in a busy hospital within the United Kingdom, I have witnessed extreme cases of dental neglect. I am also aware of the problems dental neglect causes for children, parents, and the wider community, particularly insightful in cases where I have seen bias against those with social, cultural and language barriers. Health and wellbeing from a dental perspective is the awareness that oral health conditions can impact a person holistically and when we neglect a person’s oral health, we are neglecting their human rights. Within all healthcare there are conscious and unconscious bias impacting people daily. These experiences inspired a passion for improving healthcare access and education for disadvantaged and socio-economically deprived groups.
The moment I knew I wanted to help disadvantaged groups and help overcome ingrained bias in our system, was when I treated a 3-year-old boy with severe learning difficulties. His mother had attended the hospital clinic after he refused to sit in the dental chair at their primary care dentist. His primary dentist and mum insisted that he would need to have his treatment completed under general anaesthesia, despite no additional measures having been tried in practice. They believed he would not cope with treatment without it. Upon entering the room, the child was anxious and tearful, and we utilised the first appointment to encourage and familiarise him with the team whilst reinforcing good habits. After some time, the child sat in the dental chair and was cooperative. I explained the planned procedure to him utilising various behavioural management techniques. At his next appointment, to my surprise, he jumped into the chair without hesitation — a wide smile on his face. This experience not only provided an unparalleled feeling of provoking real change through my practice, but also demonstrated how disadvantaged groups face barriers to being treated in primary care, sometimes due to lack of flexibility from their healthcare professionals. Sometimes, extra time and compassion can make a life-long impact on a child’s perspective of healthcare environments. It cemented my commitment to pursuing a career in helping those with the greatest need and I haven’t looked back since.
One passion of mine is oral health promotion, especially in young children. In my paediatric dental department, there have been issues with young, disadvantaged children accessing NHS dental treatment in primary care. The cause is multifactorial but has worsened from the Covid-19 pandemic. Over my years in clinical practice, I soon understood that oral health promotion is complex and was not as simple as instructing patients to improve brushing and reduce sugar intake. Without fully understanding various social factors which influence patient’s oral health and the need for personalisation of care, I was failing to provide the best advice to my patients. This failure is widespread and contributes to the inequalities seen.
I have since reflected, expanded my knowledge and grown to appreciate that health-related behaviours are strongly linked with social determinants of health and that most healthcare professionals are not individualising care to overcome these barriers. This is especially the case in disadvantaged groups, known to have lifestyle factors which impact their oral health. Re-programming your habits takes humility and a reason for change. Seeing the positive impact it has on the children is my reason for change.
I decided to partake in this Masters as I believe not only will I benefit from this programme, but will be able to implement further changes and programmes in my own department and wider.
