TEETH PAIN–iStock / Getty Images Plus
Oral health and overall health are interconnected. According to the American Dental Association, poor oral health, including gum disease and infections, can lead to system-wide inflammation.
Inflammation begins when the body is trying to fight against something that’s irritating it, such as a germ that causes a cold or a splinter that causes skin to become red, swollen, and painful.
Inflammation has been linked to a greater risk of health issues like diabetes, heart disease, respiratory infections, and negative pregnancy outcomes, including low birth weight. What’s more, certain conditions like diabetes can weaken the body’s ability to fight oral infections and make oral health problems worse.
That’s why good oral hygiene and regular dental care are so important. They promote a healthy mouth—the door to the body’s digestive system —and also support the body’s overall well-being.
Social determinants of health (SDoH) can make it hard for underserved populations, especially people who are unhoused/unsheltered, to maintain good oral health.
SDoH are non-medical factors that impact about 80 percent of people’s health outcomes. They include education, income, social and community conditions, neighborhood, and healthcare quality and availability. For vulnerable people, these factors are unequal due to forces beyond their control.
DR. ADRIANA MODESTO
To make oral healthcare more equal, University of Pittsburgh Professor Adriana Modesto, DMD, MS, PhD, and Pitt’s first Assistant Dean of Diversity, Inclusion and Social Justice, has created a college course titled Community Outreach Experiences for Vulnerable Populations. In it, Dr. Modesto’s 30+ dental students provide free oral healthcare and social support to underserved Pittsburghers thru the university’s Street Medicine outreach.
“To do that, we divide students into three groups,” Dr. Modesto explains. “Because unhoused/unsheltered people have a higher risk for oral cancer, the first group provides cancer screenings on the street and in shelters.” The risk factors include alcohol and tobacco use, sun exposure, chronic dental disease, and HPV infection. Like other cancers, early detection of oral cancer is key to survival.
The second group of students act as ambassadors to underserved populations, such as LGBTQIA individuals, veterans, people with physical and mental challenges, children and youth, pregnant people, and those who are unhoused/unsheltered. “These students offer care and resources, such as health screenings, follow-up treatment, appointment scheduling and transportation to and from clinics, and help with paperwork for those who are insured,” Dr. Modesto continues.
A third group of students make regular clinical street rounds.
“With Street Medicine, we all work together—healthcare providers and community organizations —to meet people where they live, be in relationship with them, and get them what they need to feel supported and live healthier lives,” Dr. Modesto adds. That can mean getting someone’s broken tooth fixed as well as providing shoes and a warm coat that fits and distributing fresh food, hygiene products, and NARCAN.
While Dr. Modesto’s course has grown in scope and student count since she began offering it in 2021, the one constant is its relevance. “The Street Medicine team now has a dental offering, which it didn’t have before,” she explains. “They’re grateful for our contributions and supportive of our efforts.
“The patients we serve appreciate the healthcare we provide that’s improving their lives,” Dr. Modesto continues. “While there’s no research to confirm this, I think the patients also feel respected and have begun to trust us as allies.” That trust is especially important for Pittsburgh’s LGBTQIA individuals who are at a higher risk for violence, rejection, homelessness, and suicide than their peers.
The dental students are also changed by the experience. “Part of the course requirement is to write about their assignments,” says Dr. Modesto. “My students’ notes include their surprise at the large number of vulnerable people who live in Pittsburgh. They also acknowledge their own privilege compared to their patients’. By doing this work on their own, many also conclude that underserved populations deserve quality healthcare, too. It’s eye-opening for everyone.”
