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Brightening smiles and lives: bringing health equity to dental care


As jazz icon Louis Armstrong famously crooned, “When you're smilin', the whole world smiles with you.”

While that may seem like a simple concept, for some people smiles don’t come easily because of barriers to accessing dental care.

That’s why, in April 2017, the Pictou County Mental Illness Family Support Association launched the Bright Smiles project, which aims to provide free dental work for people living with a mental illness.

It soon became apparent to Cecilia McRae, who co-facilitates the group, how much oral health and dental care is an issue of concern for people.

“We quickly realized that the loved ones we support often had concerns around oral health and they weren’t getting care for a number of reasons,” McRae said. “It was clear we needed to do something to help bridge the gap.”

The one-of-a-kind community-based project connects dentists and dental hygienists with people who don’t have regular access to dental care. The initiative has received donations from municipalities, as well as community health boards and organizations, including the Aberdeen Health Foundation, the Mental Health Foundation of Nova Scotia, and the Kinsmen/Kinettes of New Glasgow.

To date, there are 10 dentists on board, seeing 35 patients, with a waiting list of eligible candidates.

Many of these individuals had not been to a dental healthcare professional in many years and suffered with the pain of dental disease.

“Embarrassment was often a noted a factor – fearing how they would be treated and judged. That shame and worry is enough to keep people from accessing care,” McRae said.

One such patient is Wanda, who shared that she was “hiding because of my smile” and lived in fear of people judging her because of her teeth. But the dental work gave her a new perspective on life, improved her self-esteem, and that led to a new relationship.

In October, Public Health partnered with the group to organize a capacity building session on health equity. Approximately 40 Pictou County dentists, denturists and dental hygienists attended the event.

“We were hoping to raise awareness around the issue of health equity and … address some of the barriers related to stigma and discrimination that individuals face when accessing health care services,” said Ashlie Cormier, strategic partnerships and engagement consultant with Public Health.

One of those in attendance was Rosemary Bourque, a dental hygienist with Public Health who sat in on the session planning committee and also works part-time at a private dental practice.

Not long after the session, Bourque saw a patient at the practice who hadn’t had any dental care in the past six years.

When asked if he had experienced any health changes since then, the man said he was living with depression and taking antidepressants. He also shared that he’d neglected to take care of his teeth.

“(The health equity session) made me very aware of how he might be feeling and some things that I could do to make life a little easier for him,” said Bourque, who focused on using positive reinforcement to help make him comfortable.

“He was expecting to be judged. He was very down on himself; he’s had a hard time,” she said. “So, I tried to give him some positive messaging, saying ‘This actually looks pretty good, you’ve done pretty well to take care of yourself under the circumstances and we’ll get you back on track.’ ”

At the end of the appointment, the man asked her for a hug to show his appreciation, something that had never happened in Bourque’s 30 years of practice.

Cormier said that type of feedback is very encouraging and they are looking at possibly organizing additional sessions in other areas.

“Oral health is a priority for Public Health, and we’re exploring ways to continue developing these types of partnerships and share their experiences with others across the province.”