Getting to the Roots of Oral Health – VCU News

By David Slipher
L. Douglas Wilder School of Government and Public Affairs

When the topic of preventive health care is addressed, oral health is often considered a separate and distinct issue. However, for Sarah E. Raskin, Ph.D, associate professor at the L. Douglas Wilder School of Government and Public Affairs at Virginia Commonwealth University, that’s not the case. Raskin sees a deep and intimate connection between oral health and overall well-being. Bridging the gap between these two aspects of health is her passion and she is dedicated to finding solutions to disparities in oral health care. Through her work, she is making a significant impact in areas such as dental safety nets, workforce diversification, community-based research and rural oral health.

According to Raskin’s research, people who identify as experiencing discrimination or poor treatment in a dental setting are two to four times more likely to describe their oral health as poor/fair, to have had no dental care in two years and not schedule a future visit for preventive/routine oral care, as in a dental setting.

“Oral health has a reciprocal relationship with general health. For example, pregnant women who have periodontal (gum) disease are more likely to give birth to premature or low-birth-weight babies,” Raskin said. “Having gum disease also significantly increases the risk of controlling poor glycemia and end-stage renal disease in people with diabetes.”

Much of Raskin’s research critiques the status quo and historical deficiencies in oral health care, particularly the systemic factors that exclude racial and ethnic minorities and economically disadvantaged individuals from receiving care and from pursuing opportunities in the dental professions. To understand these disparities, she is taking a holistic view of oral health systems and incorporating her training in cultural anthropology into her approach. One constant has emerged—many of the same factors that exclude underserved patients from dental care also inhibit professional achievement among potential members of the dental workforce.

“Using social science mixed methods such as patient and provider surveys, interviews with oral health policy advocates, and ethnographic observations of service delivery, we can move beyond strictly biological understandings of oral disease and cognitive understandings of career paths ,” she said. “These underlying forces shape inequalities such as societal expectations of what a dentist should look like and how a community member should tolerate being excluded from care.”

Community partnerships are key to Raskin’s work, and as a VCU School of Dentistry faculty fellow and member of the iCubed Oral Health Core Initiative, she is using her expertise to influence best practices to include outreach as a key component for transforming dental service delivery. It partners at the local, state, and national levels with CrossOver Healthcare Ministries, Virginia Health Catalyst, and CareQuest Institute for Oral Health, respectively. Together with these groups she has worked to reduce missed appointments among dental safety net patients, expand community-based services through dental practice law changes, and document and address how discrimination within dental offices affects in patient outcomes.

Her data-driven research, which she makes publicly accessible by publishing in an open-access format as much as possible, represents a sea change in reframing the conversation about oral health. Through her recognized expertise, connections, and influence among oral health advocates, educators, and researchers, her mission is to make oral health a permanent part of the larger health equity discussion in all policy planning.