A Journey in Science as a Dentist for Everyone

 – Nicholas B. Gordon, DMD, MPH – 

It was in high school where I became more aware of the plight of those who live in poverty and the need for social justice. I attended Bishop McNamara High School, a Catholic school in Maryland. In addition to traditional classes like Biology, US, History, and Algebra, I also took a course in ethics. This is where I learned that impoverished conditions make people susceptible to food insecurity, violence, limited access to educational resources, poor living conditions and unfavorable health outcomes. With this knowledge and my Christian convictions rooted in love and service, I determined that I wanted to pursue a career in which I could help people.  A trip to Jamaica in 2003 helped to set the course of my life.

I accompanied my dad, who is a dentist, to Kingston, Jamaica with my church, where he provided dental care to the community there. Although most people I encountered were happy, I witnessed first-hand the challenges of day-to-day living with limited resources. I met a boy, my age, who did not know how to read. I learned that teenagers like him often work for “Dons” who provided stability in the neighborhoods and financial incentives for teenagers, but also pushed those who worked for them to do illegal activities to support the goals of the Dons. I realized that those living in poverty abroad and in the U.S. often have to make tough decisions in order to survive and provide for their families. Not only do people need to attain the education and economic resources to improve their quality of life, they also have to be healthy enough to do so. It dawned on me that oral health is an important aspect of one’s life and dental care is needed in the world. From this experience, I viewed a career in dentistry as my ticket to serving others and helping to improve the quality of life for vulnerable populations. 

Dr. Nicholas Gordon

At Morehouse College, I majored in Biology and minored in Public Health. I remember other students being in awe when I mentioned to them that I was a biology major. They knew that this was a difficult major to have. I quickly realized that studying and understanding science often requires one to think outside of the box to understand unfamiliar and sometimes abstract concepts like cellular respiration and cell division. I had to study differently in college compared to how I studied in high school. I started to spend more time reading textbooks in order to understand the material, rather than just memorizing it.

During the summers between each year in college, I participated in a different summer program geared at introducing those from underrepresented minority and disadvantaged backgrounds to careers in the health professions. It was in one of these programs that I learned about the specialty of Dental Public Health. I later learned that in order to have a large impact as a dentist, I would have to start thinking about how to address barriers to oral health such as poverty, race/ethnicity, geographic location and insurance status, to name a few, which affect peoples’ access to quality dental care. I would have to learn to treat not only individuals, but populations through community-based programs.

After graduating from Morehouse College, I attended Tufts University School of Dental Medicine in Boston. Other than being located in a city known for its harsh winters, Tufts is a lot different than Morehouse. The culture and the people are different, but I believed that this was an environment in which I could thrive.  It was a place I could continue my journey in science. I knew that a change from what I was used to would help me grow and be more well-rounded in the end. I decided to attend Tufts because it has a great reputation for training individuals to be excellent dentists and has a strong support system for students and students of color. In addition, it is located in a city known for advancing knowledge in science and technology. As I began matriculating through Tufts, I realized that I needed to modify my study strategy once again in order to be successful.

What makes dental school challenging is not difficulty in understanding the material. What makes it challenging is the bulk of material with a strong foundation in science that one has to learn in a short period of time. Each subsequent year of dental school, the material and responsibilities seem to increase. I realized that a mix of studying alone and studying with others was effective for me.  I received my Doctor of Dental Medicine and Master of Public Health degrees from Tufts and became the first graduate of the newly developed DMD/MPH joint degree program at the school. Later, I completed a dental public health residency program at Boston University Henry M. Goldman School of Dental Medicine while working as a general dentist at a community health center.

As a public health dentist, I collect and analyze oral health data, such as tooth decay prevalence in populations of people, in order to identify particular problems that need to be addressed. Based on the data, I identify evidence-based strategies to address dental public health problems and work to develop programs that utilize these strategies. With this approach, I developed an oral health education and prevention program for parents of children and adolescents at the health center where I worked.

The program informed parents about tooth decay and gum disease and strategies to prevent these problems.  It gave them the opportunity to ask the questions that they may not have had the opportunity to ask during their child’s dental appointment. Children who needed a dental appointment were able to make one and some children were even examined and treated on the same day

Dental decay is a common, chronic childhood disease that affects virtually everyone. According to the Centers for Disease Control and Prevention (CDC), 1 in 5 children between the ages of 5 and 11 years have at least one untreated decayed tooth.¹ Populations in the United States, such as the poor, members from minority backgrounds, children with special health care needs, those living in rural locations, the elderly, and the very young, suffer disproportionately from the disease and have limited access to care. ^2,3   Tooth decay can cause pain and infection, resulting in missed days from school and work. In some cases, it has resulted in death. Oral health plays a critical role in general health as associations have been found between periodontal disease and diabetes as well as other conditions. It is my passion to promote oral health and prevent dental disease among everyone including vulnerable and low income populations.

I am currently in my last year of an advanced education in pediatric dentistry residency program at Boston University. Additionally, I serve as Co-chair of the National Dental Association (NDA) Global Oral Health Outreach Committee. With this committee, I have had the opportunity to promote global oral health, much like my dad did in Jamaica years ago.   Currently, I am working with the NDA and the University Of Haiti School Of Dentistry to develop a sustainable oral health prevention program for children and adults in a rural area of Leogane, Haiti. Although there is much need in Haiti, there is a misconception that Haiti is too unsafe to travel to and I faced pushback as I sought support for this effort.

Despite the pushback, I continued planning and organizing and later received support that overwhelmed any pushback that I received previously. Last April we organized a global service-learning trip with students from Tufts University and the University of Haiti to implement this program in Leogane. We were able to show others that with proper planning, a safe, effective and educationally beneficial experience for students can be had in Haiti.  With dental students and faculty from both universities working together, we treated children and educated parents, nurses and other health care professionals about the importance of oral health and prevention strategies. This approach allowed us to demonstrate a model of care that worked. My work in Haiti is a realization of a dream of mine that started in Jamaica years ago.

As I look back over my journey in science, I realize that at each step of the way, I had friends and family who encouraged me as challenges arose. I have also had mentors to give me invaluable guidance that helped to chart my course. My faith in God and my Christian values formed a solid foundation that ultimately propelled me into my purpose in life. I am happy to be doing what I love and helping others, but I also know the importance of “paying it forward” to those who are looking for their purpose in life and pursuing their passion.  We need more advocates for access to dental care in America and in the world.  Although millions of children from poor and low income families receive health benefits from programs such as Medicaid and the Children’s

Health Insurance Program (CHIP), there are still many children and millions of adults who do not have adequate dental benefits in the U.S. We need public health dentists and advocates for legislation to increase access to dental care for children and adults.

Four points have helped me pursue my career in pediatric dentistry and dental public health.

• First, I surrounded myself with individuals who share common goals with me. In college, I made sure that I hung around and studied with people who were pursuing a career in the health professions, because this helped me to stay on track.
• Next, I wrote my goals and plans on paper and was willing to modify them when things did not work out. There have been many times when I faced setbacks in life, like not passing a course in school or not getting accepted in a school that I thought would be best for me. I am a strong believer that things happen for a reason and sometimes these moments we consider to be setbacks are actually blessings in disguise, which I have experienced multiple times.
• Third, a willingness to step outside of my comfort zone was beneficial to me during my travels to developing countries where many challenges persist. I could have declined these opportunities. However, I would have missed out on such wonderful and profound experiences and career developing moments.
• A last point that has helped me on my journey is an understanding of the importance of “paying it forward” to those who come behind me. I realized that serving as a mentor to others not only helps the next leaders in science and other disciplines pursue their careers, but it also helps me to master my own knowledge, skills and insights as I teach and guide others.

My journey is science has afforded me the privilege to help improve the oral health of others and I understand my obligation to serve everyone, and not just those who can afford care. The journey has been exciting and I hope my story will inspire others to embark on theirs.

References

1. Centers for Disease Control and Prevention, 2016. Children’s Oral Health. [Online]
   Available at: http://www.cdc.gov/oralhealth/basics/childrens-oral-health/index.html
2. Burt, B. A. & Eklund, S. A., 2005. Dentistry, Dental Practice, and the Community. Louis: Elsevier Saunders.
3. Lewis, C. W., 2009. Dental Care and Children with Special Health Care Needs: A Population-Based Perspective. Academic Pediatrics, 9 (6), pp. 420-426.

Cover Image by Quang Le from Pixabay