Women who live under the poverty line tend to favor other responsibilities over dental care, which may seem like elective care to some individuals. Many studies have been completed on the reasons behind a lack of dental knowledge in poverty-stricken communities. The specific detriments to adequate dental care are the same all over the world.
Perceptions of Access to Oral Care at A Community Dental Hygiene Clinic for Women Involved with the Criminal Justice System takes these studies further to elicit a discussion with women who struggle with rebuilding their lives after leaving prison. The cost of care, transportation to the dental office, and dental anxiety are all present and important, but women who have spent years in prison have further issues that are sometimes ignored and that need to be addressed.
Did you know that you can determine the future of their dental care and their relationship with the world with just your attitude?
The Women
These women have problems finding a place to live, securing a job, and finding transportation. Many of these women have children and lack advanced education. Some of these women have no additional support from friends and family. All of these issues are detrimental to solving dental problems and preventing others.
Women reentering the world after time in prison are delicate in many ways and should be treated based on these unique values and fears. Prison dental care may have been deficient, and most of the women come from generational poverty where dental health was never considered important and not taught as part of a personal hygiene routine.
Some of these women feel shame and embarrassment about their criminal past and lack of dental care. Many of these women have experienced trauma that affects their outlook on the world. It’s essential for them to trust you and the other dental staff to communicate these emotions clearly and solve them effectively to best care for them.
So, how do these researchers suggest we do this?
Trauma-informed Care
Trauma-informed care, or TIC, calls for you to be very sensitive towards how you approach your patients, speak to them, and build the surrounding environment. They are going to look to you to guide them through the entire process. Trust is essential for all of our patients, but maybe even more so for our patients who have suffered trauma.
Trauma patients, when faced with a new fear, anxiety, or competition, may freeze up, run away, or become aggressive to protect themselves. For example, a dental service’s promotional tactics are overwhelming to these patients who already distrust the system. The competition and promises of quality work that these women have never received or experienced can be overwhelming and outright rejected by them rather than draw them in.
The care that you give each patient is increased in quality simply by trust. Trust is created and supported by consistency; for example, having the same hygienist and dentist rendering treatment at each appointment.
Speaking to them in an understandable and straight-forward language shows respect for their intelligence. Sharing the details of all of your actions before you do them is essential and can greatly decrease anxiety, especially in our patients who have suffered physical and sexual abuse.
Prison, even women’s prison, causes trauma in most people. The treatment, sanctioned and unsanctioned, that they experience is not something they want to relive and share. Prison dental care they may have received may have been few and far between if women can get any care at all. Some of these women have issues that they cannot be blamed for, and they are extra-sensitive to any notions of blame.
Care without judgment or even the hint of judgment is the only way that you can fully care for these women in the way that they need to feel safe with you.
Non-judgmental, Person-centered Care
Person-centered care, or PCC, refers to your care of the entire person, meaning more than just their mouth. This means that you care to learn who they are and where they came from. Their physical and psychological state is just as important to your job as the state of their oral health.
PCC for women leaving prison must be specifically non-judgmental. Trust cannot be established between you and the patient without it.
Many of the women coming out of prison compare themselves to other women of success, and they may feel ashamed of their past. They fear disclosing past criminal behaviors and a history of incarceration because of how you will judge them and treat them with that information. Speak to them as if you are not bothered by their situation, be helpful, and treat them as you would any other patient.
The dirty hospital environment of prison makes going to an office with the same vibe very difficult. The women may feel more comfortable in larger spaces and more comfortable chairs, so if you have an operatory that is larger than the others, schedule them for that operatory specifically, for example.
Warm and light colors can be calming, as can a soothing and kind voice. Use their first names as this shows the respect that they were not afforded in their previous environment where they were referred to by either their last names or a number that stifles their individuality and self-worth.
Your chairside manner is so important to your patients. Taking the time to be self-aware of how you come across to your patients can go a long way. All these women want is to feel safe and worthy in a world that kept revolving without them in it. Besides creating healthy and beautiful smiles, giving these women respect helps these woman move past their past.
