Jennifer Hasch, BS, RDH of Louisville, Kentucky, is the founder of the PHRDH blog RDHonamission.com. She is the 2017 recipient of the Colgate ADHA community outreach award for co-founding a mobile charity clinic in December of 2015 for Louisville’s most vulnerable populations. That program has provided more than $200,000 in free dental services for the community. She is the volunteer hygiene coordinator in addition to working five days a week as a clinician in a FQHC. She believes in collaboration versus competition and that a person’s legacy is only as large as his or her love.  

Jennifer Hasch

	Advocacy is something dental professionals do every day. Hygienists discuss the importance of prevention to their patients in-depth. We go over methods, techniques, frequencies and research in order to persuade our patients to make healthy decisions. Dentists discuss recommended treatment at length, simplifying complex procedures into analogies of apples and helmets, helping patients understand and subsequently empowering them to make knowledgeable decisions for their own wellbeing. 

As a team, we sometimes need to confront parents and have tough conversations about how a child reached his or her status, attempting to reveal the underlying dietary habit or educate specifics on how to move toward better choices. This is advocacy. We are influencing our patients’ health by speaking truthfully about subjects we know to be true. We are experts at this because we do it daily, but what does advocacy look like on a larger scale for us? If we begin looking at influencing oral health on a systemic level, meaning government and policies, those conversations may seem a little more intimidating. Advocating for systemic change was not part of the clinical curriculum, but it is a natural progression for oral health providers who care. 

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	Merriam-Webster defines advocacy as “the act or process of supporting a cause or proposal.” It can encompass all types of conversations with different groups about subjects that are of interest or important to you. Vocal support can range from voicemails and Twitter tags to handwritten letters or face-to-face meetings. 

, a health care advocacy group, has a great resource for 

how to set up a meeting with your member of congress

. They say, “Engaging face-to-face with government officials and their staff is the single most powerful advocacy strategy you can pursue.” The six steps they list are a great beginner’s guide. I will highlight and summarize the four I find most relevant to dental professionals who spend the majority of their time in a clinical setting and may not have had the opportunity to head to their state or national capitol.   

	Step 1: Select legislators for a meeting

 by state. As health care providers, we can also choose to meet with the leaders of the people we serve. Speak up for your patients. Our leaders want to hear from their constituents and we have a unique ability to leverage power for our patients by being their voice in this way. Public health dental professionals have a distinct responsibility to do this, especially if we are caring for patients from a disadvantaged background. 

	Contact your legislator’s office staff to coordinate a time. You will want to mention that you are a constituent or serve their constituents for relevance. Give them a heads up on what topic you would like to discuss. If the representative is not available, meeting with a staff member is a great way to pass on meaningful information to the legislator. 

	Put together three to five key points you would like to present. Get comfortable with the data and stories you would like to tell.  Organize your thoughts and resources so that you feel prepared before the visit. It can also be helpful to bring relevant materials to leave behind like brochures, handouts and fact sheets. 

Step 4: Meet with your legislator and/or staff

	There are three tips to keep in mind during the meeting: tell your personal story, share key points about the issue and keep the conversation state or district-specific. Getting personal is a way to make a memorable and impactful impression with your leader. Telling connected stories of real people can soften sometimes distant issues. It makes decisions real and puts a face to a problem. 

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	To read more tips on this advocacy option, visit 

. Some other less time-consuming options include calling, writing letters or getting involved in social media campaigns.  There are many organizations that offer letter templates and calling scripts when relevant issues or policies surface. Subscribe to 

 to get started. Find organizations whose missions align with issues you think are important and sign up for their email updates. These advocacy groups help us stay informed and connected to national movements. Joining a larger advocacy day or project with your professional organization or state coalition the first time can make the process easier. Being with an experienced group offers strength in numbers, and they may even help you with talking points or effective messaging. 

	Helen Hendrickson, the state advocacy manager at 

Dental Access Project for CommunityCatalyst.org

, has explained advocacy in a way that makes it more approachable for dental professionals. It is educating decision makers on things we know to be true. If we show up and speak up about our values, we are sharing our expertise and experience with folks who do not have access to that information.  Policy change needs direct connection to the issues and people who can contribute to the collective conversation. Providers and patients are at the grassroots level; changes and decisions affect us directly.  In order to cultivate systems that work for everyone equitably, we have to hear from everyone. To achieve oral health for all, we need to seek out the stories of those who have not been able to access that status of health, elevate their needs to the forefront and prioritize our resources. Consider taking your daily clinical concerns to your legislature, or even Congress. Change is just an advocate away. 

Articles

Speaking up about important issues and meeting with legislators can have a major impact on your patients’ oral health. 


How dental professionals can be advocates

Speaking up about important issues and meeting with legislators can have a major impact on your patients’ oral health.

	In January of 2017, I went to Tegucigalpa, Honduras, on a mission trip. Our team of 35 was a diverse group of professionals who brought medical, dental, vision and pharmacy skills to a community of impoverished and neglected people.

	Going to a third-world country is difficult to describe; the magnitude a trip like this can have on your life is immense. While you go to help others, you come home with so much more than you expect to receive. I come home every time with a complex mixture of gratitude and guilt. Each person you encounter stays in your heart and calls you to return. I am hoping to join my team for a third time in January of 2018 to visit the community we serve. When I have discussed my trip with other hygienists, so many have been interested in learning more about dental missions. They want to know how I got involved and how they might gain the opportunity to go in the future. My advice to them: volunteer. 

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 in Harlan, Somerset and Pikeville, Kentucky. The RAM and 

 clinics are similar outreach programs that give care to those in need in states across the U.S. RAM’s mission is: “To prevent pain and alleviate suffering by providing free, quality health care to those in need.” In these rural counties, patients lined up the night before we opened the doors to see doctors and dentists for the first time in years. They mentioned income, transportation and no insurance as reasons they had not sought care. Counties in southeastern Kentucky have a rich history of coal mining. As energy trends have shifted away from coal, the Appalachian counties have suffered socio-economically. The folks we saw in this region had case presentations comparable to those in Honduras.

National Organization of State Offices of Rural Health (NOSORH)

			Adults ages 18 to 64 are nearly twice as likely to be edentulous if they are rural residents

			Of the 2,235 Dental Health Professional Shortage Areas, 74 percent are in rural areas

			Rural adults are more likely than non-rural adults to have untreated dental decay (32.6 percent versus 25.7 percent).

	Our nation has third-world patients in our rural communities and inner cities. There is a free outreach clinic in my city for the underserved. Louisville is a large metropolitan area. Many suggest the city is over- saturated with dentists, but few accept Medicaid at all, and even less accept Medicaid for adults. The patients seen at this clinic include the homeless, recovering substance users and immigrants. Volunteer clinicians serve two Saturdays per month to bring pain relief and prevention to this gracious group of individuals. Most of the volunteers I encounter in these settings have been on missions overseas. Passion for people knows no borders. 

	If you are interested in using your clinical skills to serve populations in need, you do not need to look far; there are opportunities all around us. Volunteering in your local community is a way to meet like-minded professionals, help patients who may not get care otherwise and possibly network with existing mission teams. Gaining experience with mobile and portable dentistry will help prepare you for the clinical challenges you may face internationally. Connecting with other clinicians who are determined to make an impact in all settings is the best way to get started. Reach out to your local professional organization’s component, the state board of dentistry or state oral health coalition to find outreach opportunities near you.

Those interested in using their clinical skills to serve populations in need don’t need to look far. 