Relevant Degree Programs
Dental Public Health (Underserved-access to care, Marginalization, Community-based participatory research, Stigma and Discrimination); Health Policy; Dental Education (Community Service Learning, Reflective Journaling, Teaching Pedagogies, Social Responsibility); Dental Geriatrics (Undergraduate and Graduate Education, Frailty, Access to care).
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G+PS regularly provides virtual sessions that focus on admission requirements and procedures and tips how to improve your application.
Graduate Student Supervision
Doctoral Student Supervision (Jan 2008 - Nov 2019)
Objectives: To conduct an environmental scan of unmet dental treatment needs and patterns of dental service utilization of People Living with Immunodeficiency Virus (PLWHIV) in British Columbia (BC), Canada. Methods: An online environmental scan identified services available for PLWHIV in BC. Participants were asked to respond anonymously to a 40-item questionnaire. Associations between the psychosocial factors and outcome variables were evaluated using simple and multiple logistic regression analyses.Results: A total of 104 HIV organizations were identified in BC and less than 3% of the organizations offered dental care. Most of the services identified were distributed within the geographical location of Vancouver Coastal Health which has the highest prevalence of PLHIV in BC. Amongst the 186 participants who responded to the survey, majority of the respondents were male (n = 118; 63%) and were born in Canada (n = 116; 68%). Approximately 40% (n = 74) rated the health of their mouth as fair/poor and 60% (n = 112) reported having one or more unmet dental treatment need. In multiple logistic regression analysis, dental anxiety (OR = 0.1; 95% CI 0.0; 0.4), having a regular dentist (OR = 3.7; 95% CI 1.1; 12.6) and visiting a dental office in the last year (OR = 21.6; 95% CI 6.1; 76.5) were the strongest predictors for the unmet dental treatment needs and last dental visit. Conclusion: Services in general might be available where PLHIV live, but fall short in other areas; dental services are lacking across BC despite participants having high treatment needs.
Master's Student Supervision (2010 - 2018)
Objective: To assess the direct and indirect costs of non-traumatic dental visits at the Emergency Rooms (ERs) in British Columbia (BC). Methods: Services from the Canadian Institute for Health Information’s National Ambulatory Care Reporting System (NACRS) were acquired; NACRS contains data including diagnosis and procedures coded with the International Classification of Disease representing the conditions of oral cavity, salivary glands and jaws. Direct cost relates to the billing cost of non-traumatic dental patient seen at the ER as billed to the government. Direct costs from Ontario and Alberta were used to estimate the cost for BC. Indirect cost relates to loss of income in terms of time spent at the ER only. Results: Between years 2012 and 2013, the number of visits for non-traumatic dental conditions at the ERs in Ontario, Alberta and British Columbia were 135,570 (1.16% of the total number of ER visits), 69,247 (1.51% of the total number of ER visits) and 22,786 (1% of the total number of ER visits), respectively. Out of 74, the 29 reporting emergency departments in 2013 in BC showed that the majority of the visits for non-traumatic dental conditions (70%) were made by adults between the ages 20 and 64 years-old; the most common complaints were dental and periapical abscesses and dental caries. The majority (70%) of non-traumatic dental patients in BC were non-urgent. On average the patients spent around 2 hours at the ERs at a cost ranging from $185.15 to $245.51 each to British Columbians, up to $2.99 million per year. Conclusion: Although not all emergency departments in BC report data on non-traumatic dental visits, the cost to the tax payers is substantial. It was estimated to be between $185.15 and $245.51, whether using data from either Alberta or Ontario, respectively; the cost sums up to a total of $2.25 to $2.99 million per year for 29 of 74 reporting ERs. Therefore, use of emergency rooms for non-traumatic dental conditions not only adds an extra burden and contributes to overcrowding, but also makes the health care system costly.
Objective: To determine the baseline self-reported oral health and dental service utilization of pregnant women from diverse ethno cultural backgrounds within the geographical are of the Fraser Health Authority in British Columbia, Canada. Method: A prospective 34-item cross-sectional survey was administered to all the women enrolling for a prenatal registration program between October 2012 and January 2013. For data analysis, a two-sample t-test was used, and categorical variables were tested using a chi-square test. Multivariable logistic regressions were used to estimate the odds ratio. Results: A total of 740 pregnant women filled out the questionnaire. The majority (84%) of the respondents rated their oral health as good or excellent. Fifty two percent of the women had visited dental professional during last year. Almost 1/3 of those reporting symptoms of depression rated their oral health as fair or poor. Forty-one percent reported having bleeding gums, 22% experienced tooth sensitivity, and 13% had persistent dry mouth since the beginning of their pregnancy. When asked about the beliefs associated with pregnancy, 37% of the respondents expected bleeding gums, and 34% expected tooth sensitivity. Women born in India had visited a dental professional 2.8 times more often than women who had been born elsewhere. Those with dental insurance were 6.6 times more likely to visit a dentist than those without insurance. Conclusion: The majority of pregnant women considered dental care during pregnancy to be very important and had previously visited a dental professional within the last year. However, more than 1/3 had experienced one or more oral problems while more than half held false beliefs about the effects of pregnancy upon oral health. These reported oral beliefs and problems could be addressed with patient education during routine pre-natal care and subsequent referral to a dentist if needed.
Objectives: The objective of this study was to explore the nature of stigma experienced by dental patients who have substance use and mental health issues. Methods: Semi-structured interviews were conducted with a purposefully selected group of 13 English-speaking participants (7 males) who struggled with a variety of substance use and/or mental disorders, and lived in one of two treatment centres. An interview guide containing open-ended questions was used to discuss their experiences with dental professionals, and their perceptions of stigmatization. All interviews were audio-recorded, transcribed verbatim and analyzed using a qualitative thematic analysis. Results: Analysis of about 300 pages of interview transcripts demonstrated that participants perceived stigma in dental settings when they were viewed as “junkie” or “crazy”, were negatively stereotyped, and finally were rejected as patients or received negative attitude and substandard care from dentists who were misusing their position of power. Lack of or poor understanding and education about issues of addiction and mental health were pointed out as the origin of stigma. Positive experiences with dental professionals were characterized by empathy, reassurance and communication, which were empowering for patients. Conclusion: Individuals with substance dependence and mental health issues felt stigmatized by some dental professionals who they felt had labelled, stereotyped, and discriminated against them; making them feel disempowered. Findings of the study highlighted the need to better prepare current and future dentists to address the oral care of patients with substance dependence and mental illness in their clinical practice.
Introduction: Oral Health Impact Profile (OHIP) is a widely used psychometric instrument or scale developed in English to measure Oral Health-related Quality of Life (OHQoL), and there has been many translations of the instrument into other languages, including Korean. Purpose: My thesis examines the validity and cultural equivalence of the English and Korean versions of the scale by answering the questions: “What methods are available to validate the cultural equivalence of psychometric instruments?” and “How culturally appropriate and valid is the Korean version of the short-form of the OHIP (OHIP-14K)?"Method: Ten Korean dental experts fluent in English and Korean independently assessed the clarity, relevance, and cultural equivalence of the OHIP-14K and offered suggestions for improving the cultural sensitivity and validity of the instrument content. The item-level Content Validity Index (I-CVI) was used to measure the validity of each item from the experts’ ratings followed by the calculation of Scale-level Content Validity Index (S-CVI) as the proportion of content valid items. Additional analyses including the average deviation index (ADM) and Kappa statistics (Kfree) were performed with the clarity index (CI), relevance index (RI) and cultural equivalence index (CEI) to measure the level of agreement between the experts.Results: The experts rated the OHIP-14K as mostly clear (S-CVI= 0.93), but they were concerned about the relevance of many items to the expected domains of the instrument (S-CVI = 0.42) and about its cultural equivalence (S-CVI = 0.50) to the English version. However, there was much disagreement between the experts as measured by the RI (Kfree = 0.19 to 1.00) and CEI (ADM = 0.36 to 0.96). Conclusion: The relevance and cultural equivalence of the OHIP-14K to the original English version of the OHIP-14 are not strong. Suggestions are offered for improving the OHIP-14K, which needs further testing within the Korean populations.