GAP clinic provides a unique learning experience for all
By Cheryl Bell
Caring for patients in the Monday night Government Assisted Populations (GAP) dental clinic means a 12-hour day for the dental hygiene and dentistry students who work and volunteer there, but it provides a learning experience like no other. For Ramlah Mahmood (DDH’22) and fourth-year dentistry student Heba Al-Ameri, the lessons learned there are also shaping their longer-term career plans.
The GAP clinic treats new immigrants and refugees to Nova Scotia in partnership with Immigrant Services of Nova Scotia. The clinic’s operations are one of a suite of community outreach initiatives also supported by faculty alumni through the Dentistry Outreach Clinics Support Fund and Dental Hygiene Outreach Clinics Support Fund. Many of the patients who arrive in the clinic for treatment have not received much – or any – oral health care in years. Language interpreters and students work together to provide oral health care and education to the patients, who arrived in Nova Scotia from countries such as Pakistan, Syria, Afghanistan, Iraq, Yemen, and several African countries.
Lessons learned
Mahmood now works as a dental hygienist at Paradise Dental Care in St. John’s. During the second year of her dental hygiene program, the GAP clinic was where she spent nearly every Monday evening until 8:00 pm.
She says treating GAP patients gave her skills and knowledge she would not have gained from the regular student clinic, although it was not easy to begin with.
“In the GAP clinic, we had to do all the perio and hard tissue charting ourselves,” Mahmood explains. “In the regular student clinic that’s all done for you. It was difficult at first, but definitely a great learning experience.”
A fluent Urdu speaker, Mahmood enjoyed communicating directly with patients from Pakistan in their own language. She was also happy to discover that one of her patients from Afghanistan understood Urdu, which made taking the medical history and X-rays go more smoothly.
Learning how to work with an interpreter is an important skill that is taught in the GAP clinic. “We learned to focus on the patient when we are speaking,” explains Mahmood, “even though we are asking questions and conveying information through the interpreter.”
Mahmood says that GAP clinic patients tend to be more fearful than patients on other rotations. They may not have had oral health care in a long time or had bad experiences that left them nervous about receiving treatment. But dealing with anxious patients is another skill Mahmood and her classmates acquired in the GAP clinic, equipping them to reassure patients and explain their treatments to them.
Working efficiently in the clinic helps to reduce the time patients are in the chair, many of whom have years’ worth of plaque deposits when they arrive in the GAP clinic, and Mahmood says faculty members were generous about providing tips on which instruments and techniques work best in those situations.
Mahmood admits that Mondays were long and very tiring. But the experience and knowledge gained were unique. “The GAP clinic is not like any of the other rotations we do as students,” she says. “It’s also great experience for faculty, too, because they don’t see these kinds of patients in the regular practices.”
More funding, more patients, more students, more treatments
Fourth-year dentistry student Heba Al-Ameri is in her second year as the volunteer coordinator for the GAP clinic where she is responsible for scheduling the students with patients.
The GAP clinic initially began with dental hygiene students providing treatment and oral hygiene education. In her time with the GAP clinic, Al-Ameri has seen the addition of a growing number of dentistry students. Currently there are now 12 working there: six carrying out exams and six performing treatments. Not surprisingly, the increase is having a positive impact on the clinic.
“The clinic is running so efficiently,” says Al-Ameri. “Six of the dentistry students do the exams on the patients, who are then sent to the dental hygiene students for debridement, and then the other six dentists begin working on the treatment plans.”
Students from the other years also rotate through clinic to observe, hold the suction, and assist the senior students. “They get an incredible amount of learning because these cases are more complicated than the ones students would normally see in the regular student clinic. It is truly a unique experience for us all.”
The patients are thankful for the care and attention they receive in the GAP clinic, even after multiple appointments. In addition to dental hygiene care and education, patients receive fillings and root canals, have teeth extracted, and can also have dentures fitted.
Demand for care at the GAP clinic is high and growing, says Al-Ameri, with immigrants and refugees to Nova Scotia continuing to arrive from different countries. She anticipates that patients from the Ukraine will be next.
“Funding from donors has made it possible to expand the clinic so that we now have 12 dentistry students each Monday evening,” says Al-Ameri. “But we have recently been asked if there are any more dental students available to perform more treatment in the clinic.”
More dentistry students and more interpreters would allow more patients to be treated, something both Mahmood and Al-Ameri would like to see. Both of them have been affected by their experience in the GAP clinic and it is having an impact on their plans for the future.
What next
Mahmood plans to pursue a master of public health degree. She says that her knowledge of health inequities in Pakistan, the country her parents emigrated from, underlies her interest. But it was the experiences she had at dental hygiene school and through public health courses that piqued her interest.
“It was definitely in the GAP clinic that I became more aware of the different public health issues, such as health and socio-economic status, that solidified my interest in going into public health,” says Mahmood.
For Al-Ameri, too, the future is being shaped by her GAP clinic experience. She plans to work in a rural area where accessibility to dental care poses challenges.
“I also want to continue to participate in outreach programs and give back to the community,” says Al-Ameri. “It’s something I love to do.”