I have a patient, Sally (name changed for confidentiality), who has cerebral palsy. Sally has a great sense of humour and larger than life personality. She brings so much joy and energy into every room! But when people see her wheelchair, they will often ignore her and speak to her carer instead of directly to her.
Cerebral palsy is a condition that affects a person’s ability to move and maintain balance and posture. It can lead to involuntary movements and poor balance, which may require the use of a wheelchair.
Many people with cerebral palsy do not have an intellectual impairment. In fact, I believe many have higher than average intelligence, because of their adapability and tenacity. They learn how to reach the same understanding of language, verbal and non verbal cues, and understand the world around them, in an education system and environment that puts up many barriers and isn’t designed with physical impairments in mind. So for them to reach the same level of understanding and communication of our language that people without physical impairments do, it shows how incredibly capable they are.
My life has been so enriched from connecting with people with cerebral palsy. The next time you see a person in a wheelchair, I encourage you to smile and say hello directly to them, instead of the person with them. We can all create a more inclusive world, one smile, and one conversation at a time!
It was an honour speak for International Women’s Day –a day where we celebrate how far we’ve come in creating gender equality, and continue to work toward a world where regardless of gender, everyone has equal rights, privileges, and access to opportunities. What this day represents, holds special meaning for me. What International Women’s day means to me, is our commitment to inclusion.
What does inclusion mean to you? What does an inclusive world look like to you?
For me, an inclusive world, is one where difference is valued and celebrated.
A world free of bias, stereotypes and discrimination.
So I loved the theme for the 2022 International Women’s Day: Break the Bias. The only way to break a bias, is to first become aware of them. It can be very challenging to do this, as bias may be implicit and unconscious. They are shaped by our personal experiences, the attitudes of family, friends, our living and working environments, culture and the media. All of us have unconscious biases which influence our perceptions, judgments, decisions, and actions. I encourage you to approach identifying bias with an open mind and heart. Because every bias that’s broken, brings us closer to creating an inclusive society.
Why is inclusion important? For me, it’s boils down to three words.
Every human matters.
One of the ways we recognise the fundamental, intrinsic value of every person, is by acknowledging and respecting their human rights.
This includes their freedom to make choices about their lives, and develop their potential as human beings. Their right to live a life free from discrimination, to have equal access to opportunities, and to feel included and accepted in our society.
Inclusion has been, and will always be, the primary driving value and underlying thread behind the work I do everyday –inclusion is the reason I choose to care for people’s oral health.
My father was born in Fujian, China. As a child he had a fever and was prescribed tetracycline antibiotics. The tetracycline incorporated itself into his chemical tooth structure as his teeth were developing. And it led to permanent black staining of his teeth. This condition can’t be fixed with whitening or bleaching, though he did try that and it has resulted in ongoing severe cold sensitivity whenever he eats.
He moved to Australia when he was 26 years old, excited to start a new life in a country full of freedom and opportunities – not realising how much of a barrier this tetracycline staining would be in pursuing the life he wanted to lead. Watching his struggle had a profound impact on me. I saw how being unable to eat without pain affected his nutrition and general health. I saw how his smile affected the way people perceived him – he was denied employment opportunities and felt socially isolated. He couldn’t share his smile with those around him, he withdrew from people’s judgement, feeling shame about how his teeth looked. This exclusion crushed his self-esteem and with it, his mental health.
So that’s how I learnt, that your mouth is the gateway to your body and your overall health. And your smile, is your gateway to inclusion in society.
That’s why I become a dentist, to empower people to live a full life where they can eat, speak, and smile freely. To open people’s gateway to being included in society by helping them smile, so they can feel socially accepted and find a job, to help them to speak freely without tooth pain so their unique voices can be heard and contribute to our society.
During my pursuit of this mission, I drew upon more of my family’s lived experience – my youngest brother, Arron, was diagnosed with autism and my dear grandmama battled against cancer. I saw the barriers to inclusion into society compounding for vulnerable people who had disability and medical conditions. They faced further challenges due to their circumstance, with their conditions causing higher risk of dental disease, and faced greater barriers to finding a dentist who had the skills to help them. And that’s what drove me to become a specialist in special needs dentistry.
Special needs dentistry involves looking after people with disability.
This includes people with physical, sensory, cognitive, psychosocial and medical conditions. Which currently affects over 4.4 million Australians.
Contrast that with 25 Special needs dentistry specialists in Australia.
Disability touches every demographic. People of all ages, cultural backgrounds, genders, races. It does not discriminate. We are all sisters, brothers, children and grandchildren of people who experience disability. We will all join in that experience eventually through accident, illness, injury or ageing.
Yet how many of us, when we hear the word disability, don’t identify with it. And think, “That’s got nothing to do with me.” When actually the experience of disability, and the unfairness and disadvantage it brings, is very much about us. Disability is a universal experience all humans acquire as we go through life and get older, which most of us would like to do.
Did you see the person’s disability, before you saw the person?
This is what we call an unconscious bias. The first step toward breaking this bias, is to become aware of it. Then, we can change the way we think and speak about it. Language is a powerful way of breaking down bias in our wider society.
Instead of the label “disabled person.” Talk about the person first. A person living with a disability.
Because every person is defined by their humanity, not by their condition.
Something else that contributes to our unconscious bias is the fact that most disabilities are invisible. Such as those related to learning, attention, mental health, or chronic pain. Many people with invisible disabilities are still in the closet due to stigma.
Another way we can break unconscious biases, is through speaking up to make these disabilities more visible, so as to normalise the experience of disability.
It’s interesting how 15% of the world’s population, 1 billion people are living with disabilities – which makes disability the world’s largest minority. And it’s universally known that humans are so diverse, unique and beautifully complex – and yet, it’s common to hear people talk about people without disability being “normal.” Saying “normal” implies that people with disabilities are “abnormal”.
Phrases like this imply that a disability makes a person less than, that disability is negative, a problem to be fixed, rather than a normal, inevitable part of the human experience, that 1 billion people around the world share.
Our society has come a long way, in our understanding of the term “disability.”
The outdated medical model said, disability is something that needs to be “fixed” or “cured”
The social model recognises that disability is created by society. Social barriers, are what disable us – environmental, financial, and attitudinal barriers.
Here is an example:
The Medical Model of Disability and the Social Model
The problem is that the world wasn’t built with people with disabilities in mind, and because of that, the world we live in is inherently “ableist.”
Image source: The Veil of Ignorance by Adam Morse
Just as racism and sexism is the discrimination and prejudice against groups of people based upon race and gender, ableism is discrimination based upon the belief that typical abilities are superior and rooted in the assumption that people with disability require “fixing” and defines people by their disability.
Disability is actually an experience created by society. Not by the condition itself.
Is there anything wrong with the person’s physical condition requiring the use of the wheelchair? Not if the building has a ramp. The condition only becomes a disability when there are stairs.
Example of disability created by the environment
If disability is an experience which is created by society, it means that thesolution is created by society – that is, all of us.
What can be done?
We can’t fix what we can’t see. So let’s start to recognise and become more aware of the environmental barriers that are inherent in our society.
I personally learnt a lot about the physical and environmental barriers people with disability face through a personal passion project I undertook during the start of the COVID-19 pandemic.
There has been support for people with disability to be moved out of institutions to live in the community where they have more choice in how they live, work and play – which has been a wonderful step forward for inclusion of people with disability in our society. It also, highlighted the physical barriers that still exist, when many people with disability were left homeless, as there aren’t enough houses built to be accessible for wheelchairs.
This was the case for one of my patients who uses a wheelchair, he was left homeless, and his sister was building him a house from scratch out of her own pocket. And I remember feeling so moved by that sister’s actions. It also kept me awake that night thinking, but what about the families who can’t afford to build a home? How will they find a place to live? And so I decided, I would build one. Three years later, I self-funded the construction of a universally accessible house for people with disability to live with carer support in the community.
Some of you may be thinking, this sounds a bit out of the scope of my oral healthcare mission, but it actually links back to access to oral healthcare.
My philosophy for looking after my patients is: I’m not here to just look after teeth. I’m here to look after the person the teeth belong to. So if my patient doesn’t have a home to live in, how will they ever prioritise going to see a dentist?
It comes back to Maslow’s Hierarchy of human needs. The base of the pyramid, human’s physiological need of shelter needs to be met, before anything else above that can be addressed.
Maslow’s Hierarchy of Human Needs. Image source: ThoughtCo. The Need to Belong
The solution to oral healthcare access. Ultimately, inclusion is the solution. Including people with disability in society is needed, in order for them to access their basic rights, like oral healthcare.
Through the process of planning, designing and construction of this facility, my eyes were opened to just how many barriers are inherent in our typical house designs, and how much I was taking for granted in this world designed for able-bodied people.
That’s how privilege works. It’s invisible to people that have it. It’s a luxury for me to not think about how I’m going to fit through a doorway or navigate around a corner, or to have to stay at home instead of going to a friend’s house because I can’t access their toilet, or not to worry about how I was going to get up onto the International Women’s Day stage to speak.
Every aspect of the facility was built using Universal Design principles -to create an environment that can be accessed and used to the greatest extent by all people, regardless of their age, size or disability.
Image source: Ageinplace.com
An environment should be designed to meet the needs of all people who want to use it. It’s a fundamental condition of good design. If an environment is accessible and convenient to use, everyone benefits. Not just people with particular conditions, but able-bodied people too.
Wider doorways not only benefit people using a wheelchair, it also helps parents with baby strollers and delivery workers moving furniture.
Wide doorway in the residential facility
Lever door handles as opposed to twisting knobs, help people with arthritis and wrist pain, as well as people coming home from their grocery store, holding multiple shopping bags.
Lever door handle from the residential facility
Imagine a community where every house and building is designed to be universally accessible. It would benefit every person who uses it, and it would remove a lot of the environmental barriers that people with disability face everyday. That would go a long way in helping them get their basic physiological human needs met, which then enables them access to the healthcare they need, to then open their gateway to education and employment, and live to their full potential. Then when more people with disability are living to their full potential – people’s negative biases about what they can and can’t do, start to break down.
The next layer of barriers we can break down are the attitudinal barriers and stigma that exist against disability.
Image source: Solutions for Living by Julie Entwistle
In 2017, I went on my second dental volunteer trip to Cambodia with Australian Health Humanitarian Aid where I cared for people who were orphaned because of their disability. For majority of the patients I looked after, it was the first time they had seen a dentist in their entire life. This experience not only changed the lives of those children with disability, but it also changed my own.
After seeing the stigmas against disability that exist across the world. It cemented my conviction to dedicate my career to serving those who have the greatest need for oral healthcare and who have the most difficulty accessing it. The following year, I started my specialist training.
Dental volunteering in Cambodia
The stigma and negative biases towards people with disability exists not only overseas, but in Australia as well.
So now let’s tie this all back together with oral health.
As I learnt from my father’s experience. Oral health is essential to living a full life and being included in society. When you look at someone, one of the first things you may notice, is their smile. This is even more important for a person who may rely on their smile because they only use non-verbal communication. Think of how this effects social relationships and emotional wellbeing. Think of the flow on effect this has on their opportunities to access education and employment where people with disability already face many societal barriers stacked against them.
But because there are so few special needs dentistry specialists, and so many barriers to inclusion, many people living with a disability, can’t access oral healthcare. Denying them the basic right to live a full life, but also to live the full length of their life.
Australians with an intellectual disability are dying 20 years younger than the general population. A leading cause of their premature death is a lung disease from inhaling dental plaque. I don’t want Australians to be dying from something that’s so preventable. So help me spread the word, I want all people with disability and their parents and caregivers to know, that brushing teeth saves lives!
The next piece of the puzzle, is getting them to a dentist. There are a lot of solutions we can work on at an industry level: upskilling general dentists, training in dental degrees, creating more specialist training programs. But the common denominator to address in addition to each of these solutions, is to break down attitudinal barriers and stigmas attached to disability so that more people are willing to step up and share the care.
So the reason why oral healthcare is important, is because it’s the gateway to inclusion. And the solution to oral healthcare access, IS inclusion.
And inclusion is something that all of us can work towards creating.
You are here for a reason. Who you are matters.
What you say matters, what you do matters and how you choose to serve matters.
Will you choose to serve a vision for an inclusive society, because every person matters?
How can we serve?
Remember. Disability does not discriminate – any one of us could join the disability community at any point in our lives. It’s not about them, it’s about us
Speak up about your experience with disability, or the experience of people you know with disability – to make invisible disabilities more visible and normalise the expeirence of disability.
Get to know more people with disability – positive, meaningful relationships help to reduce stereotyping and unconscious biases. Inclusion begins with a smile. It’s as simple as smiling, and saying hello to a person with disability.
Spread the word! Share the hashtag #brushingteethsaveslives!
Please join me on this revolution for inclusion.
Together we can open the gateway to health, wellbeing, and inclusion in our society.
It only takes one conversation to save a life. One life lost is one too many, because EVERY life matters.
Warning: the following content contains a non-specific recount of my experience with a patient who had thoughts regarding suicide.
A number of years ago, one of my patients disclosed her plan to commit suicide. She said her psychologist wasn’t aware, and that I was the only person she had told. I hadn’t dealt with this situation before, I didn’t know exactly what to say, I just followed my instincts: I listened to her, told her and showed her that I care, and advised I would inform her psychologist.
Thankfully, my patient is still with us and she repeatedly thanks me for the life saving conversation we had that day.
After that experience, I decided to undertake further training in how to identify early warning signs to suicide, which has helped me open many more of these conversations and help them get the support they need at an earlier stage. I encourage every person to undertake suicide prevention training, which equips you with the skills and confidence to have a life saving conversation.
It only takes one conversation to save a life.
One life lost is one too many, because every life matters.
Thank you to the Australian Dental Association for shining a spotlight on Special needs dentistry (SND) in the April 2022 ADA News Bulletin magazine. Read the full article here!
In this article I highlight the overwhelming number of 4.4 million Australians who require special needs dentistry and the severe undersupply of 24 practicing specialists. In order to address this, we need more general dentists to step up and share the care of the patients with less complex needs who are suitable to be seen in the community setting.
To my fellow oral health care professionals, I encourage you to choose to care for any person that makes it to your dental chair. When you do this, your impact extends far beyond the oral cavity, to breaking down attitudinal barriers, overcoming stigma, and contributing to an inclusive society, where every person can access oral healthcare.
Today on World Parkinson’s day I am sharing the story of one of my patients we’ll call Jack (his name has been changed for confidentiality), who has been living with Parkinson’s disease for 15 years.
The tremor, rigidity and slowed movement has affected many of his daily activities, including his ability to brush his teeth.
Jack’s grip strength and manual dexterity has been altered by his Parkinson’s disease
The first time I met Jack, he was brought into the clinic in a wheelchair by his carer, his gaze was attentive and thoughtful as I explained the state of his oral health and how I could help him. I noticed he was wearing knee pads and asked why. Jack said, “because my light bulb needed changing so I wore knee pads just in case I fell off the ladder.” His carer smiled and said, “Jack’s the type of person who would much rather wear knee pads and take half and hour to change the lighbulb himself, than get me to do it in 5 minutes.”
While the Parkinson’s disease has affected Jack’s life in many ways, he does not let it define who he is. Jack is still the resilient, fiercely independent, and reliable person he always has been.
I saw my role as adapting the dentistry and oral healthcare to Jack, not his Parkinson’s disease. So while the disease might typically dictate the assistance of a carer for his oral hygiene, for Jack, we have adapted his toothbrush handle with layers of aluminum foil so he can hold the brush and perform his oral hygiene independently. Toothbrushing for Jack means much more than getting the plaque off his teeth, it’s a symbol of his independence and his tenacity.
Treat the patient, not the disease.
People are defined by their humanity, not by their disease.
“What’s your advice to a person wanting to make a difference in the world?”
All you need to make a difference is: to care.
Know your why.
Face challenges head on, knowing you have an innate human ability to persist through difficulty.
You’ve got this.
Thank you to Southstart and Future Anything to be part of the Bright Ideas Summit!
I love speaking to young people. I love how impressionable they are, how they are open to challenging their thinking and sharing their views with the world around them.
The Bright Ideas Summit led students across Australia on a deep dive into brainstorming problems they could see in the world and how think innovatively to solve it.
The problem that I pursued fixing, was one broader than just looking after teeth, it was inclusion.
Inclusion is the driving value behind what I do. Inclusion is why I care for people’s oral health.
The story begins with my dad, who was born in China. As a child he had a fever and was prescribed tetracycline antibiotics. The tetracycline incorporated itself into his chemical tooth structure as his teeth were developing. And it led to permanent black staining of his teeth. This condition can’t be fixed with whitening, though he did try that and it led to ongoing severe cold sensitivity whenever he eats.
Dad moved to Australia when he was 26 years old, excited to start a new life in a country full of opportunities – not realising how much of a barrier this tetracycline staining would be in pursuing the life he wanted to lead. Watching his struggle had a profound impact on me. I saw how being unable to eat without pain affected his nutrition and general health. I saw how his smile affected the way people treated him – he was denied employment opportunities and felt socially isolated. He didn’t smile with those around him, withdrawing from people’s judgement and feeling shame about how his teeth looked. This exclusion crushed his self-esteem and with it, his mental health.
So that’s how I learnt, that your mouth is the gateway to your body and your overall health.
And your smile, is your gateway to being included in society.
That’s why I became a dentist, to empower people to live a full life where they can eat, speak, and smile freely. To open people’s gateway to being included in society by helping them smile, so they can feel socially accepted and find a job and live to their full potential.
During my pursuit of this mission, I drew upon more of my family’s lived experience – my youngest brother, Arron, was diagnosed with autism and my dear grandmother battled against cancer. I saw their conditions create more challenges in their life, in addition to challenges with oral health, and saw the barriers to finding a dentist who had the skills to help them. And that’s what drove me to become a specialist in special needs dentistry.
Through sharing my story, I hope to encourage you think a little differently the next time you see someone smile. Realise that your smile goes beyond health, to helping you reaching your full potential as a human being, and feel included in our society.
I have cared for many people with autism as a Specialist in Special needs dentistry and my youngest brother, Arron, has autism. What I have learnt from these experiences is that while autism is a developmental condition that affects how a person learns and interacts with the world around them, it affects each individual differently and each person has unique needs – just like every other human on the planet. This diversity is a beautiful thing – this is why I believe every person’s experience, voice and contribution matters, because it is unique to what any other person can bring.
One of the best things you can do to understand autism, is to listen with the intent of learning more about what autism means to that particular person, without any preconceived ideas of what their experience of autism is like. Focus on their strengths and passions to help them foster their best selves. Today on World Autism Awareness day, I encourage us all to take it further than just being “aware” of autism, to understanding autism, and becoming more accepting of it. Through understanding others, we can grow into a more inclusive and neurodiverse society.
Arron used to find it very distressing to go to public places with bright lights due to light sensitivities from his autism. Now he wears sunnies whereever he goes and loves it! I’m so happy that Arron can now enjoy going shopping with us and pose for photos with astronauts! The next time you see someone wearing sunnies indoors, instead of looking at them strangely, give them a smile instead!
