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In 2007, 12-year-old Deamonte Driver died after bacteria from an untreated tooth infection spread to his brain. His death was entirely preventable. Like many children in underserved communities, Deamonte didn’t have access to timely dental care. 

As a general dentist at an FQHC in rural Central California, I see firsthand how systemic barriers prevent people from receiving even the most basic oral health care. Working in public health in a rural area has taught me a difficult truth: having a good idea is not enough. Even when the intention is right, the need is obvious, and the solution is evidence-based, there are countless obstacles that prevent turning ideas into action. 

Together with some members of the King’s County Oral Health Coalition and in partnership with UCLA, we recently introduced an initiative to improve access to oral health care for children in our region. Like many underserved areas, King’s County has high rates of tooth decay, missed routine dental visits, and children who only see a dentist when they're already in pain. According to the 2018–2019 California Third Grade Smile Survey, 75.9 % of third graders in the Central Valley have experienced tooth decay, and nearly 30 % have untreated decay, which is well above the statewide average. 

These children are growing up without access to basic oral health education and preventive care. So, we decided to meet them where they already are--at school. 

Our team proposed implementing simple oral health screenings and fluoride varnish applications, done by school nurses. It’s quick, evidence-based, and cost-effective. We even explored grants to fund training and…

Based on 2018-2022 dental equity data, Guerneville has the highest rate of preventable oral health emergencies in Sonoma County. As a practicing dentist and dental director of a clinic in Guerneville, I witness this reality first-hand and know that negative perceptions of tap water quality can lead many residents to prefer bottled water and sugar-sweetened beverages (SSBs). This not only increases their risks of obesity, diabetes, and dental decay, but also adds unnecessary costs for those on limited or fixed incomes.

To better understand community perceptions of water sources, I partnered with the Sonoma County Department of Health Services’ Oral Health, Healthy Eating Active Living, and Lead Prevention teams, and UCSF Dental Public Health Resident, Dr. Lauren Gritzer, to conduct an initial survey of residents in Guerneville. Among 141 respondents, 60% reported a high level of distrust of their tap water being safe to drink. While local tap water meets safety standards, negative perceptions appear to be driving Guerneville residents toward more expensive and less healthy bottled alternatives, perceived as safer and more palatable. Of our respondents 52% never or rarely consumed tap water and 53% consumed bottled water every day.

Research (1) (2) has shown that improving perceptions of tap water quality and promoting its consumption can significantly reduce reliance on bottled water and sugar-sweetened beverages. This shift not only supports public health by reducing the prevalence of obesity, diabetes, dental decay and other chronic diseases that are associated with sugar-sweetened beverage consumption, but also promotes environmental sustainability by…

In today’s modern world, our role as healthcare providers must evolve—returning to the original intention of medicine: caring for the whole person. This means going beyond diagnosing disease to also address the physical, mental, emotional, social, and environmental factors that influence health, especially in chronic conditions like obesity. At this point in history, it’s imperative that we reclaim this holistic approach. Yet, our current healthcare system has created time constraints and inadequate reimbursement structures that often prevent us from delivering the kind of comprehensive care our patients truly need. Perhaps it’s time we rethink how we approach obesity in a non-stigmatizing, culturally sensitive way—focusing on overall health, not just weight.

Leo’s story is a poignant example. I first met Leo at age 3 when he was struggling with poorly controlled asthma. After several emergency room visits, we finally managed to get his asthma under control. As Leo got older, his BMI skyrocketed into the severely obese category, and I noticed a dark rash on his neck—an early sign of insulin resistance and potential diabetes. When I shared these concerns with his mother, she was deeply worried. Leo’s family has a history of obesity and Type II diabetes – his sister, at 16, lives with severe obesity and uses Wegovy for weight management, while his 6-year-old brother has already been diagnosed with Type II diabetes.

Leo’s mother is desperate to prevent him from following the same path, but she faces systemic challenges: food insecurity, limited access to culturally relevant health resources, and a lack of safe spaces for physical activity. While I am fortunate…

“It’s been so hot this summer, we drink agua frescas throughout the entire day to help cool off.” My seven-year-old patient, Camille, had a mouth full of dental caries. Camille’s mom was explaining why she had been drinking so many sugar-sweetened beverages. “My favorite is the Jamaica!” exclaimed Camille. As a dentist, I see many patients who suffer from increased dental disease and pain due to their dietary habits. Something as simple as one’s choice of beverage can deteriorate oral health outcomes over time.

So, what exactly counts as a sugar sweetened beverage, or SSB for short? SSBs are drinks that contain added sugars, including sodas, fruit drinks, sports drinks, and coffee and tea beverages with added sugars.1 Overconsumption of SSBs can lead to chronic health conditions, such as obesity, diabetes, and cardiovascular disease. But the risks tied to overconsuming sugary beverages don’t end there. Increased sugar consumption also contributes to poor oral health, including conditions such as dental caries and erosion of teeth.2 How can we as health professionals educate and empower our communities about the dangers of excessive sugar consumption?

As a Champion Provider Fellow, I collaborated with the Los Angeles County Department of Public Health to implement an SSB Screening and Education Program at my community health center, Wilmington Community Clinic. All patients aged 6-9 years old receive this intervention during their biannual exam. The patient’s parents or other caregivers answer two questions: “On a usual day in the last month, how often did the patient drink 100% juice?” and “On a usual day in the last month, how often did the patient drink…

“Rethink Your Drink” sounds so catchy. I know it means choose water instead of sugary drinks, but I wonder if the children in my neighborhood know what it means. Do they know that we are trying to educate them to be more aware about the sugar in the drinks they are consuming? As a pediatric dentist, my strongest passion is educating parents and children on the importance of consuming tap water that contains fluoride which prevents dental decay. When parents become skeptical about using fluoridated toothpaste, drinking fluoridated tap water, and applying fluoride varnish, I explain to them that research studies show that fluoride helps reduce cavities by at least 25%.1 2  Most of the time, I manage to win them over. That’s because these children and parents are already in my office and they trust me. However, educating and persuading an entire community like North Hollywood – a suburb in North Los Angeles County with many high-risk children suffering from dental disease—to change their sugary drink habits may not be so easy. Creating sustainable change in this high dental-risk population requires ongoing motivation and constant reminders. The “Rethink Your Drink” campaign provides a valuable opportunity for me to educate and encourage children in my community about the benefits of drinking tap water. Even if it means an uphill battle, it’s worth it! 

With guidance from my local health department and CalFresh Healthy Living liaison, I began my outreach by connecting with children at local schools, where they…

My first in-person fellowship meeting in Sacramento brought chills of excitement. What I heard that day from inspiring speakers, including former fellows at the forefront of public health and policy change, was inspiring. I realized this is what I had been looking for to complement my direct patient care by serving my community in a meaningful way.

As physicians, we learn to make rapid assessments and come up with solutions for our patients’ problems, sometimes within minutes. Changing policy, environment, and systems requires a different approach that is not taught in medical school. This is where the Champion Provider Fellowship comes into play.

When my current supervisor, Dr. Gina Johnson, a previous Champion Provider Fellow, recommended I apply to the same fellowship I immediately jumped at the opportunity because I wanted to do more than just spend a few minutes with each patient. Admittedly, I did not really grasp the full scope of what I was signing up for. I recently obtained a master’s degree in healthcare quality and safety management but was still figuring out how to apply this to my clinical work and improve the lives of my patients.

At the onboarding, I met a previous fellow, Dr. Lena Al-Sarraf, who is also a medical provider in Los Angeles County. She shared with me about her project with the LA Food Bank addressing food insecurity, which she pushed to implement during her time as a Fellow. Dr. Al-Sarraf’s story and her project had my mind racing and as soon as I was back at my clinic, I called my local health department and CalFresh Healthy Living liaison, Fatinah Darwish, to discuss how to pick up where Dr. Al-Sarraf left off. Fatinah…

Dental care is crucial for both maternal and child health, yet it is often overshadowed by numerous other health priorities during pregnancy. The absence of pain is not the absence of dental disease, and the consequences of neglecting oral health can be severe. For perinatal mothers, poor oral health has been linked to adverse pregnancy outcomes, and in children, to poor developmental trajectories.1

The poignant case of Jessica, a 28-year-old first-time mother and a patient at our clinic, tragically underscores the dire consequences of overlooking dental health. Due to misconceptions about the safety of dental treatments during pregnancy, such as concerns around bacteria translocation and increased risk of infection, Jessica avoided dental care during the first trimester of her pregnancy. Only when faced with debilitating pain and swelling did she seek help. Unfortunately, her delayed action led to an advanced infection that escalated to septic shock, multiple organ failure, and ultimately spread to her brain. Despite being placed in an induced coma to sustain her pregnancy, Jessica passed away after her child was delivered via C-section. Jessica never got the chance to meet or hold her baby, leaving behind a child to grow up without a mother.

This tragedy could have been prevented with earlier dental intervention. Jessica’s story highlights the urgent need for mandatory referrals from OB/GYN to dental services at the first prenatal visit.

In light of Jessica’s story and similar other tragedies, I am advocating for the immediate implementation of mandatory dental referrals and establishing dental clearance as a standard of care for pregnant women…

“Help! I need a doctor!” Mona’s mother was frantic. “She’s in pain. Someone please help!” Mona, a four-year-old girl who loves chocolate milk, was wailing in fear in my dental chair.

Finally, after I delivered the anesthetic, Mona’s tooth was numb. I was seeing Mona for her second emergency tooth extraction. This is not how I wanted the situation to play out, but Mona was a fearful four-year-old with cavities. Typically, a child with this much dental fear is treated with sedation to make the extraction procedure more comfortable and less anxiety-inducing. However, my next available dental sedation appointment was 10 months away because so many other patients also needed treatment for similar dental disease. Furthermore, Mona was overweight, which made sedation relatively contraindicated due to increased risks of adverse outcomes. The only help that I could offer was an emergency extraction. I reassured Mona’s mother, “Mona’s tooth is getting numb. It’s not pleasant but I assure you she is not feeling pain.” Six minutes later, after tears, more anxious cries and a skillful tug, the tooth was out.

Chocolate milk was new to Mona a few months ago. She entered transitional kindergarten last fall and fell in love with it. Soon, mom was buying chocolate milk for home, too. Since starting school, Mona would no longer accept plain milk and the extra calories contributed to Mona’s weight gain, increasing her risks for adverse health consequences like diabetes and hypertension. Sadly, Mona was not alone. Children get a taste for cavity-causing sugar-sweetened beverages, like juice and chocolate milk, that are introduced and made available at…

Youth mental health is the defining public health crisis of our time.

                                               -Vivek Murthy, US Surgeon General

There is a crucial need for more mental health care support in our country. Today, 157 million Americans live in areas with a shortage of mental health providers. (1) Limited provider capacity means that of the 46% of young adults who have diagnoses of substance abuse or mental illness, 55% of them receive no care. (2) And for historically underserved communities, including BIPOC and LGBTQ+ populations, finding a culturally sensitive provider can be even more challenging. (3)

I’m a doctor. A doctor’s toolbox includes medical education and training, a license to diagnose, and the ability to prescribe treatment. So, when a colleague suggested that unlicensed folks with lived experience might be as good or even better at meeting the needs of people who are struggling with mental health, you might think that I’d be skeptical.

As I looked at the literature on peer support, I realized that the model of connecting those who have lived through the same struggles has been helping people for decades outside of clinical settings. Communities for people who are mutually struggling with grief and addiction (4), for example, are trusted and commonplace. No one can better understand what it is like to lose a loved one or to hit rock bottom than someone who has been there, too. It’s why groups of people continue to gather week after week,…

It has been a challenging few years, learning to connect with patients while hiding my smile behind a facemask, in an environment where trust in the medical establishment has decreased and social media memes have become absolute truth. But screening for food insecurity has become a secret weapon for building rapport with my patients and fulfilling my calling as a pediatrician at a federally qualified health center serving an underserved community. When I walk into an exam room with a guide to healthy food resources in my hand, knowing that the family in front of me has limited access to food, I immediately connect with them on a personal level. We may not agree that today is the right day for their child to be vaccinated or that their child may benefit from weight loss, but we can unite on the fact that $7 for a dozen eggs is too expensive and $5 for a gallon of gas causes us to modify our spending habits. Our therapeutic alliance rests on the reality that so many people in our country are facing food insecurity, that our health center has recognized this and provided opportunities for me, their pediatrician, to address it.

Food insecurity is common. Nationally, 12.8% of families are food insecure. (1) Food insecurity may result in changes in eating habits, like consuming more calorie-dense and low nutritional value foods that tend to be more affordable and accessible. (2)(3) These habits can increase the likelihood of children developing chronic diseases like obesity. (4) Children also experience toxic stress associated with intense short-term and long-term food insecurity, even when their parents attempt to shield them from experiencing hunger. (4) This stress…