Kelly Braun, a registered dental hygienist, serves as the executive director of the American Board of Dental Public Health. Dentistry33 believes in the importance of public health, and we are recognizing her as our featured dental hygienist in September for her work with the board and in rural health networks in her state.
In 2022, Braun joined the board, where she manages the organization’s day-to-day operations, including overseeing a yearly certification process for dentists specializing in public health. Braun also works for the Pennsylvania Office of Rural Health and is an adjunct faculty member for Concorde Career College’s dental hygiene program. She obtained a master’s degree in dental hygiene with an emphasis on education from the University of Bridgeport. Braun also completed the National Rural Health Association’s Fellows program in 2021.
Q: Most people understand public health, but they may not know about dental public health. How do you describe the field?
Braun: So often, especially as a hygienist, as we go through hygiene school, we think about dental health as visiting the dentist every six months. A patient sees the hygienist and dentist and gets a checkup. But to impact as many people as possible, we need that public health aspect in dentistry, thinking about the broader population rather than just the one person in your chair. What can we do to promote health across that population instead of with one patient over one hour in the chair?
Q: When did you first become interested in dental public health?
Braun: I started my master’s program and while I hadn’t specialized in public health, my education led me down a public health path. That journey ties in nicely with the work I’m doing for the board. It’s education-focused, we manage and help to administer a certified exam for clinicians.
I graduated from dental hygiene school at a time when jobs were somewhat scarce. I decided to remain a student, completed my bachelor’s degree online and I started work in a hospital setting, where I stayed for seven years. I also finished my master’s degree during this time.
I loved the work I was doing at the hospital. It was clinical dental hygiene, but we saw patients that were a little more complex than what a private dental practice would oversee. This included seeing hospital employees, patients with advanced medical needs, people who had to be cleared before cardiac surgery or a joint replacement, patients with head and neck cancer, and those with cleft palate.
As I was working on my master’s degree, I ended up collaborating with a group of clinics for my practicum. One of the pediatric dentists talked with me after attending a conference and he said that he’d met a local pediatrician who wanted to incorporate oral health care into her practice. She was interested in using fluoride varnish, so I created several presentations for them, on how to use the varnish and that was my practicum.
My sister is a physician assistant, so I also started exploring non-physician providers and their attitudes and beliefs towards oral health. In my sister’s training, she had two hours of oral health education. With two hours of training, how comfortable are you talking about oral health?
I began exploring what it would take to help educate these providers.
Fast forward to two years after I finished my master’s degree: there was a job posted with the Pennsylvania Office of Rural Health. A colleague of mine shared it with me and thought it would be a good fit. The position involved working with medical providers and teaching them to integrate oral health into their practices.
Once I accepted the position, one of the first groups of practices that I worked with was that same set of medical offices from my practicum. They were one of the first groups we brought on board to comprehensively integrate oral health into their practices. So, they now conduct oral health screenings, are trained in how to use fluoride varnish and provide education for patients and parents.
The biggest piece of the puzzle was dental referrals and medical records. How do you refer out to a dental office and then get a summary back from the dental office on who they saw, if someone was a no-show, or if they need follow-up care. Getting those bidirectional referrals was the trickiest piece. Medicine and dental still practice in silos and getting them to communicate with each other was hard. Plus, not all these practices have electronic health records that can “talk” to each other.
Q: What are some of the hot topics in dental public health?
Braun: From the board’s perspective, our role is to administer certifying exams. We don’t necessarily weigh in on specific topics.
If I step into my role with the Pennsylvania Office of Rural Health, the workforce continues to be an ongoing concern. Colleagues at the PA Coalition of Oral Health released several workforce reports over the last year.
Locally, near State College, Pennsylvania, our local water authority started talking about rolling back fluoride. Again, this was work outside of the board, but I sat through these meetings. It’s something that is of interest to me as a dental hygienist and a community member. I offered some comments on what they were proposing. The local authorities did unfortunately end up rolling back fluoride in March.
On the flip side, in Meadville, a group of clinics that we worked with on dental-medical integration were successful in adding fluoride to their water. There were several meetings about it, wasn’t an easy fight but they did get it enacted and the local government is now fluoridating their water.
Q: Since you mentioned workforce and the reports from the coalition, what are you seeing in that area?
Braun: It’s sometimes challenging to get patients in following the backlog after the early days of the COVID-19 pandemic. Some of the waitlists can be long. If you’re a new patient calling for care, it could be a good year or two depending on where you’re at, who you’re trying to see and your insurance.
The PA Coalition for Oral Health conducted secret shopper surveys with four different scenarios, including when dental practices would see a new patient that is a child on Medicaid, a family with no insurance, and other scenarios.
Some of the wait times were two years unfortunately, just to get in the door for an exam.
It’s a combination of the backlog, offices being shut down, lack of staff and some of that does stem from COVID-19 and workforce issues. Young people considering dental assisting for example can make a similar salary at a big box store or a convenience store and these jobs do not come with high stakes.
I’ve experienced the wait times personally. I needed to see a specialist and had to wait three months before I could get that procedure done. Some people end up in the emergency room for oral health issues, which drives up the cost of care. Unfortunately, emergency rooms are not equipped to treat the root causes of dental pain and disease. There are a lot of moving parts in these scenarios that make them complex.
Q: What else would you like people to know about the American Board of Dental Public Health?
Braun: The board work I’m doing involves helping public health dentists become certified and walking them through that pathway through certification. They must pass a qualifying written exam and once they pass that exam, they are eligible to take the certifying exam.
Clinicians submit written project reports, and they defend them in an oral format. They are also given an assigned problem and they have approximately 24 hours to come up with a solution and defend that as well. That part of the exam is given in-person every year in coordination with the National Oral Health Conference, which will be held in St. Louis, Missouri in April 2024.
Learn more about the American Board of Dental Public Health: https://abdph.org/
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