Pediatric Dentist Learned to Address Barriers, Advocate for Patients

Aug. 21, 2014

Dr. Moncy MathewWhen Moncy Mathew, DDS, MPH, who graduated from the Eastman Dental pediatric dentistry program, encountered patients with complex psychosocial issues, he sought consultation with Eastman Dental’s social worker.

During on-call one evening, Dr. Mathew recognized that a dentist’s responsibility does not end with providing emergency dental care in the hospital’s Emergency Department.

“While patients have dental needs, we rarely understand the obstacles families experience in trying to access dental care,” he said. “One of the most difficult challenges we face when treating children is addressing those barriers. Teamwork is very important in dentistry, and collaborating with social work allows us to address barriers and to be successful in treating children who otherwise would suffer from not being part of a dental home.”

The following scenario describes how the collaboration between Pediatric Dentistry and Social Work has benefited a patient.

Suspected Dental Neglect

Dr. Mathew was called to the ED late one night when a 2 year-old female presented with a dental abscess, large facial swelling, and fever. Initially, the patient was brought to a local hospital emergency room; however was transported to Strong Hospital via ambulance. During the oral assessment, Dr. Mathew identified extensive cavitation on multiple teeth, with some teeth requiring extraction.” The child’s mother reported that she obtained sole custody since leaving the relationship eight months ago and that the child’s father is incarcerated.

little girl with tooth painFollowing a psychosocial risk assessment the ED Social Worker filed a Child Protective Report for suspicion of medical neglect and lack of proper guardianship. The child was discharged the next morning and instructed to follow up at Eastman Dental.

r. Mathew and EIOH Sr. Social Worker Lenora Colaruotolo discussed the case and strategized how to approach the family. Despite two voice mail messages, the family failed to follow through or confirm the child received follow-up dental care with another dental provider. Due to the severity of the child’s treatment needs, along with the concern that the dental neglect was soon going to cause a subsequent visit to the ED, we collaborated on how to facilitate the child’s care.

The assigned Child Protective caseworker and Colaruotolo partnered to support the mother in obtaining insurance for the child, and follow up with Eastman Dental. As a result, the child received necessary dental care in the operating room under general anesthesia.

Getting to know Dr. Mathew  

Why do you want to be a pediatric dentist?

As a Public Health Dentist, my efforts had been focused on preventing dental caries at the population level.  I had been involved with water fluoridation, school-based fluoride rinse programs and dental sealant programs at the state level.  While working as faculty at the dental school, I was asked if I would work locum tenens for a school-based dental program to cover for a dentist on maternity leave.  I began to enjoy working with children and wanted more.  Over the next 5 years, I received more locum tenens requests and every experience was better than the previous one.  I realized, although late in life, my calling was to working with children and decided to pursue pediatric dentistry.

How did you become interested in dentistry?

I always wanted a profession that included working with my hands.  After exploring numerous options, I decided to pursue dentistry as it had more of an emphasis on the ‘art’ of dentistry within the science of the profession.  It appeared very rewarding when something that you could do with your hands could help people attain a better quality of life with improved oral health. 

Describe your experience with Eastman Dental.

During the residency match process, I had ranked EIOH as my first choice.  One of the factors that influenced my decision was the presence of a social worker within the dental department.  No other program that I interviewed at had a social worker. 

The pediatric dentistry program has a perfect balance between didactic coursework and clinical experiences.  Dentistry is so much more than just teeth – the resources available through the Strong Hospital made my experience more well-rounded and enjoyable.  I hope the knowledge and skills learnt at EIOH will help me be a more compassionate dentist.