Oral Health :: Routine screening for oral signs of disease can save lives

An assistant professor of dental hygiene at New York City College of Technology (City Tech), she is on a mission to educate her students and a variety of providers in the metropolitan New York area — hygienists, physicians, physician assistants, nurse practitioners and hospital HIV/AIDS counselors — to routinely conduct periodontal evaluations and oral cancer and vital sign screenings as well as how to recognize the clinical signs of such systemic diseases as HIV/AIDS.

“Dental health providers can be the first line of care when it comes to oral health,” she says. ?The mouth is the portal to the body and a reflection of general health. We as health providers need to be able to recognize things like a yeast infection that doesn?t go away or specific tumors and be able to bring up such subjects with our patients.?

Statistics bear out her concern. According to the American Dental Association, only about seven percent of dentists offer the mouth and neck exams they should.

Dr. Cohen-Brown, who became a dentist in the mid-1980s when the AIDS crisis reached epidemic proportions and saw many patients with HIV/AIDS, makes this point when she speaks at hospitals, prisons, clinics, health care conferences, training programs and rehab, medical and mental health centers in the tri-state area, which she does as often as time permits. She also offers in-person health care provider continuing education on HIV-related topics through Cicatelli Associates.

“While HIV/AIDS is no longer in the news as much, it is still an epidemic that needs to be contained, and education is key,” she explained. The New York City case rate of 45.4 per 100,000 people is more than three times the U.S. average and 45 times the target goal for Healthy People 2010, a set of health objectives for the nation to achieve over the first decade of the new century. Particularly hard hit are the city’s Black and Hispanic populations, which account for 81 percent of new HIV diagnoses, as reported this past September by the New York City Department of Health and Mental Hygiene.

Dr. Cohen-Brown explains to providers the laws about HIV testing, what occurs in pre-counseling, and the types of tests available. Dentists can?t do HIV testing (New York State has strict requirements about providing counseling with testing), but can refer patients to clinics, hospitals and agencies such as the Brooklyn AIDS Task Force that perform confidential or anonymous testing, especially the Rapid HIV Test, which delivers negative results in 20 minutes.

Just as importantly, she informs her audiences on how to bring up the subject of HIV/AIDS testing — where to refer patients, how to help them access those places, what needs to be done and what to expect.

And since success in steering patients to HIV testing may hinge on the ability to remain nonjudgmental, she also gives her audiences examples from her former oral pathology practice on how to approach patients in a way that won?t make them panic. ?The more comfortable you are, the more comfortable they?ll be,” she says. “You have to know which questions will elicit answers. As long as I?m not judgmental, the patient will be comfortable.?

Dr. Cohen-Brown, whose advanced studies in oral and maxillofacial pathology led her from dental practice into teaching, works with the AIDS Institute, the New York State Department of Health and the Department of Corrections, lecturing on mandated cleanliness standards, equipment maintenance, exposure prevention, infection control, post-exposure medication and how the HIV Rapid Testing kit works.

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