San Francisco Community Health Center Announces New Dental Care Services And Interview With Dr. Thomas Nguyen
San Francisco Community Health Center is excited to announce new dental care as part of our growing wellness clinic in the Tenderloin district. Adding dentistry as a service is something we always wanted to offer here at the agency and thanks to a number of special grants from the city San Francisco by Supervisor Sandra Lee Fewer of district 1, the state of California as well as a special equipment donation from UCSF School of Dentistry, we are able to fully launch our dental services on March 3rd 2020. Lack of accessible and affordable dental services has been on the rise in the city especially for the homeless or marginally housed, transgender and gender non-conforming as well as other LGB populations we see here at SFCHC. Many of the patients we see have had issues with their oral health and previously we have always had to refer out. This new addition will great add to the wide array of in house medical services we have here at the agency.
To expand on the impact of of adding dentistry to the agency I interviewed Dr. Thomas Nguyen who will be leading the dental practice here at SFCHC.
Can you tell us a little about your background? How did dentistry become a profession for you and why choose to practice at San Francisco Community Health Center?
Prior to dentistry I worked in various fields, including education, food service, and art conservation. I was preparing to become an art conservator when I became ill with a rare autoimmune condition. I was fascinated by the disease process and realized that my hand skills could be better utilized helping those who suffer. I graduated from UCSF School of Dentistry in 2019.
I chose to practice at SFCHC because I share the organization’s vision of providing quality health care to the most vulnerable and underrepresented populations in San Francisco.
In your words, why is dentistry an important service to provide to the community, especially in a neighborhood like the Tenderloin?
On cold days, I see homeless sleeping on top of steaming manhole covers. At the most basic level, an hour in my dental chair is a moment of warmth, dignity and care (and if we are both lucky, sleep). It is important to change public perception about oral health, that it can be attainable not only by the wealthy but by all who seek it. As a graduate of a publicly-funded university, it is important for me to give back to the local community that has supported my education and career.
What aspects of building a dentistry practice at San Francisco Community Health Center are you most excited about?
I am grateful to work for a social justice organization that actively supports innovative practices which place patient needs first. I am excited about:
Designing a dental practice around the needs of a specific population
Supporting local suppliers of dental products and services
Using environmentally-friendly products in the clinic as much as possible
Integrating dental care with existing medical and behavioral health services
Learning from and providing a “dental home” to the residents of the Tenderloin
What are some of the dentistry services you can provide at San Francisco Community Health Center? What are the kind of unique needs do you expect solve with our clients?
Services: Exams, cleanings, hygiene instruction, fluoride and sealant treatment, fillings, extractions, emergency visits, referrals for specialty services, unsolicited critique of your hair and makeup. (Dentures and crowns planned for the future; we need more space!)
Unique needs:
Harm reduction: how to maintain oral health while actively using substances
Trauma-informed care
Transgender care
Treatment modifications for medically-complex and behavioral management patients
How do you intend to bill for patient services? What kind of out-of-pocket cost are expected of the client?
As a Federally Qualified Health Center, dental treatment for Medi-Cal, Medicare, and San Francisco Health Plan patients is covered by the state.
Patients who do not have insurance or are under-insured are subject to the Sliding Scale Fee Schedule which assigns discounted rates based upon yearly income level and household size. The goal is to provide affordable quality care regardless of ability to pay.
At San Francisco Community Health Center we like to provide wrap around services and like to be considered a “one stop shop” for healthcare needs. How do you intend on working with the existing programs and services at the agency?
SFCHC will formally integrate medical, behavioral health and dental services by developing a bidirectional referral system. For example, if a nurse practitioner sees a patient with oral health issues, they can directly schedule that patient for a dental examination or emergency dental visit at our front desk. Likewise, any medical or behavioral health issues that I discover can be flagged and addressed by the appropriate provider in our clinic. This system is crucial for our clients because they often lack the capacity to navigate on their own the existing health services in the city.
There can sometimes be a negative stigma by seeing a dentist. Why do you think that is and how do you expect to overcome this to make our clients feel at ease?
PAIN: A certain amount of pain is unavoidable in most dental procedures. If a patient at SFCHC is experiencing pain during treatment and I have exhausted all available means of alleviating that pain, I have no problems stopping the appointment and trying again another day.
MONEY: Dentistry has evolved into a profit-driven industry and most patients are primed to question a dentist’s motives. Our patients will rest assured that oral health and wellness is our guiding principle.
JUDGMENT: Many of our patients have a long history of substance abuse and dental neglect or trauma and feel a certain amount of shame about the state of their oral health. You will never hear terms like “meth mouth” in our clinic because we treat our patients like family.
Are there any new studies, products or procedures that is transforming the dental world that you can bring to San Francisco Community Health Center?
Oral health is extremely time sensitive. The longer you wait to get a filling placed or a biopsy analyzed, the more expensive the treatment will be to save that tooth (or your life). Recent studies have associated gum disease to heart disease, diabetes, and even macular degeneration. We encourage our patients to see the dentist on a regular basis, not just when you have a toothache.
Perhaps the most beneficial product to emerge recently in the US is SDF (silver diamine fluoride). The solution is painted on the tooth surface and requires no anesthesia or drilling. It neutralizes the bacteria that cause the progression of dental cavities. This procedure is particularly useful for patients with multiple cavities because it resets the clock and buys the dentist some time to complete the fillings over the course of multiple visits.
Where do you expect the dentistry practice at San Francisco Community Health Center to grow and how can our community support this process?
A San Francisco supervisor recently announced his goal of making dental care free for all city residents. We would love to have enough equipment, staff and funding to help achieve this goal, but we must also ground ourselves in what is possible and what is needed. Free care is not necessarily quality care, and it is likely not healthy for the city budget. Like SFCHC as a whole, the dental practice will take calculated risks and evolve in step with the changing needs of our community.
San Francisco Community Health Center will be accepting patients for dentistry starting March 3rd 2020.