“Listening to Each Other”: A Project to Improve Relationships with Underserved Members of Our Society

In a previous JCDA article¹ we wrote about poverty and the challenges it poses to society and, in particular, to oral health care professionals who treat underprivileged populations. In our conclusion, we noted the recent efforts of some provinces to reduce social inequities by developing poverty reduction plans. The values underpinning such actions are universally recognized: to ensure basic human rights and social justice for all members of society. Because economic and social disparities are often accompanied by health disparities, we called on oral health professionals to join the movement to help reduce poverty and alleviate its consequences. Too often we see first-hand how a lack of dental care and poor oral health perpetuate the cycle of poverty by negatively affecting employability and health, and in the case of children, their abiltity and readiness to learn. We therefore challenged the dental profession to 1) improve relationships with underserved members of society; 2) develop strategies for positive and effective interactions; 3) improve access to dental services for poor populations.¹

These 3 recommendations are the foundation of a project that has been conducted in Montreal, Quebec, titled "Listening to Each Other." A detailed description of the project has been published elsewhere.² Our aim in the present article is to provide a brief overview of the project in order to show how professionals and antipoverty groups can work together to improve access to dental care for poor populations. We also describe a pedagogical tool produced as a result of this project that can be used in undergraduate professional teaching.

A Participatory Approach for Developing Educational Tools

Dentists often report experiencing frustration with patients on social assistance and acknowledge they have difficulty understanding their health behaviours and lifestyle.³ On the other hand, people on social assistance feel that health professionals do not necessarily understand their perspectives or perceive the difficulties they encounter related to poverty.⁴ For these reasons, the professional dental bodies in Quebec and anti-poverty groups decided to work together to address and reduce the mutual misunderstandings that exist between oral health professionals and people on social assistance.²

Representatives of these groups, in collaboration with researchers, have been meeting on a regular basis since 2006 to develop educational tools for use by the profession. The group's philosophy, in tune with participatory research methods, is to share responsibility for decisions made at all stages of the development of these tools.

One of the tools developed is a 1.5-hour DVD, in which 6 people on social assistance talk about their lives in general, their oral health and their experiences with the oral health care system. The DVD can be used in undergraduate teaching to help future oral health professionals better understand the perspectives of people on social assistance. It should also prepare and encourage students to embrace opportunities for community fieldwork that provide first-hand experience at communicating with and providing services to low-income populations.

Future Areas to Consider

The "Listening to Each Other" project demonstrates that the dental profession can, through fruitful collaborations with anti-poverty groups, be part of a national movement to reduce poverty and its impact on our society. However, there is more work to be done. Although it is essential to improve the profession's understanding of and relationship with underserved members of society, the issue of access to care for underprivileged social groups remains a multifaceted challenge. Collaborative action should also include lobbying governments for improved coverage for dental care for several at-risk populations.

Professional involvement in antipoverty efforts may also have a direct, positive impact on the image of the dental profession in our society. In a paper published in JCDA that summarized the results of a public opinion survey,⁵ Dr. Croutze revealed that Canadians' perception of dentists needs to be improved. In light of these findings, we wanted to share the results of our collaborative project as an example of the progress that can be achieved when the profession, anti-poverty groups and patients work together. We hope that the "Listening to Each Other" project will serve as a catalyst for similar endeavours in the future.

THE AUTHORS

	Ms. Lévesque is a research coordinator of the "Listening to Each Other" project, division of oral health and society, faculty of dentistry, McGill University, Montreal, Quebec. She is currently enrolled in University of Montreal's public health doctoral training program. Email: martine.levesque2@mail.mcgill.ca
	Dr. Bedos is an associate professor and head of the division of oral health and society, faculty of dentistry, McGill University, Montreal, Quebec. He is also head of the public health and clinical research branch of the Oral Health and Bone Research Network of the Quebec Health Research Fund (FRSQ).

Acknowledgements: The "Listening to Each Other" project partnership also comprises: Nathalie Morin (Order of Dentists of Quebec), Johanne Côté (Order of Dental Hygienists of Quebec), Sophie Dupéré (Quebec Coalition for the Elimination of Poverty), Isabelle Laurin (Montreal Public Health Agency), Alissa Levine (McGill University), Nancy Wassef (McGill University), Christine Loignon (Sherbrooke University), Anne Charbonneau (University of Montreal). We hereby acknowledge the importance of their enthusiasm and contributions to this project.

This article is dedicated to the memory of Louise Whitmore, a participant in the "Listening to Each Other" project.

The quotations are reprinted by permission of the Journal of Dental Education.² Copyright 2009 by the American Dental Education Association.

The views expressed are those of the authors and do not necessarily reflect the opinions or official policies of the Canadian Dental Association.

This article has been peer reviewed.