Marwa Abdinoor Mackenzie Rigg / CTMirror.org
Marwa Abdinoor Mackenzie Rigg / CTMirror.org

Connecticut has made huge strides in improving access to dental care and reducing disparities over the years, but health care advocates and providers are concerned about what will happen going forward given the state’s financial challenges and potential Medicaid cuts at the federal level.

One teenager from West Hartford hopes to help more school-aged kids receive dental exams during these uncertain times. Months ago, Marwa Abdinoor, 17, decided to study the relationship between socioeconomic status and oral health for her senior research project.

As part of her project, Abdinoor plans to offer free dental exams at at least two public schools in Hartford. Abdinoor, who goes to Capital Preparatory Magnet School in Hartford, is working with Stewart Joslin, chief financial officer of the Charter Oak Health Center. Charter Oak has two community health centers in Hartford and will provide the professionals and equipment needed for the exams.

In this Sunday Conversation, The Mirror spoke with Abdinoor about her research project.

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Marwa, tell me about your project — what have you completed so far?

Each senior at Capital Preparatory Magnet School is required to complete the Social Justice Project (SJP Capstone). This project has to be a mixed-method action-based research study for a senior to be granted graduation. This means that each student has to pick a local injustice and create an informed action plan to help solve the injustice of their choice.

There is an extensive research phase of the project as well as analyzing acquired data. I chose to investigate the correlation between socioeconomic status and oral health. Low income families are not receiving adequate preventative dental care for a variety of reasons, and society’s misconceptions on overall wellness does not aid the issue at hand.

The purpose of my study is to offer adolescents of low-income households the opportunity to receive dental examinations in a convenient setting. I am working with the Charter Oak Health Center  to bring a team of dentists to schools with portable dental equipment to provide free dental examinations.

I have completed my research and I have gathered pre-data. In other words, I analyzed five empirical articles and wrote the literature review, the chapter two portion of my essay. Each senior is required to write an essay that is broken into five chapters. I have completed chapters one, two, three, and part one of chapter four. I have also identified which schools in Hartford have a school-based health center and which don’t for my pre-data phase. Going from there allowed me to prioritize which schools I need to reach for my treatment.

When you first started this project, what did you know?

At first when I started the project, I wanted to cover health care disparities among low income families and their struggles. But then I soon realized that’s such a broad topic. I didn’t really know much about dental care and advanced dental disease, and how some low-income families don’t have preventive care, so it turns into advanced diseases that could have been prevented.

What are some things you didn’t know than that you know now?

I know much more now regarding healthcare after being devoted to my study but there is still so much for me to learn. For instance, I didn’t know the importance of preventative care before I started my research study. Preventative care is a highly controversial because it’s such a great thing but not everybody has it. Preventative care can allow for the discovery of general health problems, infections, immune disorders, injury and cancer.

After readings about the death of Deamonte Driver, I understood the importance of preventative care along with health disparities and inequity across the nation among underserved populations.

[Deamonte Driver was a 12-year-old Maryland boy who died in 2007 when bacteria from an untreated tooth infection spread to his brain. “Driver’s death transformed the oral health discussion as more people — including members of Congress — recognized the potential seriousness of untreated oral disease. His enduring story has contributed to the sustained interest in oral health seen in recent years,” according to a 2011 study by the Institute of Medicine of the National Academies.]

What are some of the reasons that you found about why people don’t go to the dentist?

I’ve found that some people are simply not aware of the importance of going to the dentist, and have this mentality that if I can’t see anything physically wrong then there’s no need. Some don’t go because they have dental anxiety and fear going to the dentist. Lastly, some don’t have the coverage to go.

In relation to my project, I’ve also found that because of the responsibilities low- income parents have taking their children to the dentist might not top the list. That’s why I refer to the schools as a convenient setting because it’s truly convenient for all the parents and kids.

What have you learned are some of the consequences of not going to the dentist?

Not going to the dentist can present a plethora of consequences. I’m no dentist but my research informs me that an infection can undoubtedly develop if an individual struggles to maintain oral cleanliness. If the infection goes untreated it can spread to other parts of the body. Additionally, dental caries can turn into advanced dental disease. One can also develop gum disease and cause tooth loss.

You told me that Mr. Joslin informed you about a lot things going on in Connecticut that you were oblivious to. What are some of those things?

When I first met with Stewart he gave me multiple packets filled with information in relation to dental care in Connecticut. One of the discussions Stewart and I had informed me that less and less providers are accepting HUSKY and medical costs are continuing to rise.

Charter Oak Health Center in Hartford

The Connecticut Health Foundation reported from the 2012 Connecticut Department of Public Health statewide survey that “….40 percent of third graders had tooth decay, and the rate among low-income children is four times that of high-income children.” Furthermore, black and Hispanic children are more likely to have untreated tooth decay. As a result the article discusses how black and Hispanic children in urban regions had the highest sealant application rates among all other populations.

This surely opened my eyes to the disparity going on in the state I was born in.

How did it make you feel when you saw the data and realized how many people in your community are going without preventive dental care?

In a sense, heartbroken. I have insurance and I’m able to go the dentist. In a way, I feel helpless, but working on this project I feel like I’m giving back to society.

What has been the hardest part of your research so far?

Getting into a school. I created an action plan but nothing is really going as I intended it to. I didn’t expect so many obstacles, but in a way that’s helped me as a person. Life throws you things so you have to learn how to get over those hurdles.

What is the ultimate goal of your project?

The ultimate goal of my project is to lessen the health disparity in Connecticut, even by a little. The objective of my project is to give low-income adolescents the opportunity to be examined by dental professionals and expel misconceptions on oral health within the community.

I plan to expel misconceptions regarding oral health by organizing a community oral health fair. Dental professionals will speak on the importance of oral health, and they’ll offer beneficial information on ways the audience can seek preventative care, how to avoid dental caries, affordable ways to maintain oral cleanliness, how to look out for symptoms of dental cavities and disease.

How has this project changed you as a person and what you plan to do in the future?

This project made me realize that I take far too much for granted. I never used to think twice once my parents pulled out our insurance card when taking my sibling and me to the doctors or dentist.

After educating myself on healthcare, I feel privileged to an extent, in realizing that I can receive medical attention and services when I need. I plan on studying biology in college. As I see myself working in healthcare and making a difference in society.

This interview has been edited for length and clarity.

Mackenzie is a former health reporter at CT Mirror. Prior to her time at CT Mirror, she covered health care, social services and immigration for the News-Times in Danbury and has more than a decade of reporting experience. She traveled to Uganda for the News-Times to report an award-winning five-part series about a Connecticut doctor's experience in Africa. A native of upstate New York, she started her journalism career at The Recorder in Greenfield, Mass., and worked at Newsday on Long Island for three years. She is a graduate of the Columbia University Graduate School of Journalism, where she wrote her master's thesis about illegal detentions in Haiti's women's prison.

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