I remember my first dental visit vividly. I was 13 years old and in excruciating pain. Pain that would not let me sleep. Pain that kept me home from school. Pain that would not allow me to eat. Pain that would not subside. My only option? To suffer through the pain because my parents couldn’t afford the root canal I needed.
My story is far from unique—in fact, it's the story of many in the Latin community. The facts are that Hispanic and Blacks are twice as likely to have untreated cavities.1 Seven out of 10 Mexican-American children ages 12 to 19 have cavities in their permanent teeth.1 The data is astonishing for our older adults (65 years and older)—it indicates that more than nine out of 10 older adults have cavities.1
What is culturally competent care?
How do we combat these odds? Through culturally competent care. Culturally competent care means looking at the disparities and barriers facing this community and addressing those issues. It is empowering yourself with knowledge about the community you serve.
Simply put, culturally competent care leads to better patient care.4,5,6 It leads to more efficient care and reduces medical errors.4,5,6 It also helps you build rapport with your patients.4,5,6 From an economic standpoint, this is important because Latins contribute significantly to our economy, and building relationships with them will enable you to gain better case acceptance. 3 More than that, Hispanics and Latins are the largest ethnic minority group in the US, meaning you’re quite likely to treat Latin or Hispanic people in your dental career.
Things you should know about the Latin community
The Latin community is made up of 20 countries, including Nicaragua, Puerto Rico, Columbia, Peru, Honduras, Guatemala, El Salvador, and my beloved Mexico. It includes people of different races: white, Black, and indigenous. We are not all tan and do not all eat tacos—we have different dialects, different foods, and different skin tones. We do not all speak Spanish; Brazilians speak Portuguese and Haitians speak Creole and French. Although we have many differences, we also have a lot of similarities. Studies show that while we eat different foods, the Latin community has a high sugar intake in their diets.2 So no matter if your patient eats Mofongo, pupusas, or empanadas, they may require nutritional counseling.2
Understanding that we all come from different backgrounds will help you understand why there’s no term to define us all. You have most likely heard the term Hispanic, which refers to someone who has ties to a Spanish-speaking country. People from Spain are Hispanic, but Brazilians are not. Latino (masculine) and Latina (feminine) refer to someone who has cultural ties to Latin America; people from Spain are not Latin. Latinx and Latine are gender-neutral terms used for people of Latin America; only 3% of Latins identify as Latinx.7 All these terms can be confusing, even for me, a Latina. For me and others in my community, my Latino-ism is very personal and a source of pride. For this reason, it is best to ask your patients what they identify as instead of making any assumptions.
Education is key to growth and change
I cannot emphasize enough the importance of education. We need to provide education at all stages of life. Many of us are not taught the importance of good oral health as children or as adults. The truth is, I didn’t know that floss existed until I was an adult and didn’t know how to floss correctly until dental hygiene school.
There are several great resources available for dental professionals wanting to provide education to their patients in Spanish. The National Institute of Health (NIH) will mail you free educational pamphlets in English and Spanish. You can order pamphlets from their website on topics ranging from dry mouth to brushing straight.
The Hispanic Dental Association has partnered with Dentalcare.com to provide a free handbook with commonly used vocabulary and phrases translated into Spanish. They also offer audio pronunciation for individual terms. If you are interested in purchasing a dental Spanish terminology book, I recommend "Spanish Terminology for the Dental Team". I also provide one-minute Spanish oral hygiene instruction videos and information for caring for the Latin community on Instagram, @thelatinardh. For children, I recommend my not-for-profit Spanish and Spanglish dental book titled "Smiles Por Vida." This book was created in partnership with public health dental hygienist Maxine Cordova and tells the story of Mateo sharing his dental care experience with his abuelita (grandmother). All profits from this book go to funding outreach initiatives in low-income communities. It is also incredibly valuable to take cultural competency dental courses that focus on the Latin and Hispanic communities.
Remember, while this month is designated to celebrate Latin culture and contributions, we Latinos, Latinas, Latinxs celebrate every day! As dental professionals, we can honor this by caring for the Latin community holistically and competently.
References
1. Disparities in Oral Health. Centers for Disease Control (CDC). https://www.cdc.gov/oralhealth/oral_health_disparities/index.htm
2. Rivera Y, Boyd LD, Libby L. Hispanic Seasonal Farmworker Caregivers' Beliefs and Perceptions of Early Childhood Caries. J Dent Hyg. 2020 Oct;94(5):14-21. PMID: 33008945.
3. Pisani MJ. New Age Informality: Hispanics and the Sharing Economy. Adm. Sci. 2021, 11, 23. https://doi.org/10.3390/admsci11010023
4. Castro A, Ruiz E. The effects of nurse practitioner cultural competence on Latina patient satisfaction. Journal of the American Academy of Nurse Practitioners. 2009;21(5):278-286. doi:10.1111/j.1745-7599.2009.00406.x
5. Sobel LL, Metzler Sawin E. Guiding the Process of Culturally Competent Care With Hispanic Patients: A Grounded Theory Study. Journal of Transcultural Nursing. 2016;27(3):226-232. doi:10.1177/1043659614558452
6. Anthony A Romeo. Culturally competent care is the most effective care. Orthopedics Today. 2019;39(7)
7. Latinx Used by Just 3% of U.S. Hispanics. About One-in-Four Have Heard of It. Noe-Bustamante et al. https://www.pewresearch.org/hispanic/2020/08/11/about-one-in-four-u-s-hispanics-have-heard-of-latinx-but-just-3-use-it/
Amber Lovatos, BSDH, RDH, “the Latina RDH,” is the director of dental services at TOMAGWA HealthCare Ministries. She has been compassionately blazing trails personally and professionally for more than 10 years. As a clinician, educator, and champion for public health issues, she inspires industry colleagues with unique stories that include triumph over abuse. She can be reached at [email protected] or on Instagram at @Dentalhygienespark and @thelatinardh.