Asking for a Friend: How can I improve cultural competency in my dental office?

The four Cs of cultural diversity and competency

You’re in the morning huddle and are told, “Mr. X doesn’t speak English.” “OK, what language does he speak?” No one knows. Yikes. Hygienists and dental professionals must be culturally competent providers to enhance the quality of care to the patient and community; part of this is making an effort to address language barriers. I'll often see in the side notes that a patient “doesn’t speak English” or “doesn’t speak English well,” but it’s not followed up with their preferred language. Failing to secure this information is an example of an office lacking cultural competency.

By definition, cultural competence is the ability to understand, communicate, and effectively interact with people from diverse backgrounds. It means being aware of and respecting different cultures, beliefs, and practices. After all, according to research, by 2050, 50% of the United States population will be of non-European origin.¹ How do we bring this to the attention of our respective offices and propose solutions to correct deficiencies? First, let’s review the four Cs of cultural diversity and competency.

Communication

The ability to communicate is imperative in building trust and providing the standard of care in a compassionate and caring environment. Dental providers must be able to communicate effectively with patients who speak a different language or have a different cultural background. Examples of demonstrating cultural sensitivity in communication include asking a person how they would like to be addressed, respecting their cultural health practices during assessment, and using terminology that patients can understand.

Language interpretation services should be readily available to ensure effective communication, including on-call interpreters or digital applications as quick and straightforward as Google Translate. New and advanced interpretation applications provide live connections to translators of 250 languages, including sign language. When a language barrier is present, at the very least, learning “hello” in a patient’s native language will make them feel more comfortable and welcomed. Another note: It takes less than 20 seconds to look up the phonetic spelling of how to pronounce someone’s name correctly. You have time for this, trust me. One study found that patients were willing to return to a dental office with a language barrier if they felt welcomed and respected.²

Compassion

With compassion, we can empathize with patients and understand their autonomy, taking into account their cultural beliefs and practices. One study reviews how different cultures have different levels of health and wellness in the US based on varying disparities.¹ Health care disparities refer to differences in access to or availability of facilities and services, while health status disparities are the varied rates of disease and disability that exist between socioeconomic, racial/ethnic, geographically defined, and other groups. These disparities are primarily the result of historic systemic inequalities. Despite our good intentions, a lack of cultural understanding can lead to poor health outcomes in patients, underscoring the need to demonstrate compassion and make an effort to learn culturally tailored care.

Capacity

Capacity refers to the knowledge and skills that health-care providers have to manage cultural diversity. We can enhance our understanding of cultural practices, beliefs, and values by regularly taking continuing education courses on these topics. We become more comfortable providing culturally diverse and competent care by staying educated on the subject. Make it a team-building event to ensure your office is sharing the same information. Using cultural assessment tools is a good start to assessing the capacity and cohesion of cultural competency in your office.³

Coordination

Coordination refers to the ability to collaborate effectively with our patients, their families, and other health-care providers to deliver comprehensive care. We should strive to develop a comprehensive care plan that considers the individual’s cultural beliefs and health objectives in a well-understood manner. Ensuring that the patient understands the plan and communicating that effectively to other involved parties may require modifications to our typical recommendations and the aid of translation services for the patient and family. In periodontal practices, it is most beneficial to the patient when you reflect their needs in your periodontal maintenance letters to the general dentist. These reports can also be sent to other medical providers the patient has to help them bridge communication gaps.

Competent or bust

Keep an ear out in your office once the team has started working together in cultural competency and diversity. Listen for appropriate and inclusive language and conversations, effective use of nonverbal communication, implementation of translation technology, and the effort put into the four Cs outlined above. Note strengths and weaknesses and work on things together to find better solutions. If you still feel you are working in an office that does not align with your ethics surrounding cultural sensitivity, it may not be a good fit for you. I would encourage pointing out this deficit in an exit interview if only for the benefit of the patients.

Editor’s note: This article first appeared in Clinical Insights newsletter, a publication of the Endeavor Business Media Dental Group. Read more articles and subscribe.

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