Dr. Chintan Desai: I believe oral health awareness improves when preventive care becomes a regular part of daily life rather than something people think about only when they are in pain. During my Dental Public Health residency at the University of Rochester, I saw how well school based programs work. We created a dental home within a public school, screened children, provided cleanings, sealants, and fluoride treatments, and worked closely with the school nurse. This approach reduces barriers and helps children build long term healthy habits.

Mobile dental vans also play an important role in reaching underserved communities. These vans operate like fully equipped clinics and allow us to provide care to families who may not have transportation or easy access to dental services.

Insurance coverage influences how often people seek preventive care. In the United States many preventive services are covered, which encourages routine visits. At the same time coverage varies widely, and some families still experience barriers. In countries where dental insurance is limited, people often delay treatment until pain becomes severe, which shifts the focus away from prevention.

For communities with limited internet or digital access, in-person education remains essential. Health fairs, school programs, community centers, and local health workers help deliver simple and practical oral health messages.

Overall, a combination of early education, accessible care, and supportive public health policies can strengthen oral health awareness and encourage people to view oral health as an important part of overall well being.

During my dental training in India, I often encountered patients who came to the clinic very late in the disease process. I would ask them why they had not come earlier, because in many cases timely treatment could have saved their tooth. Many patients explained that they had taken medication recommended by someone in their neighborhood. This pattern is very common. People experience pain, use over-the-counter painkillers, feel temporary relief, and assume the problem has resolved. Because the symptoms disappear for days or even months, they delay seeking proper dental care until the condition becomes severe.

In the United States the situation is somewhat different. A significant number of patients have dental insurance, which encourages them to visit dental clinics more regularly for preventive care. Insurance reduces the financial burden, making it easier for families to schedule routine checkups. In many private insurance plans, preventive services are covered fully, and basic procedures may require the patient to pay only a portion of the total cost. For example, in some plans, a patient might pay around 20 percent for a basic procedure while the insurance covers the remaining amount. However, it is also important to note that not everyone in the United States has dental coverage, and access still varies based on income and state policies.

Dr. Chintan Desai: We do manage emergencies when they arise during community dental camps, and our camps are connected with a community dental center so that patients can receive proper follow up care. We begin by taking a complete medical history, including allergies, medications, and recent hospital visits. We also ask about personal habits because they influence oral health. After that we perform an examination and take radiographs when they are clinically necessary.

If we identify an urgent problem, we provide same day care whenever possible. When a case is more complex, such as a difficult root canal, an advanced infection, or a procedure that requires specialized equipment, we refer the patient to an appropriate specialist. General dentists can perform a wide range of treatments, but referral is essential when the case would benefit from the expertise of an endodontist, oral surgeon, or periodontist. We always include a complete referral note so the specialist has all the clinical information they need.

In our community clinic we provide far more than routine screenings. We offer restorations, cleanings, extractions, and denture services. When specialists are part of the clinic, advanced procedures can be performed on site, which improves access for patients.

The situation in many primary healthcare centers in India is different. Some centers have limited dental equipment, and the dentist may be able to perform only basic examinations or simple procedures. As a result, patients are often asked to visit a private clinic for full treatment. This varies by region, but it is a common challenge in rural and underserved areas.

If a patient comes to me with concerns about previous care, I do not criticize the other dentist. It is important to remain professional. My focus is on understanding the patient’s current condition and guiding them toward the appropriate treatment plan. This approach maintains trust and supports quality care.

Dr. Chintan Desai: Not necessarily wrong. I believe it is a positive approach. It protects the integrity of our profession. For example, as a pharmacist, if you dispense a medication and the patient experiences a side effect, they may consult another pharmacist. If that second pharmacist immediately says that you were not trained well or that you made a mistake, it would feel unfair and unprofessional. The same applies to dentistry and medicine because many situations are accidental or clinically complex. There is room for more than one opinion.

The same is true in clinical care. If a case comes to me for a second opinion and I feel unsure, I will refer the patient to my senior colleague. This builds trust. Patients feel safe when they see that we prioritize their well being rather than our personal pride. If we openly criticize each other in front of patients, it weakens their confidence in the entire profession. Instead, we should discuss concerns privately. After I finish treating a patient, I can call the previous provider and say, for example, that I noticed something in the case and would like to discuss it. This keeps our communication respectful and maintains the dignity of our profession.

Dr Chintan Desai: Based on my experience, education often has the strongest influence on oral health. When people understand why oral care matters and learn the right techniques, they are more likely to make lasting changes. In many school and community programs in India, I noticed that the teaching was mainly verbal. People listened, but they did not always stay engaged. When we use visual tools such as models, pictures, demonstrations, or short videos, the message becomes clearer and easier for them to remember. Good education can improve awareness, build confidence, and change daily habits.

At the same time, access to care plays a major role, especially in the United States. Many families still face barriers such as distance, cost, or limited availability of appointments. Newer approaches like tele dentistry are helping by allowing patients to receive guidance and follow up without coming to the clinic. It does not replace in person care, but it supports people who might otherwise delay treatment.

And, this is why tele dentistry has become an important tool for rural outreach. At the university where I am training, we work with several communities that do not have easy access to dental care. Some locations are far from the main clinic, so the university either partners with local centers to set up small community sites or provides a tele dentistry station. The patient sits in a room with video equipment, and a local assistant helps during the visit. We speak with the patient on video, answer their questions, and review images that the assistant sends using an intraoral camera or scanner.

As part of our Public Health training, we also visit these communities in person. We hold health fairs and educational events in schools and community centers. During these visits, we teach proper brushing techniques, discuss diet and tobacco related risks, and encourage families to seek early care. These programs help people understand that support is available even if they live far from a main clinic.

Dr. Chintan Desai: Social determinants like awareness and income have a major effect on oral health in every community. When people have limited awareness, they often do not know the right brushing habits, the value of early dental visits, or the risks related to diet. This is why community education is so important. During health fairs, we use simple tools such as models, pictures, and short videos to explain these concepts. Visual demonstrations, like showing the sugar content in common drinks or demonstrating brushing on a model, help people understand the message more clearly. These methods are often more effective than giving advice through words alone.

Income also has a strong influence on oral health. Families with lower incomes may struggle to access routine dental care or preventive services. This can lead to delays in treatment and more severe disease. In the United States, many public schools provide meals that help reduce food insecurity, but some of the food choices can be high in sugar or starch, which may contribute to cavities if daily oral care is not consistent. In India, low income families may wait until pain becomes severe before seeking care because of cost and limited availability of services. These delays increase the overall burden of oral disease.

Overall, people with fewer resources or limited awareness face the greatest challenges. They often have less access to care and less information about prevention. This is why community outreach plays such an important role in improving oral health outcomes.