The Intersection of Diversity and Disparity
In the 14 years since then-Surgeon General David Satcher sounded the alarm about the “silent epidemic” of oral health disparities in the United States, the gaps in dental care for underserved populations remain wide and unabated.
Chelsea Brockway, DDS, was 13 when Oral Health in America was issued, but she had already discovered what the report made abundantly clear: that a more diverse health workforce will improve care for racial and ethnic minorities.
Brockway, 27, whose mother’s family is from Honduras, saw firsthand that patients’ inability to speak the same language as their health care provider can create huge barriers. It shaped her approach to patient care, and even led her to take a Spanish-immersion trip to Honduras. “When you’re confronted with medical issues, it can be very scary,” she explains. “I wanted to be able to communicate with Spanish-speaking patients.”
That strength of purpose is aligned with other SMDEP alumni. They clear racial, ethnic, and socioeconomic hurdles, and then go on to make a difference in underserved communities. Brockway describes the six weeks at the Columbia University program site as reinforcing her desire to practice in Hispanic communities in her native Florida.
“I don’t want a career that serves only the most privileged people,” she says.
Legacy of Service
The only child of an insurance salesman and an ESL (English as a second language) teacher’s assistant, Brockway grew up watching her mother work selflessly to help children learn English.
“All of these people were waiting to be helped, and they had walked such a long way to see us,” says Brockway of her medical mission to the Dominican Republic.
“A lot of these kids come here speaking only Spanish, and they’re scared. Someone like my mom who speaks their language and helps them learn English makes them feel less out of place,” she says admiringly.
Brockway has continued that legacy of service by participating in several medical missions and externships, the most recent of which she describes as “Go fast! Do root canals!” Working out of a makeshift office in the small rural mountain town of El Naranjito, Dominican Republic, she provided free dental care to a community that gave new meaning to “underserved.”
“It was a crazy whirlwind of 10 days where you had to do a lot for people in a short amount of time,” she says of the trip.
In addition to local patients, Brockway treated a large number of Haitians who had walked 75 miles or more from their border towns to El Naranjito. “That was shocking and overwhelming,” she says. “All of these people were waiting to be helped, and they had walked such a long way to see us.”
She remembers a Haitian patient whose teeth had all been extracted, leaving nothing but a large piece of blood-soaked gauze in his mouth. “You go on these trips hoping you can help people, but often you end up having to pull out a lot of teeth because they’re so decayed,” she says softly. “That was traumatic. No dentist wants to leave someone with no teeth at all.”
Brockway left El Naranjito feeling profoundly connected to the human side of her work. “Dentists can work hard, be smart, and do a good job,” she observes. “But we also need to remember there are people attached to the bodies we’re examining.”
Initiative to Learn
She settled on a career in orthodontics at age 16—a decision influenced by her own orthodontist. Ruth Berry, DMD, a respected practitioner in Brockway’s hometown of St. Petersburg, FL, delivered guidance that extended well beyond straightening young Chelsea’s teeth.
“Dr. Berry being a woman made it seem more accessible,” Brockway explains. “I’m not sure I would have thought about it as a career otherwise.”
“When she told me she wanted to pursue orthodontics as a career, we decided the best thing she could do was to observe what an orthodontist does on a daily basis,” says Berry, who hired Brockway as a part-time sterilization technician. The high school sophomore progressed quickly to scheduling appointments, assisting with patient care, and performing laboratory work.
Berry has effusive praise for her mentee, whom she says had both an innate ability to relate to patients and a passion for the inner workings of orthodontics. “When she came back to work for us during her summer break in 2006, she kept me on my toes,” says Berry. “She was always asking questions, always wanting to know why and how teeth moved. Her eagerness to learn was exciting.”
As Brockway began applying to dental schools, Berry didn’t hesitate to provide a letter of recommendation. “Her integrity and initiative to learn are truly impressive,” she wrote. “I look forward to having her as a colleague.”
A World Outside of Florida
Brockway’s “initiative to learn” was a factor in her decision to attend SMDEP in one of the world’s busiest cities: New York.
“SMDEP showed me a world outside Florida,” she says. “It opened doors, and made it possible for me to expand my education.”
One of the most beneficial aspects of the program, she says, was a “mock interview” with the dean of Columbia’s College of Dental Medicine (CDM). “It forced me to examine whether I was going into dentistry for the right reasons,” she explains. It also gave her valuable practice in how to answer questions, which helped when she interviewed—successfully—for a spot at CDM.
In addition to getting a firsthand view of the intricacies of dental school, Brockway was greatly influenced by her SMDEP teaching assistant. “I wanted to be like him—to find that balance between working hard and being smart, but also being friendly and honest and willing to help other people get there, too.”
Today, Brockway sums up the SMDEP experience in one word: “Unforgettable.”
“I met people who had to be driven to get that far,” she says. “I never imagined myself living in New York and going to an Ivy League school. Being accepted by SMDEP at Columbia made me realize I might have what it takes to succeed.”
Extending Her Reach
Brockway’s unassuming manner belies her academic achievements. At the University of Florida, she received the Anderson Scholar of Distinction Award and was a fixture on both the Dean’s List and the President’s Honor Roll. At Columbia, she was awarded the Underrepresented Minority Dental Student Scholarship by the American Dental Association. She also had the distinction of being selected by the director of Columbia’s Salivary Gland Center to assist in his research.
In addition, she was an active participant in student service organizations such as the Hispanic Student Dental Association, serving as the Columbia Chapter treasurer and helping other students learn important dental terms so they could communicate more readily with their Spanish-speaking patients.
Already looking beyond her residency at the University of Florida, Brockway is marshaling her skills and resolve to serve underrepresented patients, whenever and wherever possible. Her goal, she says, is to see as many patients as she can, whether through monthly free clinics or regular mission trips.
“No matter what your financial situation is, you should be able to get comprehensive dental care if you need it.”
The reason is simple: “People in need, like the Medicaid population, are not always in places where it’s easy to set up a practice.”
Brockway recognizes that her commitment to these communities may seem at odds with the specialty she’s chosen—a perception she disputes.
“A lot of people think orthodontic care isn’t important, especially when low-income populations have so many other health issues. But I don’t agree,” she says. In fact, untreated orthodontic issues can lead not only to gum disease, loss of teeth and bone, and difficulty eating, but also to speech problems and ill health overall.
“The truth is that oral health is important to overall health,” Brockway insists. “And no matter what your financial situation is, you should be able to get comprehensive dental care if you need it.”