By Ann-Marie C. DePalma
C. Austin Risbeck, RDH, recently changed his health-care teaching hobby into a full time endeavor. He has taken the hygienist into the arena of health-care provider — teaching clients, family, and friends about their health. Hygienists are well suited to screen and monitor risk factors associated with cardiovascular disease, stroke, obesity, and diabetes.
"Dental hygienists have more interaction with clients who perceive themselves as healthy than any other provider," according to Austin. This interaction gives the hygienist the unique opportunity to screen for underlying medical conditions the client may not be aware of. By taking a comprehensive medical history, monitoring blood pressure, obtaining diet and activity levels, and identifying tobacco use, dental hygienists can establish disease risk and refer patients to appropriate medical providers.
Austin graduated as valedictorian of his class, and received his associate degree in applied science in dental hygiene while serving in the U.S. Army. The program was accredited by the American Dental Association and was designed to teach not only dental hygiene, but also dental therapy. As a hygienist in the military, Austin provided hygiene as well as dental therapy assistant (DTA) services. As a DTA, he placed, carved, finished, and polished amalgam and composite restorations. After graduation, he became a CPR instructor with the American Heart Association (AHA). During his 13 years of military service, Austin was an instructor, which allowed him to become an allied health instructor in Texas, teaching medical assistant students front and back office procedures upon military discharge. He also volunteered at the Dallas AIDS Resource Center.
A move to California and passing that state's boards enabled Austin to practice dental hygiene with the ability to administer local anesthesia. He continued his volunteer work with the San Francisco AIDS Foundation, working as a hotline educator who provided HIV/AIDS-related health counseling.
Since becoming a basic life support (BLS) instructor with the AHA, Austin is familiar with the role health-care providers play in recognizing the risk factors associated with cardiovascular disease and stroke. Austin lost his own father prematurely of a heart attack at age 54, so he is well aware of the risk factors and disease. Upon the release of the U.S. Surgeon General's May 2000 report, "Oral Health in America," Austin found the link between dental disease and general health. He began to research the topic, and found information in Shirley Gutkowski's June 2001 RDH article "Bringing Physicians into the Fold," which highlighted Karen Stueve's program in which physicians can refer their periodontal patients to the dental office for evaluations. Austin also attended a program by Trisha O'Hehir about the role of the hygienist as a primary preventive specialist and the connection between oral and overall health.
After attending the program, Austin decided to put everything together in a brochure for his clients. However, there was so much information he couldn't fit it all into a single brochure, so he created a bulletin board. Currently, the bulletin board contains the "Six Steps to a Healthy and Longer Life." It includes information about regular medical and dental checkups, tobacco use, regular blood pressure screenings, healthy weight, a physically active lifestyle, and good eating habits. Austin also found an article by Dr. Michael Glick in JADA called, "Screening for Traditional Risk Factors for Cardiovascular Disease: A Review for Oral Health Care Providers." From Dr. Glick's and the AHA's recommendations, Austin produced a medical history update form which includes a risk assessment for cardiovascular disease.
Austin wanted to share this history taking with other hygienists. His article "Periodontal Disease and Atherosclerosis" was published in the January 2003 issue of RDH. The response was phenomenal. Cardiovascular disease is the number one killer of men and women, and hygienists want to learn all they can about the impact of periodontal disease on overall health. Due to the article's response, Austin founded a coalition of oral health advocates called "Dental Hygienists Against Heart Disease." The international coalition is composed of dental hygienists, dentists, nurses, nurse practitioners, and dietitians. A goal of the coalition is to raise awareness so that oral health becomes an accepted component of overall general health. The coalition has become partners with several organizations including the AHA, the American Diabetes Association, and the American Dietetic Association.
Austin has also developed several programs that he shares with hygienists around the world. During his presentations, he incorporates a handout with all the slides from his PowerPoint program which enables participants to take all the current literature with them and extend the learning process. The current handout also contains over 60 online resources. He has even incorporated a video titled, "The Power of Prevention." Austin filmed and produced this video as a unique and fun way to introduce his programs.
His program is divided into three sections, and he moves around within each section. Participants leave Austin's programs understanding their role in promoting oral health and preventing oral disease, improving and promoting general health through evidence-based tobacco control, healthy eating and physical activity, blood pressure control, and heart healthy and stroke-free lifestyles. Participants also learn about the pathogenesis of atherosclerosis as it relates to periodontal status, and how a comprehensive medical history is essential to identifying potential clients who are at high risk for cardiovascular disease.
All dental professionals need to understand that identifying risk and providing patients with the lifestyle choices to reduce that risk can not only prevent disease, but can save lives. Dental professionals treat the whole client, and are becoming recognized health professionals, not just clinicians.
Austin is a member of the ADHA Tobacco Cessation Task Force, a national program office of the Robert Wood Johnson Foundation. The action plan of the Task Force is to encourage hygienists to learn about clients' tobacco use, advise those who use to quit, and refer those who wish to quit to appropriate support. Austin incorporates this tobacco cessation information into his programs.
Several hygienists, including Shirley Gutkowski, have inspired Austin to pursue his passion for teaching through continuing education programs.
Shirley states, "Austin is awesome. He has a passion for Whole Hygiene that I've never seen in another hygienist. He's developed a concept and made it work for him, the patient, and his office."
Maria Perno is another hygienist who has mentored Austin. Maria comments, "Austin is passionate about spreading the message that dental hygienists can save lives! As a past ADHA president, spreading the word about who we are and what we do is a commitment I accept with enthusiasm. Austin does also, sharing the message with both the profession and the public. I am proud to be considered as one of Austin's friends and mentors."
And dental hygiene is privileged to have him as a voice for the profession.
Ann-Marie C. DePalma, RDH, BS is a practicing hygienist in a periodontal-implant practice.She is a graduate of the Forsyth School for Dental Hygienists, is active in the Massachusetts Dental Hygienists' Association, and is a Fellow of the Association of Dental Implant Auxilliaries and Practice Management.Ann-Marie has written articles and presents programs on dental implants, TMD, and developmental delays and can be reached at [email protected].