A combination career

June 1, 2006
This month’s spotlight features a dental hygienist who practices in a variety of settings.

This month’s spotlight features a dental hygienist who practices in a variety of settings. C. Austin Risbeck, RDH, combines private practice and public health opportunities to experience a fulfilling career. Although he works in a progressive private practice, he has formed his own company to promote public health and has won several awards. He has spoken throughout the country and published numerous articles in various dental hygiene periodicals. Austin has decided to do it all in dental hygiene, and the public is certainly benefiting. Following is an interview with Mr. Risbeck.

Why did you decide to go into dental hygiene?

At the age of 19, I joined the Army to become a dental assistant. After a few years as a dental assistant, my next step up the military career ladder was dental hygiene school. At the time, I thought it was a way to get promoted. I had no idea what my future as a dental hygienist would entail.

How did you get into dental public health? Did you need additional education?

During National Dental Hygiene Month in 2000, the ADHA theme was “Want Some Life-Saving Advice? Ask Your Dental Hygienist” ... about the importance of oral health to total health. I was not prepared to educate my patients about the oral-systemic connection, so I ordered a copy of Oral Health in America: A Report of the Surgeon General. This publication opened my eyes to the ongoing research regarding the connection between chronic oral infections and other health problems, including heart disease, diabetes, and adverse pregnancy outcomes. One major theme in the Surgeon General’s Report is, “Lifestyle behaviors that affect general health such as tobacco use, excessive alcohol use, and poor dietary choices, affect oral and craniofacial health as well.” As a health-care provider, I assumed the responsibility of promoting healthy lifestyles by incorporating tobacco cessation and nutritional counseling into my clinical practice. I want my patients to benefit from the research regarding the connection between periodontal disease and systemic conditions. I emphasize the importance of maintaining periodontal health.

We don’t need additional education to improve and promote oral health. We need to work together with other health-care providers to broaden the public’s understanding of the importance of oral health and its relevance to systemic health. However, I am planning to pursue a master’s degree in public health soon.

What are your current positions?

I serve as a member of the ADHA Council on Public Health, ADHA Tobacco Cessation Task Force, and CDHA Public Health Council, as a California Tobacco Cessation liaison, a consultant to the Smoking Cessation Leadership Center, and as a continuing education provider. I am owner of a consulting firm that provides tobacco cessation, nutrition resources, and other educational information to local, state, and national organizations. My firm provided the resources and helped with the design of the ADHA’s Ask. Advise. Refer. Web site. In 2004 and 2005, I designed several Web pages as part of CDHA’s public health Web site to provide dental hygienists with the resources to help their patients quit using tobacco, eat better, and manage their diabetes, and to help hygienists include oral cancer, diet, and blood pressure screening as part of their hygiene appointments.

Can you discuss any particularly interesting experiences you’ve had in your dental public health positions?

In April 2004, I attended and provided a poster for the 2nd National Steps to a HealthierUS Prevention Summit hosted in Baltimore, Md. This national summit, created by former Secretary of the Department of Health and Human Services Tommy Thompson, focused on chronic disease prevention and health promotion, and featured presentations on obesity, diabetes, heart disease, stroke, and cancer, as well as lifestyle choices, including tobacco use, nutrition, and physical activity. The Steps to a HealthierUS program aims to help Americans live longer and healthier lives by reducing the burdens of diabetes, overweight and obesity, and through tobacco cessation, healthy eating, and physical activity.

As the only dental hygienist at this national summit with more than 1,400 participants, I was asked by two participants, “What is a dental hygienist doing at a prevention summit?” and “Why does a dental hygienist need to know about nutrition?” I loved these questions. I answered that dental hygienists are now involved in treating tobacco use and dependence, and have long been involved in nutritional counseling and blood pressure screening. By providing these services and obtaining a comprehensive health history, dental hygienists can establish the presence or risk of chronic disease, and refer those who are at risk to an appropriate medical provider.

I cited reports that state:

• “Dental hygienists have more interaction time with their patients than other health-care providers, and their patients visit them two to four times per year as they perceive themselves as healthy.”

• “Dental hygienists can expand their role to help other health professionals with the responsibility of achieving and maintaining the total health of the public.”

• “Dental hygienists can expand health promotion and chronic disease prevention efforts by incorporating tobacco cessation, nutritional counseling, and blood pressure screening into their practices.”

• “Many diabetics, or those at risk for diabetes, do not regularly visit a primary care provider but may seek the services of a dental hygienist.”

• “Dental hygienists are well positioned to deliver prevention messages, communicate the need for metabolic control, and facilitate multidisciplinary diabetes care.”

• “By all of us working together and sharing our expertise and experiences, we can all improve quality of life and reduce the burden of chronic diseases in America.”

They both replied, “I had no idea.”

At the Steps to a HealthierUS Summit, Secretary Thompson released Prevention: A Blueprint for Action. This USDHHS Steps to a HealthierUS Initiative outlines simple steps that people can take to promote healthy lifestyles. I brought this Blueprint to the CDHA leadership, and they implemented an effective weight-reducing initiative and continued to promote a smoking cessation initiative called The New California Gold Rush. CDHA is committed to informing and educating individuals about the importance of healthy eating, regular physical activity, disease screening, and avoiding risky behaviors such as tobacco use to promote health and prevent chronic disease.

What advice would you give a practicing hygienist who is thinking of doing something different?

Dental hygienists are teachers and educators. An exciting way to teach colleagues and the public is through publishing articles in scientific and peer-reviewed journals and through continuing-education courses. I currently work at The Center for Aesthetic Dentistry in San Francisco as a clinical dental hygienist three days a week, and as a consultant from home the rest of the week. This includes weekends sometimes, but it’s worth it!