Alum Champions Dental Public Health.

Katie Conklin presents her and her colleagues’ research “Experiential Learning of Dental Public Health Residents in Implementing Community-Based Oral Health Interventions” at the American Public Health Association Annual Meeting in Atlanta, Ga.
Alum Champions Dental Public Health
After more than a decade working as a dental hygienist, Katie Conklin (SPH’23) pivoted to public health in the hopes of expanding access to pediatric oral health care.
Katie Conklin (SPH’23) long took dental care for granted. Brought up surrounded by family in the dental profession, it was not until Conklin completed training to become a dental hygienist herself and volunteered to screen kindergarteners at a rural health center that she realized not every child receives regular oral health care.
As a hygienist at a private dental practice in Davis, Calif., Conklin treated many professors from the state university. They had health insurance and were well cared for, she says. This stood in stark contrast to the lack of resources in Stockton and the other health clinics in the San Joaquin Valley where she volunteered. Many of the kindergarteners she screened were the children of immigrant farm workers with limited means.
Some of these families would need to drive four to five hours to bring their child to a dentist, says Conklin. “That was really eye-opening for me. We would go out, we would do screenings on kindergartners, and then we would be able to see that their [younger] siblings were doing better because we were doing education and fluoride and all these approaches that you can use to prevent oral health disease. I just fell in love with [the program].”
After more than a decade volunteering on the side, Conklin pivoted full-time to dental public health in hopes of expanding access to pediatric oral health care on a larger scale.
As a student in the Executive Master of Public Health (MPH) program (now the Online MPH program) at the School of Public Health, Conklin completed her practicum with the California Oral Health Technical Assistance Center (COHTAC) at the University of California San Francisco (UCSF) and the California Department of Public Health (CDPH) Office of Oral Health, helping to pilot a program that trained a county health department in evidence-based strategies for implementing the state-mandated Kindergarten Oral Health Assessment in their communities. The pilot went so well, Conklin says, her practicum project served as the model for implementing the system across California.
Today, as a project coordinator at COHTAC, Conklin collaborates with more than 20 counties across the state to help plan, implement, and evaluate data-driven oral health promotion programs. She also coordinates a post-doctoral grant from the Health Resources & Services Administration (HRSA), called the UCSF Open Smiles Collaborative, which aims to increase the number of dentists trained in public health.
The biggest challenge in oral health care is access, says Conklin. Half of children in California are on Medicaid, she says, and very few dentists accept Medicaid patients, especially children. Through her work, Conklin endeavors to recruit and train the next generation of pediatric dental public health visionaries and leaders. She spoke with SPH about her own discovery of the often-overlooked nexus of oral health and public health.
Q&A
With Katie Conklin (SPH’23)
Can you elaborate on what you did for your MPH practicum project and how it has evolved since you graduated?
My project involved implementing a new system in California called Results-Based Accountability (RBA). It is a performance management system that the state has adopted through the California Department of Public Health. The Office of Oral Health piloted the system in four counties beginning in 2019. When I came on for my project in 2022, I reached out to the state, and they connected me with one of the counties participating in the pilot that was not yet using the performance management system. I worked with the dental director, the chief of surveillance, and then this county to get them to start to understand the ‘why’ behind the program.We did a SWOT [Strengths, Weaknesses, Opportunities, and Threats] analysis, looked at their needs assessment, and then worked with them to start using [RBA].
I started with the one county, and then COHTAC said, ‘Wow, this is going so well. We want to implement your model across the state.’ So, then I started building RBA learning collaboratives. Our first goal is to promote the kindergarten oral health assessment, which is a law that was passed in 2005 [mandating that] all kids entering [public] kindergarten are screened. We find one out of two kids entering kindergarten already has a cavity, and when you look at equity, 25% of those untreated cavities are in vulnerable populations. We really want to be able to target those kids so they can have the best experience going forward in school.
Why is it important to support counties in this way?
Data from these screenings is supposed to be entered into a statewide database, so we can see it and then we can drive policy. However, that whole cycle has not been happening. There is just a lot of turn-over, and it is a collaboration between the school districts and local oral health programs to oversee it but the law has no teeth, so it is hard to enforce, and [schools] have so many other priorities. My whole project is trying to take this mandatory kindergarten oral health assessment and help counties capture their data, enter it into this database, and understand the law so that they can make changes in their communities.
If the child is diagnosed with a cavity in a school screening, is there a way to connect them with dental services?
Yes, there is, and that is the whole reason that the law was developed, to make sure every kid has a dental home and not allow insurance to be a barrier to care. We work closely with Medicaid to help ensure that the kids are receiving their benefits, finding a dentist, and getting follow-up care. That is a big piece of our work.
You also work on the UCSF Open Smiles Collaborative, a post-doctoral training grant from HRSA trains dentists in dental public health. While MPH and MD programs have existed in tandem for a while, is this a relatively new option for dentists?

It is. Often dentists will get an MBA, a business degree. We are trying to bring them into the public health space. It is exciting, and it is working too—[of] the dental residents that are now graduating, more are assuming leadership positions in the Office of Oral Health and local health jurisdictions, and more are going into [federal] health centers to work, which reduces the wait lines there and allows the health centers to treat more advanced cases without having to refer them out. One of our aims of the grant is to build a pipeline of dentists into dental public health because there is not a lot of awareness around dental public health as a specialty and the future job opportunities it offers.
What kinds of public health work have dental residents undertaken as part of the Open Smiles Collaborative?
Another aim of the grant is for students to collaborate with federally qualified health centers, so we train health centers on how to integrate medical and dental care. A new mom usually brings her baby to 8 to 10 medical appointments in the first year, but the child will not go to a dentist until the age of 5. By then it is way too late and when we see them for the kindergarten screening, they already have cavities. We want them to have a nice first dental visit, so what we can do with MDI [Medical Dental Integration] is we can put fluoride varnish on their teeth at their well-child visits, and that reduces their chance of getting cavities. Because you get your first tooth when you are six months old, so we want to start talking to the parents about their oral health [early]. It is so important.

One of our other projects is a school-based program. Imagine a dental office in a school at the base of Yosemite where the closest dentist is an hour away on winding roads. We have this team called Smile Keepers, and they drive there every Wednesday morning. They have a whole setup—a dental chair, x-ray machines, computers—so the hygienist can take x-rays, upload them, do the cleaning, do the sealants, do the fluoride varnish. About 60% of what the kids need can be done at the school. Then the kids that need [advanced] care, we are able to refer them out. It is this beautiful relationship between the school and Smile Keepers.
Recently, we presented a poster at [the American Public Health Association annual meeting] that showed, based on entrance and exit surveys, how dental resident’s attitudes and confidence towards treating diverse patient populations have improved over the course of their participation in the Open Smiles Collaborative.
What advice do you have for MPH students who are interested in oral public health? Are there opportunities to get involved outside of working as a dentist or hygienist?
There is so much we can do with policy, [such as] advocating for those who are not receiving services and giving a voice to the importance of oral health. [Tooth decay] is the most common chronic disease across the world, but it is overlooked, so [we are] trying to shift this mindset to one of prevention. BU gave me the skills and the confidence to be able to grow something. Every week I would learn something new, and I could take that back to my practicum. If there was ever a time that you wanted to get your MPH, just do it.
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