Tien Jiang, DMD, MEd, is an instructor in Oral Health Policy and Epidemiology at Harvard School of Dental Medicine (HSDM), and brings her background in dentistry and education to the Center of Integration of Primary Care and Oral Health (CIPCOH). Jiang is also heavily involved in the Initiative to Integrate Oral health and Medicine and HSDM’s Office of Global and Community Health, spearheading curriculum work in Vietnam and more. Jiang is particularly invested in exploring how interprofessional education and curriculum reform can benefit oral health and primary care integration efforts across the globe.
How long have you been collaborating with the Initiative to Integrate Oral Health and Medicine and the Center for Integration of Primary Care and Oral Health (CIPCOH)? Discuss your role with CIPCOH specifically.
I’ve been collaborating with CIPCOH and the Initiative for four years now. I have conducted research ranging from evaluating interprofessional education (IPE) at primary care medical and dental training programs, to examining the impact of an oral health knowledge network on oral health care delivery in pediatrics. One of CIPCOH’s missions is to disseminate our research findings as well as share best and promising practices and resources from the field. As such, I have helped achieve this mission through organizing webinars, as well as creating the Resource Library for Integration of Oral Health and Medicine.
Tell us a little bit about your background.
I’ve spent most of my life in New England. In fact, I was born in Boston at a hospital that is just blocks away from where I became a dentist and now work. It’s funny how life works! As for my training, I studied Linguistics and French (one of the best decisions of my life!) at Dartmouth College and received my DMD at the Harvard School of Dental Medicine (HSDM) and both my certificate in Prosthodontics and Masters in Education at the University of Illinois at Chicago.
You recently launched an online Resource Library for the Integration of Oral Health and Medicine. What inspired you to pursue creating this resource?
One inspiration was the multi-institutional and multidisciplinary team at CIPCOH and the work that they have completed around integration over the years and decades. Jane Barrow’s expertise and experience as the lead for CIPCOH’s community of practice was another huge inspiration. After the Interprofessional Education to Practice Summit in June 2019 at HSDM, our team realized that there was a need for a “one-stop-shop” for publications, toolkits, media, and other resources that would help paint a picture of the breadth of work around the integration of oral health and medicine. The information was out there but disjointed, so our solution was to create the Resource Library.
How to do you hope this resource will help advance the important work of organizations like the Initiative to Integrate Oral Health and Medicine, CIPCOH, and others?
A colleague of mine who has spent decades integrating oral health into medicine recently said to me, “What’s so disappointing is that you spend all this time doing work that you think is important, and then two people show up to hear about it”. I share this story because so many individuals and organizations like him are working incredibly hard to help close the gaps in health care through integrating oral health and medicine. Yet sometimes they don’t receive the spotlight they deserve. My hope is that the Resource Library will shine a light on the work of these integration “superheroes” as well as make it easy for those interested in integrating to obtain the proper tools to make their dreams a reality.
Over the last year, CIPCOH has launched a four-part series of online Continuing Professional Education webinars aimed at addressing interprofessional care during the COVID-19 pandemic. How has the pandemic highlighted the importance of an interprofessional approach to oral health, primary care, and overall health?
There are many ways that the pandemic has highlighted this. One example is during the early days of the pandemic when it was unclear how safe it was to seek health care. Health care professionals were forced to improve their communication strategies with not only their patients but also with each other. I’ve also had to be sensitive to the significant mental health crisis that has resulted from the pandemic. Many more patients have not only started anti-anxiety medications which can impact the oral cavity but also, in my personal experience, they are fracturing their teeth more frequently, likely due to their delayed dental treatment and/or increased stress. Lastly, some of my patients who most need dental care are the sickest and therefore unable to come to our clinic. This motivates me to think outside of the box in how I and their health care team can care for them remotely.
You’re currently a fellow in Harvard Medical School’s Media and Medicine Intensive. How do you hope to incorporate this opportunity into your integration work?
Similar to the inspiration for our Resource Library, my participation in the Media and Medicine Intensive has inspired me to pursue sharing my dental and education background as well as my integration work with the general public. Just like the evidence around the positive health effects of exercise, the evidence around the bidirectional relationship of oral and overall health is strong and continues to grow. However, this information may not be getting to our patients as it is reaching other stakeholders, such as policy makers and health professionals. My goal is to bridge this gap and to help drive consumption of health information that is packaged in a way that helps individuals make healthy and simple choices for their oral and overall health.
You recently became involved in the Teaming and Integrating for Smiles and Health (TISH) project. What is the goal of TISH, and how has it already impacted how you view interprofessional practice?
The Teaming and Integrating for Smiles and Health (TISH), which is a CIPCOH project led by the HMS Center for Primary Care, is a three-month accelerated learning collaborative comprised of dental and primary care providers focused on strengthening interprofessional “partnerships and increasing early detection of hypertension and gingivitis while also leveraging recent advances in telehealth.” For the last month, I have participated in three virtual meetings along with teams around the country. In the clinic, I experience a lot of competing priorities, yet TISH has allowed me to see the health of my patients in a different way. In fact, I’ve already started to implement new ways of screening for hypertension in just a matter of weeks. Change in the clinical setting doesn’t usually happen this quickly, which speaks to the uniqueness of TISH. The pandemic and this learning collaborative have taught me that interprofessional partnerships can be successfully strengthened on a virtual platform thus proving that there is an opportunity to replicate this model globally.
In your opinion, what does the future of integrated primary care and oral health look like?
In the short-term, integrated primary care and oral health care will mean reform to existing health care systems. In the long-term, new integration clinics and systems will be created where interprofessional teams will work in the same building (or remotely through telemedicine and tele-dentistry) with interoperable electronic health records. Patients will seamlessly navigate their health care in one place. Just like our “one-stop-shop” Resource Library, my hope is that the “one-stop-shop” health clinic will become the norm.