In Conversation with Barts Community Smiles
Barts Communities Smiles is a QMSU volunteering group that aims to raise oral health awareness in Tower Hamlets and beyond. Barts and The London dental students deliver basic oral health promotion in a number of different community settings, including outreach health centres and schools. Volunteering involves teaching and motivating oral health behaviours that also have a positive impact on general health and wellbeing. Debra Chow is a dental student who founded Barts Community Smiles in 2018, serving as the group’s President in its first year. Natalie Liu was on the original committee as the External Affairs Officer, before stepping up to lead the group as President during the 2019-2020 academic year. We sat down with both Debra and Natalie to reflect on how this oral health promotion project has grown and developed, as well as their personal experiences of leading a student volunteering group.
Could you tell me more about the events that led up to starting Barts Community Smiles as a group?
Debra: At the time I was the third year BDS course rep, we had difficulty with low patient numbers. As a result, I decided to organise an oral health promotion day at our outreach centre to drum up interest and bring in more patients to student clinics. Being on the information stand and interacting with the public, it looked like students were practicing the skills they had gained from PTSR (the Professionalism, Teamwork & Social Responsibility module on the BDS course). There weren’t any student-led oral health promotion groups at BL. As the only dental school in East London, an area which statistically has poor oral health compared to the rest of the country, starting something to help the community just made sense. It was that first oral health promotion stand that drove me to start something bigger.
When you saw those interactions on that first oral health promotion stall, how was that different compared to being on clinic?
Debra: We were seeing some patients as third-year students, but not many. On the stands, students meet members of the public for the first time. Instead of caring for the same patients – essentially giving the advice over and over again to the same individuals – holding a community stall or going into schools, you can communicate information to a much wider range of people. It develops how you speak, adjust and tailor your advice to different people. Since this is all information that we need to know for our future careers, students are practicing the reiteration of tailored advice. Students need to also be able to think on their feet. This different way of interacting with patients is definitely beneficial for students.
Natalie: Patients are usually coming to us on clinic already with motivations to change their oral health. They come with a specific problem and tend to be more receptive to learning and listening to what you have to say. Maybe it’s just from my experience volunteering, but I don’t get as much resistance or scepticism from my patients compared to say when I go and do oral health promotion for BCS at our outreach centres. I’m not sure if that’s because I’m a student and there may be an assumption that I am less competent than a professional? But I do feel that sometimes they are not as keen to learn about oral health. It’s then up to us to address this challenge – how we try to convince them, how we try to draw them into the stall in the first place, how we present evidence to them to show that what we are saying is evidence-based and effective. It’s another way of communicating that we don’t have as much of a chance to use on clinic.
Debra: It would also be difficult to get some of these individuals into the clinic and having that interaction in the first place. Having these community stands in high-traffic places where we know that there is a large number of families reaches out to people to remind them that their oral health is important as well. We see so many people at a stall in the course of a day that giving very personalised advice to each and every individual is impossible. It’s more about being a gateway, in the sense that an eye-catching stall draws people in and gets them thinking about their oral health. Sometimes just sowing that seed in people’s minds, just that one thought-provoking encounter, can lead onto the next step of going to the dentist and receiving more tailored advice there. That very much ties in with the group’s main aims; as the starting point of a new and improved oral health journey for the individual.
The group is very community-focused and interacts with a number of groups in East London. What has volunteering shown you about the community we study dentistry in?
Natalie: There are a lot of low-income families in Tower Hamlets and a general lack of health knowledge. You encounter common misconceptions when interacting with the community; “you shouldn’t use fluoride” is a frequent example. Somewhere along the line, the message seems to not have gotten across. This is the case even for some very basic oral hygiene knowledge you might assume everyone should already know. I feel like our oral health promotion work helps to address this problem. Although it might not be ‘high-tech dentistry’, it is this basic information that actually forms the fundamentals of maintaining good oral health.
Debra: The local East London community is very diverse. When the group started out, it was really important to consider how we communicate with all these groups of people. They might have different values systems or there may be a language barrier. Even factoring in the affordability of the oral health products we recommend because of the local population’s lower socioeconomic status.
As dental students, we learn in the classroom and hospital. Sure, we see patients. But it’s different when we go out into community. Actually standing there, meeting and talking with individuals, you get a much deeper understanding of their problems. Much more than you would just from reading about it in a research paper or textbook. There’s this face to face ‘human connection’ that a lot of the students who volunteer with us always find rewarding. For example, initial thoughts from an outsider’s perspective might be, ‘oh, that child has tooth decay’. But speaking further with the young parents, you might learn that the mother has to take care of five other children at home by herself, her husband has to work long hours, and she can’t manage brushing everyone’s teeth twice a day. Listening to individuals’ stories shows you a more accurate picture of what living in the community is actually like and, as a future healthcare professional, a better idea of what the community needs.
It was really encouraging to see that members of the public did sign up to attend student clinics as a result of interacting with the student volunteers.
Debra: Most of the people we meet at the stalls, they know they should brush their teeth twice a day, they know they sugar is unhealthy, they know that smoking is a risk factor for cancer. But having the knowledge doesn’t necessarily mean there will be behaviour change. Life can take over, these things are forgotten and not prioritised at that point in time. I guess that as well as raising awareness, it’s also about reminding people that oral health is important. Taking part in annual oral health awareness campaigns is an example of creating a cycle of reminders every year. Ultimately, it’s the individual’s choice. We are just there to help push them along the right direction.
Returning to the same events each year, like the QMUL Science Festival and the Festival of Communities, can, therefore, act as that reminder for people. Natalie, could you tell me more about the new projects Barts Community Smiles have taken on this year?
Natalie: This past year, we branched out to do more activities with older adults and the elderly. We ran an oral health promotion event at the mosque, which had a great response. They were so welcoming and wanted us to go back to run the stall again. But before we do so, I think we need to organise the translation of our materials and resources into Bengali. This has been difficult but is something we’ve been looking into.
We were also invited to present to the community diabetic support group at one of their meetings in Newham Library. This form of oral health promotion was very rewarding; from preparing a presentation, to then delivering it and interacting with the audience, who were all very engaged and asked a lot of questions. It also highlighted the gap in knowledge that many people have. This was shown by data collected in a pre and post-talk survey. We did a similar style of oral health promotion and discussion at Toynbee Hall in Aldgate with the elderly day centre group, which also went really well. People were very enthusiastic! They were so interactive and asked so many questions that I regret only asking for a one hour slot. As a dental professional, it is easy to assume that people would be aware of what seems like very basic knowledge to us. But that’s not actually the case most of the time.
I feel like we engaged with different age groups and different cultural backgrounds this year, while also getting more student volunteers involved with the Sugar Smart Schools programme
The messages about oral health can also come from different members of the family then – both children and adults.
Debra: I think you’d be surprised at how easily and quickly children pick things. It’s a good reminder when they return home from school and are keen to tell their parents about what they learned at school that day. The free toothbrushes and toothpaste samples we hand out are great conversation starters, but it’s also something that they can take home and use.
Looking at your personal leadership journeys, I also wanted to ask you about the impact this project has had on your personally, and what you’ve learned from this whole process of leading the group?
Natalie: I definitely matured. This is especially evident when I support students from younger years in interacting with the public. I remember so vividly leading the stall at the QMUL Science Festival with a group of second-year students, who were panicking slightly. When you step back, you realise how much you have grown from just one year of experience. Obviously, we aren’t experts, but I feel like it’s definitely trained me to talk more confidently and succinctly with different age groups of patients and the general public.
I haven’t taken the opportunity to lead any groups before, so it was quite a challenge for me. After volunteering and committing a lot of time and effort during the group’s first year, it felt like it was time for me to step up. It is a project that I’m really interested in, and I am really glad that I’ve continued my engagement in BCS. From moving up to the role of President, my perspective has definitely changed. Previously, I felt like my role was to be a good volunteer and helper for senior committee, whereas this year, I have been looking at the wider picture. Instead of focussing on minor details such as completing one single project or delivering the right message on a stall, as a leader, you have to step back to make sure everything runs smoothly, whilst taking care of more responsibilities. That was certainly a step up.
There were ups and downs in the experience of leading the group. The ups were that I worked with a very helpful and effective team. It’s been so great to see the growth in my committee members. Being President also gave me more autonomy to lead BCS to pursue projects and reach out to groups I was interested in, as well as taking more pride in the work that I do. I guess the downsides are that sometimes it can be lonely. Unless you’ve been in that position, not many would understand the work that goes on behind the scenes. They might not fully comprehend how a lack in one area would affect the whole process, because they don’t have the same oversight. Communicating effectively as a leader with your team includes bringing everyone together to work cohesively. And trying to bridge the gap and helping everyone understand what other people are doing and why.
Debra: I very much saw myself as a team member rather than a team leader. So, I found that putting myself out there to speak to members of the public – raising awareness, getting them interested in how they can take care of their oral health – definitely built my confidence. Barts Community Smiles has also developed my leadership skills. Especially when you start a new group from scratch, there’s no road laid out for you to follow! We had to go back and forth liaising with many individuals, ensuring we had appropriate supervision and getting approvals from the dental institute. There was a lot we needed to make sure we got right first time. There can be a lot of times where it’s frustrating, where you feel like giving up and letting someone else sorting it out – but you can’t do that as a leader. You definitely grow stronger and more resilient by facing difficulty. The whole experience has really developed my perseverance.
We had to start off by defining everyone’s roles as a brand new team. At the beginning, it felt like there was a lot of micromanaging and I took on a lot more work than I should have. What I learned about leadership as the year went on is that you’ve got to let people find their own paths; steering them in the right direction, rather than doing it for them. I think I eventually got the hang of that. Overall, my team were fantastic. The need for motivation applied to everyone – I needed that motivational push at times, so a good team where you balance and bounce off each other is very important. I really tried to work openly with all of my team. I was always open to feedback and suggestions for new projects. As the year progressed, committee members began leading their own events. I think that taking on more of this responsibility helped them develop further.
From the start, we tried to build the group in a way that was sustainable. We didn’t want it to be a one-hit wonder! We made sure to create organised systems, get a good amount of funding and establish connections, so when the next team took over, they could use and grow these resources to carry out their own ideas. Sustainability was definitely key – I am very happy that this past year’s committee was excellent. They have done a fantastic job and started new initiatives, such as their event at the local mosque. I feel like every person who leads will have a different vision for the group. And as long as this is in line with the objective of serving and benefiting the community, then it will be worthwhile.
Barts Community Smiles has certainly been a success in so many ways. You and your teams should be really proud of your achievements! Is there a particular moment or memory that stands out from your time leading the group?
Natalie: Being nominated for the National Societies & Volunteering Awards is something from this year that I’m proud of. While it was a pity we didn’t win, ultimately, it’s not about winning the award. Not winning an award doesn’t falsify the efforts that you’ve put into your work, and it was rewarding to have our work recognised on a national level. It is also great to hear about other students all around the country doing something meaningful for the community.
Debra: The most impactful moments for me were the times we presented to older community groups. I’m not a natural public speaker, so it definitely pushed me out of my comfort zone. It was very rewarding to be able to answer people’s questions and give them advice at these events. They approached us after the talk to express their gratitude, saying that they found the presentation helpful and hoped we would come again.
I also think that these talks were significant memories because most of the time at events, I was running around organising things and making sure things were in order. These talks showed that there are people in the community who do want to learn more about oral health and how to take care of themselves. So I always encouraged my team members to take part in delivering the talks as well. It is very beneficial and fulfilling for everyone involved, both the student presenters and the public, so I would definitely encourage more of these in the future. Collaborating with Dr Huda Yusuf on her SugarSmart Schools programme in Tower Hamlets has created even more opportunities for students to engage in this style of health promotion.
I am glad there is a lot more opportunity for dental students at BL to take part in these kinds of experiences. It has definitely made an impact on me. I hope that the project carries on being beneficial and rewarding for students and the community, and truly hope that it can continue on for a long time.
Thank you so much to Debra and Natalie for sharing their reflections. If you would like to learn more about Barts Community Smiles and the work they do, you can find them on Instagram, Facebook, Twitter and the BLSA website.
