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How to become a more culturally competent dental practice

It can be easy to think that most people you interact with have a similar background to your own. But when it comes to practicing dentistry, making these sorts of assumptions and judgements can actually restrict your ability to successfully treat your current patients or even to grow your patient base.

So how do you address and change these beliefs and habits? That’s where cultural competency comes in.

What is cultural competency?

Cultural competency is your ability to understand, appreciate and interact with people from cultures and belief systems that differ from your own. Cultural competence is a lifelong process of becoming more aware and seeing past your deeply engrained viewpoint.

Cultural competency consists of five components:

  • Cultural awareness. Taking time to understand your patients’ beliefs, values and practices.
  • Cultural knowledge. Learning about the world views of diverse patient groups.
  • Cultural skill. Collecting relevant cultural data about your patients’ health problems and conducting interviews and evaluations to determine treatments based on needs.
  • Cultural encounters. Participating in multicultural activities to learn about diverse groups directly.
  • Cultural desire. Delivering care for all patients equally, regardless of cultural values and beliefs.

The goal isn’t to change your beliefs or values. Instead, you’re learning to shift your perspective so you can better work with and help people who may be different than you. By understanding your patients’ viewpoints and meeting them where they’re at, you can provide more effective treatment and support that will fit their unique needs and means.

How to become more culturally competent

The first step to becoming more culturally competent is evaluating where your practice currently stands.  For example, consider how patients who primarily speak a non-English language would navigate your office to schedule and come in for a typical visit. Would they be able to easily communicate with your staff and fill out forms? Would your important in-office signage be understandable? How would you discuss procedures with them?

Do your best to identify areas of improvement and start working towards addressing them. Try to think about how people of different religions, ethnicities, races and customs would experience your office. It’s likely that you won’t see everything, but even small changes can be a massive help to patients. Make sure that you create a warm, welcoming environment so that every patient feels comfortable asking questions and participating in their care so you can better serve them.

One great way to address issues is by giving patients an easy way to submit feedback and encouraging them to do so. Here are some ideas on how to get started:

  • Create a place for feedback. Set up an email address or an online form where patients can provide direct feedback. You should also consider creating a place where everyone who works in your practice can add their thoughts or ideas that patients mention off-hand.
  • Tell your patients how to submit feedback. You could include a small card in any goodie bags with a URL, email address or even a QR code that points to the form. To get the most helpful feedback, include instructions in commonly spoken languages and give examples of the kind of ideas you’re looking for.
  • Analyze the results. When you start receiving responses, pay attention to trends and suggestions that pop up frequently. If multiple people are having issues with the forms in your practice, it may be time to update them!

An important part of cultural competence is taking action, with the goal of improving your service and creating better outcomes for your patients.

Resources from Delta Dental

Delta Dental offers a variety of resources to help you create a culturally inclusive practice.


As a more culturally competent practice, you’ll be in a much better position to care for your patients and grow your practice.

How to serve non-English speaking patients

The U.S. is more of a melting pot than ever, with about 350 languages currently being spoken, according to the latest census statistics. That means more people may be coming into your practice who may have difficulty communicating with you.

What can you do to help patients with limited English proficiency? You can receive free language assistance for Delta Dental members through our Language Assistance Program (LAP). LAP gives you access to interpretation and translation assistance that meets state and federal requirements for language assistance services.

Request interpretive services

You can get interpretive services in 170 different languages through LAP. This service is available to Delta Dental members at no charge and allows you to talk to patients through an interpreter so you can understand their needs clearly and give them the best care possible. For phone interpretation, just call 866-530-9675 to get an interpreter the next time you need one.

If you prefer to talk with a patient face to face, an interpreter can also meet you in your office and translate any conversations you have. Live interpretation services require 72 hours’ notice.

Get member materials

Members can access information about our plans and benefits in different languages, too. The Delta Dental website is available in Spanish, and members can learn about the different plans and benefits as well as read articles on dental health and wellness.

Plan materials can be translated into other languages and made into accessible formats such as Braille and audio files upon request.

Spread the word

If you or someone in your practice speaks another language, it’s worth advertising this fact. Make sure your dentist directory listing includes the languages spoken at your practice. This can help patients who speak your language find you easily.

Create a welcoming environment

You can do even more to welcome patients who don’t speak English. Create a protocol for your staff to follow when talking to patients with limited English proficiency, and make a conscious effort to be aware of and respect cultural differences.

If you have a large number of patients who speak a specific language, make sure your policies, brochures and forms are available in that language.

Patients with limited English proficiency may feel uncomfortable at first, but if you create a warm, welcoming environment and help them overcome the language barriers, you’ll serve them better and grow your practice at the same time.

In dentistry, diversity matters

The minority population of the United States is growing — the U.S. census put it at nearly 40% in 2019. Despite this, ethnic and racial disparity persists within the dental industry, both in terms of who receives care and who provides it.

Gaps in dental care for minorities are significant

While the gap has closed somewhat in the past decade, utilization of dental care among minorities, including Blacks, Hispanics and Native Americans, still significantly trails that of whites.

For people of color, cost is a significantly greater barrier to dental care than it is for their white counterparts. And this gap is growing — since 2005, the cost of seeing a dentist has increasingly become more of an issue for Black and Hispanic adults and seniors than it has for whites.

  • In 2019 almost 30% of black seniors reported that the cost of dental care was an issue, compared with only about 10% for white seniors.
  • The number of Black seniors reporting cost as a barrier to care has increased nearly 20% since 2005.
  • The number of white seniors who reported cost as a barrier has increased only 6% during the same period.
  • Cost has become less of a barrier to dental care for minority children since 2005, in part because dental services for children are now a mandatory benefit within Medicaid.

Language can also create a barrier to dental care. For instance, a study found that limited English proficiency is related to oral health and dentist visits. Among the groups studied, Spanish-speaking Hispanics reported the poorest oral health, most infrequent dentist visits and fewest teeth. Limited English proficiency can also be a barrier to dental care for some Asian populations.

There’s also a significant lack of diversity among dentists

Blacks, Hispanics and Native Americans are severely underrepresented among dentists in the United States, and this situation has remained largely unchanged for more than a decade. 

  • As the white population of the United States has decreased during the past 15 years, so has the number of white dentists. However, whites are still overrepresented, with 60% of the population contributing more than 70% of its dentists.
  • Asians are significantly overrepresented, contributing 18% of the country’s dentists despite making up only 5.6% of the population.
  • Meanwhile, the Hispanic population in the United States has increased to around 18% from 14% during the same period. Despite this, the percentage of Hispanic dentists in the U.S. has increased only slightly, to 6%.
  • For the Black community, both its percentage of the population and the dental pool has remained unchanged, making up only about 4% of the country’s dentists despite comprising more than 12% of the population.

Among dental assistants, situation is more encouraging. More than 30% of registered dental assistants are Hispanic and 7% are Asian, and the majority are women. However, Blacks are also underrepresented here; fewer than 7% of dental assistants are Black.

Looking toward the future, there is some cause for optimism.

  • The number of women dentists in the U.S. is increasing. They’re also more ethnically diverse than their male counterparts, with a larger percentage of Hispanics and Blacks.
  • Applications to dental schools by underrepresented minorities have risen, increasing to more than 15% in 2015 from 12% in 2000.
  • Dental school enrollments were also up during the same period, with underrepresented minorities making up about 5% more of the student population in 2015 than they did in 2000.
  • Dental school enrollment among Native Americans has seen significant gains, according to a 2019 study.

However, the 2019 study also found that Black enrollment in dental schools is stagnant. And despite the growing dental school enrollment numbers among minorities, population parity among U.S. dentists is still a long way off. 

For example, dental school enrollees from underrepresented minorities in 2015 totaled less than 2% of the dentists needed to achieve true parity among dentists in the United States.

Why diversity matters

Minority dentists are crucial to ensure that diverse communities have access to dental care. Studies have shown that while minorities make up a disproportionately small percentage of the country’s dentists, they provide a disproportionately large share of the dental care to our nation’s minority and underserved communities.

  • 40% of Black dentists report that more than half of the patients they serve are Black.
  • Native Americans dentists report than more than 20% of their patients are Native American, even though Native Americans make up less than 2% of the U.S. population.
  • Minority dentists also serve a much-higher-than-average number of patients on public insurance than do white dentists.
  • Conversely, while white dentists make up the majority of dentists in the U.S., they’re also the least likely to participate in Medicaid or the Children’s Health Insurance Program (CHIP).
  • More than half of Black, Hispanic and Native American children are insured through Medicaid and CHIP or another form of public insurance, as opposed to only about a quarter of white children.

Trust is another issue. Studies have indicated that minorities, particularly those in lower socioeconomic brackets, often have a higher level of distrust for physicians than do whites. 

However, when treated by a physician of their own race or ethnicity, not only are minority patients more trusting, they’re also more likely to be satisfied with their level of care, receive preventive care and agree to necessary procedures.

How to make your practice more culturally inclusive

Cultural awareness and sensitivity has become more important than ever for an inclusive practice. A great way to ensure that your practice is inclusive is to develop cultural competence.

An important part of cultural competence is taking action, with the goal of improving your service and creating better outcomes for your patients. Another crucial component of cultural competence is being able to communicate effectively with your patients:

  • Try to learn a few relevant phrases (hello, goodbye, please, thank you, open your mouth) for your low English proficiency patients. To help you communicate with Spanish-speaking patients, Delta Dental offers a downloadable English-to-Spanish phrase guide for dentists.
  • Ask whether anyone on your staff is at least partly fluent in another language — you might already have a valuable resource. If not, considering hiring staff members who are bilingual or multilingual. Don’t forget to update your Delta Dental directory listing to reflect the languages you and your staff speak.
  • Make health and wellness materials available in relevant languages. Delta Dental offers a variety of Spanish-language health education materials, including Grin! magazine and wellness videos.

How Delta Dental can help

Delta Dental offers a variety of resources to help you create a culturally inclusive practice.

  • Delta Dental’s Language Assistance Program (LAP) offers enrollees interpretation via telephone in more than 170 languages.
  • On-site interpreters are also available for Delta Dental enrollees with limited English proficiency — at no cost to the enrollee or you. (Onsite interpretation services require at least 72 hours advanced notice.
  • You can learn more about the LAP by logging in to Provider Tools and navigating to the Reference Library.

As part of our commitment to fight racism and build minority representation in the dentistry profession, Delta Dental plans to partner with universities to provide scholarships for qualified applicants who are Black, Hispanic or represent other communities of color.

Finally, to advance dental health and access, the Delta Dental Community Care Foundation also supports dozens of agencies and nonprofits that provide dental care to underserved and minority populations.

Are you on your patient’s wavelength?

Each patient visit is an opportunity to build trust in your care. Being culturally aware enables you to communicate clearly and understandably with patients, no matter their ethnic or cultural backgrounds. One-to-one communication with patients at their levels shows respect and can increase cooperation in their treatment.

Why is this more important now? Your current (and potential) patients’ cultural backgrounds and ethnicities reflect America’s growing diversity. According to the U.S. Census Bureau’s July 2019 estimates, this is the makeup of the U.S. population:

  • White (not Hispanic or Latino): 60.1%
  • Hispanic or Latino: 18.5%
  • Black or African American 13.4%
  • Asian: 5.9%
  • American Indian, Alaska Native, Native Hawaiian or other Pacific Islander: 1.5%

Since the 2010 U.S. Census, the non-white population percentage has increased from 36.2 to 39.9. Being aware of cultural differences, especially language, will put you and your patients on the same wavelength for achieving quality care. And you can develop valuable skills to do this.

Cultural competency consists of five components:

  1. Cultural awareness. Take time to understand patients’ beliefs, values and practices.
  2. Cultural knowledge. Learn world views of diverse patient groups.
  3. Cultural skill. Collect relevant cultural data about the patients’ health problems and conduct interviews and evaluations to determine treatments based on needs.
  4. Cultural encounters. Participate in multicultural activities to learn about diverse groups.
  5. Cultural desire. Deliver care for all patients equally, regardless of cultural values and beliefs.

To raise your practice’s competency level, you can take steps to more effectively communicate with patients of diverse backgrounds and their friends and relatives.

3 steps for closing the language gap

Ask your patients (or their friends or family members) what their preferred language is and what makes them comfortable and note it in the chart. Communicating with a patient in his or her native language is key.  Not only does this put patients more at ease, but it also makes it easier to track their concerns about care.

Besides English, the top languages spoken at home in the U.S. are (ranked in order by most speakers):  Spanish, Chinese, French or French-based creoles, Tagalog, Vietnamese, Korean, German, Arabic, Russian and Italian.

But what if you don’t speak your patients’ native languages? You can take three steps to boost your practice’s language capabilities:

  1. Take advantage of Delta Dental’s Language Assistance Program. Customer Service phone assistance is available in over 170 languages for enrollees.
  2. Advise patients with limited English proficiency that they can call the LAP to arrange for a qualified interpreter to help at no cost. For onsite interpretation services, call at least 72 hours in advanced of the appointment time.
  3. Keep on hand printed materials translated in the languages most relevant to your practice so they’re available to patients. This may include forms, pre- and post-operative instructions, health and wellness materials, emergency phone numbers and anything else that may help.

How to boost your practice’s cultural awareness

Learning more about cultural differences and achieving competency are two ways to ensure that your practice thrives in a changing cultural landscape.  You can do this by gaining skills:

  • Attend classes and continuing education courses, onsite or online, that address social customs among different cultures in your community.
  • Go to multicultural events to learn about the interests, lifestyles and values of people with diverse backgrounds and form relationships.
  • Learn a few key phrases in native languages, such as “hello,” “please,” “thank you,” “open wide,” “where does it hurt?” and “do you have any questions?”
  • If you have bilingual or multilingual staff members, encourage them to help co-workers communicate with patients.

Achieving cultural competency can help your practice welcome more patients. You can update your Delta Dental directory listing if you have fluency in non-English languages. Let patients know you are on their wavelength

Delta Dental language resources for your practice

  • Our website in English and in Spanish
  • Automated telephone service for eligibility, benefits and more in Spanish
  • Downloadable English to Spanish phrase guide (PDF)
  • Dentist Handbook: Log in and select Reference Library; you can find LAP resource information and English, Chinese and Spanish versions of enrollee grievance forms.

7 tips for serving deaf and hard-of-hearing patients

Happy National Deaf History Month! If you haven’t heard of this awareness month, it runs from March 13 to April 15. Nearly 15% of adult Americans report trouble hearing, so you may have patients who have hearing issues and aren’t even aware of it. If you don’t know American Sign Language (ASL) yourself, you may be at a loss for where to begin. Fortunately, there are plenty of steps, from the simple to the more complex, that you and your staff can take to help your deaf and hard-of-hearing patients feel at ease.

Simple steps

  • Have office protocols for serving deaf and hard-of-hearing patients. With a little bit of planning and forethought, you and your staff will be ready to welcome your deaf and hard-of-hearing patients from the moment they make an appointment until the moment they schedule their next one and head home. Make sure that your patients can schedule appointments without having to make a phone call, such as by text message, email or social media. You should also think about little touches for when your patient arrives, such as offering a dental cup to patients who may want to remove their hearing aids while they’re in the chair. (Hearing aids can be shockingly expensive and are definitely not something your patients want to lose!)
  • Speak slowly, clearly and directly facing your patient. This helps your patient read lips, as well as avoiding the possibility of carrying on a conversation with a patient’s “bad” ear. Given that you and your staff will likely be wearing a mask because of COVID-19, speaking slowly and clearly even more essential (you can also use clear facemasks).
  • Go the extra mile to make your patients feel comfortable. Patients who are experiencing hearing loss from old age may be embarrassed that they can’t follow conversations as closely as they used to. If you notice that a patient isn’t quite hearing you, apologize and repeat yourself with a focus on slow, clear communication.
  • Encourage your patients to talk openly with yourself and their other doctors. As a dental professional, you may notice a patient’s sensitivity to sound (or lack thereof) or other issues before the patient does. If you suspect that some of your patients may have hearing issues they’re not aware of, encourage them to consult their physician or a specialist.

These are all great steps that any practice can follow to better serve patients who are deaf and hard of hearing. If you have patients with greater needs, or you simply want to develop your practice’s capabilities, there’s even more you can do.

Taking it to the next level

  • Add more electronic text throughout your practice. The prevalence of text-based tools like email, online messaging and chat apps has been a game changer for many people who are deaf and hard of hearing. Increasing your digital presence and making your practice available through multiple venues both helps new patients to find you and existing patients to contact you through their preferred method. If your practice regularly posts videos on YouTube or other services, make sure that the videos are captioned.
  • Take American Sign Language (ASL) classes or add someone to your staff who knows ASL. Having staff members who know languages other than English is both a great way to reach a wider part of your community and a nice perk when it comes to updating your Find a Dentist directory listing. If you already have staff who are fluent in ASL, make sure you mention that on your directory listing! If your staff doesn’t have anyone who knows ASL, you can find classes at local universities, colleges and community colleges, as well as more specialized institutions like schools for deaf people, deaf service centers or interpreter training programs. If you’re not ready or able to sign up for classes, you can always learn a few key phrases online.
  • Make use of Delta Dental’s Language Assistance Program (LAP). The LAP is a free service that your Delta Dental patients can use to get professional interpretive services (along with phone assistance, written materials and more). This includes ASL interpreters who can come to your office to assist in communication.

More than 35 million people in the United States report having trouble hearing, whether they suffer from mild hearing loss or are completely deaf, so thinking about how to serve this population is well worth your time. Whether you want to master ASL or you just want to begin accepting appointments by email in addition to the phone, taking steps to make your practice more inviting to patients who are deaf and hard of hearing is well worth your time.

Get assistance communicating with patients who don’t speak English

Do you have patients who speak languages you don’t? Whether your patients don’t speak the same languages as you and your staff, or if they’re just most comfortable speaking in their native tongue, being able to successfully communicate is essential in delivering the care your patients need and deserve.

Fortunately, that doesn’t mean you have to take the time to learn a whole new language (although doing so is certainly a worthwhile endeavor!). Delta Dental offers interpreters via telephone, on-site interpretation services and more through our Language Assistance Program (LAP).

LAP is here to help

Delta Dental’s Language Assistance Program is an invaluable tool when it comes to communicating with patients who may not share any languages with you or your staff. LAP is available free of charge to all Delta Dental enrollees and includes the following benefits. We strongly encourage you to refer your patients to the LAP page on our website.

  • Customer Service phone assistance in over 170 languages
  • Professional interpretive services, including in-person interpretation
  • Written materials in non-English languages (and accessible formats)
  • And more!

Providing care to Spanish speakers

Did you know that, after English, Spanish is the most commonly reported language spoken by Delta Dental enrollees? More than any other language, a non-English-speaking patient of yours is likely to speak Spanish. That’s why we’ve put together extra resources to help you communicate with these patients.

Steps you can take to boost your skills

There are steps you and your staff can take to make communication easier and to create a more welcoming environment for your patients. We recommend these strategies:

  • Attend classes and continuing education courses that address the social customs among your patients’ different cultures.
  • Document your practice’s protocols for working with cultural differences and make sure all of your staff are familiar with it.
  • Allow time to make sure that your patients understand you and the care you recommend for them. Be ready to answer questions and don’t be afraid to ask some of your own.
  • Familiarize yourself with professional interpretive services and resources available in your community to assist your patients.
  • And finally, ask your patients and their accompanying relatives and friends how you can create a more comfortable environment.
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