How DAP Health improves physical wellbeing by addressing oral health
When sitting in Dr. Ryan Yamashiro’s dental chair at DAP Health, Robert Coughlin says he has gotten emotional enough to cry.
Coughlin laughed when asked how many times he had cried in the dental chair.
“I think he knows who I am,” Coughlin said. “I just get so overwhelmed sitting in that chair.”
The emotion Coughlin feels is not fear, apprehension of drillings, or root canals. Living with HIV for decades, Coughlin said his treatments at dentist offices were degrading, whether it was having the room covered in plastic or being refused services when they saw his HIV status.
It is different when Coughlin sees Dr. Yamashiro at DAP Health.
“They just come into the examination room with so much compassion and understanding,” Coughlin says. “I expected to be treated as a pariah with my HIV status as I had been with (past) dentists before. I just get emotional when they treat me with such kindness.” He explains that there is not a hint of judgment anywhere. And because of that he feels cared for.
Coughlin says his oral health was in bad shape when he first came to DAP Health because of years living with addiction. Today, Dr. Yamashiro has Coughlin’s teeth and gums in much better shape.
There have been bumps along the way. During the COVID lockdown, Coughlin broke his dentures. Dr. Yamashiro found a way to see Coughlin, addressing the dentures and working on getting him a new set.
In contrast to Coughlin’s emotional expressions of gratitude, Dr. Yamashiro has a different take. Yamashiro says he is just doing his job.
“It’s a real old-school way of seeing it, but that’s just how I was brought up. I am not trying to get any brownie points or anything like that. I’m just here to do what I’m trained to do,” Yamashiro explains.
Dr. Yamashiro takes an honest approach when talking with his patients because he believes that a patient’s oral health has everything to do with self-care.
It is not unusual to see a new patient 10 times in the same year. “I’ll ask ‘Are you going to keep brushing your teeth after I restore them,’” Yamashiro says. “I just want to know how dedicated they are to helping me because the other 355 days they aren’t in my chair requires them to brush and floss.”
Yamashiro credits Kimberly Tollison for the dental clinic. Tollison came to DAP Health from a private practice 13 years ago. In 2021, the clinic saw 4,122 visits. The staff consists of two full-time dentists, a full-time hygienist, two full-time receptionists, two registered dental assistants and Tollison, the office manager.
Case managers will screen a patient and complete a dental referral to the clinic as the clinic only takes Medi-Cal (non-HIV) or qualified Ryan White patients. Patients that are not insured can qualify for the sliding scale for discounted services.
Currently, the dental clinic is closed to new patients while DAP Health works on hiring additional dental employees. Prior to COVID, Tollison said there were talks about expanding the service, which would include adding chairs to the current clinic and opening a satellite clinic.
Tollison says she sees firsthand the need for a dental clinic for HIV positive patients.
“It is refreshing to be able to offer much needed dental care to our HIV+ community and also service adults with Medi-Cal,” Tollison said. “In my private practice, our HIV+ patients would experience quite a bit of stigma, and it’s a pleasure to offer dental care at DAP Health in a stigma-free environment.”
While Yamashiro downplays the impact he has on his patients' lives, he does have a simple philosophy to provide care: Treat them as he would treat a family member.