22 APR 2012 access

Patient communication is vital to effective dental hygiene care, and it’s hard enough to accomplish in the same lan-guage. Many dental hygienists work in communities with large populations who do not speak English, and others make dental mission trips abroad. While some hygienists may have additional language skills, explaining oral health issues is very different from simple conversation. In these settings, translators and interpreters play vital roles in helping dental hygienists deliver quality care.

According to the Bureau of Labor Statistics, “Interpreters convert one spoken language into another—or, in the case of sign-language interpreters, between spoken communication and sign language,” while “translators convert written materi-als from one language into another.”1

“It is very common for people to get translating mixed up with interpreting,” said Maria Perno Goldie, RDH, MS,

president of the International Federation of Dental Hygien-ists. “It is also common for people to think that anyone who can interpret can translate and vice versa. This is not the case.”

Goldie has worked with interpreters primarily in Italy, Spain, Russia, the Ukraine, the Czech Republic, Slovakia and Mexico. She explained that working with interpreters varies with each individual, and that advanced preparation is im-portant when discussions involve technical, legal or sensitive subjects. “In the dental hygiene education world, often the interpreter will request my PowerPoint presentation. I may

points,” she said. “Depending on the language, interpreta-tions may take much longer than the original. I cut my pre-sentations in half. Working with a dental hygienist or dentist interpreter has been the most successful, as they know the oral health ‘lingo.’”

Working Abroad

Melissa Reese, CDA, RDH, BSDH, is a Lieutenant in the United States Public Health Service (USPHS), whose mission is to deliver public health promotion and disease prevention programs and advance public health science. In May 2010, Reese was deployed aboard the naval hospital ship, the USNS

scale humanitarian effort utilizing both military and civilian specialists to deliver medical, dental and other services to six host nations. Her seven-week trip consisted of providing dental hygiene services and oral health education in Vietnam and Cambodia.

“I knew providing periodontal treatment and oral hygiene

thoughts I had were of my ‘old days’ in private practice when a non-English speaking patient would visit our clinic. Inevitably, one of three things would happen: (1) the staff member would speak louder, as if volume would somehow help the patient understand; (2) the staff member would

Working with Translators and InterpretersBy Mariam Pera

Michelle Panico, RDH, MA, works with a Spanish-

interpreter.

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speak exceedingly slow; or (3) the staff member would combine an interesting variety of dramatic facial expressions and hand mo-tions to signify key points, such as ‘open wide,’ ‘spit,’ etc. None of the methods were particularly successful. While I was ponder-ing which one of the aforemen-tioned methods to employ [on my trip], I was informed that foreign [interpreters] would be available at the mission sites. The news brought both relief and wariness. Would the [interpreter] understand the information I was providing? Would they accurately relay instructions without errors or improvising?”

To Reese’s relief, prior to

-ing through [interpreters]. “The training lessened my anxiety and contributed to the success of the experience. The [interpret-ers] were easy to work with, helped relay questions and ease patient fears, and allowed for the provision of valuable oral health education to a much underserved population,” she said. “It was a mutually gratifying experience, as they had the opportunity to help us help their people. Typically, by the end of each mission, the [interpreter] was well-versed in teaching oral health education, and I managed to broaden my foreign vocabulary with a few words

having an interpreter to enhance communications for non-English speaking patients can be an effective and surprisingly rewarding experience.”

Yvonne Work, RDH, BS, BA, traveled to Braila, Romania with Serving HIM (Health International Ministries), in 2009, 2006, 2005 and 2004—with four dentists and two hygienists among the 20 team members. “Each year seems to be more rewarding than the one before,” she said.

Serving HIM has been going over to Braila since 1998, team-ing with the Holy Trinity Baptist Church, which owns a health and dental clinic. The clinic serves the local poor free of charge, including children from the orphanage the church runs. “These people suffer from a lifetime of oral neglect, with 95 percent of the adults never having a prophy in their lives. There was lots of periodontal disease, of course, and no anesthetic for the patients. Our cavitrons and suction saved the day! We came away realizing that the preventive and periodontal cleanings we gave them might be the only ones they get in their lives!” Work said. “Our interpreters were high school seniors or college students who attended the church that invited our team over there. They all spoke good English. As I would clean the patient’s teeth and give them dental hygiene education, the [interpreter] would translate everything I had said to the patient. If it had not been for the [interpreters], I would not have been able to educate the patients.”

Dana Shaffer, RDH, BS, PHDHP, participated in a dental mission trip to Honduras in March 2010, which was organized by Central American Relief Efforts (CARE)—based in Lancaster, Penn. The vol-unteers provided screenings and oral hygiene education. There were seven dental hygienists, as well as a husband and wife who helped with educating locals. A local dentist even performed extractions as needed. The team worked through several interpreters: Stephanie, a local college student; Steven, 14, whose family hosted the volun-teers; and Marel, who served as the trip’s coordinator.

“We would not have been able to get across our message without -

it did slow you down. You had to say a sentence, then let them translate, and sometimes you’d lose your train of thought. We had a lot of visuals as well, which really helped, because as the week went on, we didn’t have to say quite as much; the interpreters kind of knew how we were doing things.”

Working in Diverse Communities in the U.S.

Michelle Panico, RDH, MA, partnered with Dignity Health, a -

tice preventive dental clinic. “We now have two clinic sites. One is inside an elementary school and the other is on the grounds of an elementary school in the community health clinic,” Panico explained.

A Vietnamese translator (third from left) interprets for Melissa Reese, CDA, RDH, BSDH (fourth from left).

“ Whether working abroad or in

Dana Shaffer, RDH, BS, PHDHP (center) with translator Steven (second from right) and Flo, another dental hygienist on the mission.

24 APR 2012 access

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Amy Soss, RDH, helped one of her students overcome a language barrier by using a free app on her smartphone. The patient who presented spoke only Italian, and there were no Italian-speaking doctors or students on the {

access APR 2012 25

hope to continue to broaden my career opportunities in the future with the use of my bilingual skills.”

Amy Soss, RDH, is a part-time clinical instructor at New York University College of Dentistry. She helped one of her students overcome a lan-guage barrier by using a free app on her smartphone. The patient who presented spoke only Italian, and there were no Italian-speaking doctors

at the time. “I decided to sit with my student and use my iPhone Google Translate app,” Soss explained. “You speak into the phone, and it translates into the language of your choice. The app will actually speak back what you said in the other language, as well as spell it out. There are a multitude of language options. I found that this method of communication was extremely helpful in this situation.”

Soss said she has actually worked with an [interpreter] in the -

nicating what she was trying to say. “With the [app], I was speak-ing into the phone and communicating exactly what I intended. The patient appeared to completely understand what I was getting across to him as a health care provider,” Soss said. “I truly believe my student and I would not have understood what type of pain and sensitivity the patient was suffering without the help of the phone. It turned out he was having hot and cold sensitivity and needed root canal therapy on that tooth.”

Since then, Soss has applied the same communication technique

-cating home care instructions. “Then I remembered I have Google Translate! I was able to explain how to use soft picks for implant care and proxy brushes for interdental spaces, as well as recom-mend that the patient purchase an electric toothbrush for better plaque control,” she said. Typically, Soss would have had to wait for the Russian-speaking dentist to explain this to the patient, but with the her app, she could do it herself. “It made the patient more

them what they should be doing to improve their oral health, rather than the dentist.”

She believes the app immediately made the patients more com-fortable. “In both cases, I could sense frustration that they could not communicate as they wished to and, as the health care provider, I also felt frustration that I could not communicate with the patient as I normally can. Once I brought out the device, in both situations, the patients smiled and felt comfortable communicating this way. It even lightened up the mood of the appointment as it was fun using the phone during treatment,” Soss said. “Now, it was not just about getting their teeth cleaned by someone who didn’t speak their lan-guage, but rather it opened up the opportunity for both the health

they needed to express something.”Laura DeHennis, RDH, PHDHP, vice president of the Pennsylvania

interpreter at a free clinic where she volunteers. “I have been with this clinic for over 10 years, and I enjoy being able to help people who [recognize] the need for dental care, have now found a way to attain it, and appreciate my effort to help them,” DeHennis said. The patients must meet eligibility requirements to be seen, and clinic

rules specify that patients must present with an interpreter. If not, they must reschedule their appointments.

“If there are patients speaking another language, they need to come with someone that understands English,” DeHennis said, add-ing that communication through an interpreter was not a problem since many aspects of dental hygiene can be demonstrated. “Now we have a Spanish-speaking dental hygienist on staff … so there are no problems with making sure the patients are aware of what to expect during and after treatment. It is great to work together with her.”

In conclusion, the dental hygienists interviewed for this article suggested some tips for working with interpreters:

-sible, without paraphrasing or improvising.

-tients/audience and counterparts, not the interpreter.

after major points have been made.

you.

or colloquial expressions. Keep your language basic, using words the interpreter understands.

in most cases.

-nitely a plus and very helpful when working with interpreters.

Reference

1. Bureau of Labor Statistics. Available at: www.bls.gov/oco/ocos175.htm.

Mariam Pera is Access’ editorial and graphics assistant. ■

Screen shot of translation app used by Amy Soss, RDH

What excites youthe most aboutthe 2012 meeting in Phoenix?

Angie Kelly, RDH, BS:

“ Changing locations always adds excitement to a new meeting. What will they do next? What classes will they offer? Will I see old friends that I met in years

prior, and how many new ones will I meet? I am excited already!”

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