The United States Census 2010 reports that the number of people reporting birth in another country exceeds 38,500,000. Other demographic information indicates that more than 58 million people over the age of 5 in the United States speak a language other than English in their homes. This diversity in ethnicity, culture, and language enriches our lives, but it also adds a challenge to communicating important health information that is needed for the safe provision of dental care.

The University of the Pacific Dental School uses a thorough health history that is divided into sections related to medical signs and symptoms, diagnosed diseases, and specific medical treatments and/or medications that may influence the diagnosis of oral diseases and/or modify dental therapy. As the diversity of their patient population increased, UOP realized the need to have the health history translated into multiple languages.

The health history was translated, but kept the same question numbering sequence. Now, a dentist who speaks English and is caring for a patient who doesn't, can ask the patient to complete the health history in his or her own language. The dentist then compares the English health history to the patient's translated health history, scanning the translated version for "yes" responses. When a "yes" is found, the dentist is able to look at the question number and match it to the question number on the English version. For example, the dentist would know that a "yes" response to question 34 on the non-English version is the same as question 34 on the English version and relates to high blood pressure. A Chinese speaking doctor could also use the multi-language health history with an English-speaking patient and have the same cross-referenced information. A dentist who speaks Spanish could use the multi-language health history with a patient who speaks French. The MetLife Dental Advisory Council, which oversees quality initiatives at MetLife, was looking at the issue of dentists who did not have health histories available for patients who spoke other languages. Dr. Jon Glenn, of Newport Beach, California, one of the practicing dentists on the Dental Advisory Council and a University of the Pacific graduate, with the assistance of Dr. James Kennedy, chairman of the Dental Advisory Council, developed an agreement for MetLife Dental Care to fund translations of additional languages. UOP, with the assistance of the California Dental Association, had already translated the health history into ten languages. Members of the MetLife Dental Advisory Council and employers who have selected MetLife as the dental benefit plan for their employees identified fifteen more languages. Additional languages were added in response to cultural competency assessments by MetLife and by the American Dental Education Association, which contacts Associate and Assistant Deans at U.S. and Canadian dental schools to determine what languages would be helpful to dentists. The translations are done by Transcend, a Davis, California company specializing in translation services and authenticates (medically and legally certifying that they are correct) the translations.

Dr. James Crall, Professor and Chair Section of Pediatrics, UCLA School of Dentistry, developed a health history form for children to address their unique needs. The children's health history follow the format of the adult health history system, with numbered questions that can be compared across languages. Like the adult health history library, the children's health history library consists of the forms in the 40 most frequently spoken languages in the United States.

We believe that this project will improve future education and enhance the quality of oral health care, while at the same time acknowledging and respecting the diversity and cultural heritage of the patients we serve.

Peter L. Jacobsen PhD DDS
Professor, Department of Pathology & Medicine
Director of Oral Medicine
University of the Pacific, School of Dentistry

Susan Baker
Director, Quality Initiatives Program
MetLife Dental