Continue to respond unflinchingly to the needs of people, including feeding and swallowing rehabilitation of children and people with disabilities.
C dental clinic (Miyagi, Japan)
Dr. Hisashi on treatment with his assistant.
The ideal is a stylish dental office. But the reality is muddy and hard work.
C dental Clinic in Miyagi is a community-based dental clinic that provides general medical services as a primary medical institution in the community, while also providing as much medical care as possible. They also provide treatment for disabled kids (patients), feeding and swallowing rehabilitation, visiting dental treatment, and implantology and orthodontics in the special treatment room, as well as general dental treatment. In 1995, Dr. Hisashi and Dr. Akiko, who were classmates of a university school of dentistry, opened a dental clinic next to the hospital where Dr. Akiko’s parents lived.
Dr. Hisashi, who was born and raised in Tokyo, said, “I actually wanted to open a practice in the city center, but I thought it would be fine to go with my beloved wife to her hometown. It was a historic samurai residence, so the grounds were spacious and I could create the clinic as I wished. I came here envisioning myself in a stylish clinic room, treating patients in a relaxed atmosphere,” he recalls of the time he opened his clinic.
However, when it came time to open of their clinic, such ideals were instantly blown away.
“There were so many children with cavity and grown adults with full or partial dentures.
It was not unusual for people to have full dentures in their 40s or 50s, and there was no end to the number of elderly people who complained that their old dentures didn’t fit or that they could no longer chew. The aging rate in the area had already exceeded 25% by 1995, and I felt as if I were looking at Japan 20 years in the future. At the beginning, I was confident with my history and skill after I remained and worked in the department of conservative dentistry at the university, where I also served as a lecturer (I am currently an adjunct lecturer in the department of conservative dentistry), and I also worked as a part-time dentist in Tokyo and Saitama. However, I was devastated by the reality that I was getting patients that I had never seen before.” said Dr. Hisashi.
In the city, such patients could be transferred to local specialists or university hospitals, but not here, where even the nearest university hospital is not accessible without taking the Shinkansen bullet train. Thus began the days of struggling to deal with all the patients who came to this clinic. When a patient was unable to come to the clinic, they would go out to treat the patient, even if it was far away, and take responsibility for the patient’s treatment until the end.
As word of mouth spread that they never turned down any patient, patients with disabilities who had been difficult to receive treatment at other clinics began to come to this clinic.
He says, “Before I knew it, I had become a town doctor who treats just about anything. It’s a muddled style, but I felt this was the kind of dental care this community needed.” says Dr. Hisashi.
Also the family of disability patients help to move the patient.
Also the family of disability patients help to move the patient.
Connecting human resources and services to enhance the quality of life of patients.
It was during these days that Dr. Hisashi took a fresh look at the ingestion and swallowing rehabilitation that Dr. Akiko had been working on for many years. Dr. Akiko first became interested in this field when she was in her fifth year of dental school. In a lecture on “Eating and Swallowing Dysfunctions” given by then Professor Kaneko, a pioneer in the field of feeding and swallowing rehabilitation in dental education, she saw a slide showing children with disabilities having food forcibly stuffed into their mouths and thought, “This reality is hard to accept. I felt I had to do something about it. Of all my classmates who took the same class, I was the only one who went into feeding and swallowing rehabilitation.” Her father had already passed away, and she considered studying while working, but there were no assistantship positions available, so she had no choice but to go on to graduate school. However, her mother, a otorhinolaryngologist, encouraged her, saying, “It is important to learn several points of view for a certain period while you are young.”
She continued her research on the development and disability of eating function and completed her graduate studies in 1991, earning her degree. She then became an assistant professor in the department of special needs hygiene and oral health at a university, and later became an adjunct lecturer, a position she holds to this day.
At the same time of opening the clinic, she established ‘outpatient of disability of eating function’. While accepting and treating patients from other prefectures who have difficulties with eating and swallowing, she deepened her expertise and became certified as a certified physician and instructor by related societies.
While working with Dr. Akiko, Dr. Hisashi also engaged in feeding and swallowing rehabilitation, and after witnessing people who had never eaten by mouth gain the ability to eat, he realized the significance of such rehabilitation.
In 2006, a “feeding and swallowing room” was added to the clinic. They are increasingly focusing on teaching and training people how to eat and providing psychological support for the individual and his/her family.
Dr. Akiko says, “Now that more dentists are involved in feeding and swallowing rehabilitation, there may be an image that doctors and dentists examine patients with a swallowing endoscope, make a diagnosis, and then prescribe subsequent responses to other professionals, but what I have done is quite different from that image of specialists. I start by educating the staff of local medical institutions and facilities about oral health care and prevention, and then I work with patients in a multidisciplinary team as much as possible to gradually improve their condition to the extent that it is reasonable.
I see my role in this community as connecting people and services to improve the QOL for our patients.”
To reduce the gap in awareness about feeding and swallowing rehabilitation, this clinic leads a study group called the Shiroishi Team Approaching Team (STAT) with medical and nursing professionals. The original “feeding and swallowing assessment sheet,” which is used to share patient information, was also created through discussion among the members.
In addition, the “Feeding and Swallowing Support Seminar” for teachers at support schools and rehabilitation professionals at local facilities has passed the milestone of 50 times in 12 years. Furthermore, Dr. Hisashi was a symposium presenter and Dr. Akiko was a panelist at the 2018 Feeding and Swallowing Rehabilitation Conference, where they spoke about some of activities they have been working on.
Dr. Akiko sais “The base of dental care is to care for patients. On top of that, I want to utilize our expertise.”
Contribute to community healthcare through medical treatment and social activities.
They are both enthusiastic about community activities. Dr. Hisashi has served as a school doctor at a junior high school and high school, while at the same time serving as vice president of the local dental association and as a board member of the regional medical countermeasures committee, which consists of two neighboring cities and seven towns. During this time, he called on his colleagues to establish visiting dental treatment in the community, which had been almost non-existent until then, and established a system in which portable units are loaned to members by the dental association. Dr. Hisashi, who has been using Osada portable units since he was a member of the medical staff, has continued to support Osada’s previous portable units, including the OPU-6 and Daisy, even after opening his own clinic.
In April 2019, he was also appointed vice president of the newly formed dental association, which is the second largest dental association after the prefectural government in this prefecture, after the local dental association and two neighboring dental associations merged. Taking this opportunity, he is working on a plan to create an oral health center in his hometown, which is commonplace in large cities, and to make it a center for medical care for disabled children (and people) and visiting dental treatment.
He is also a member of the board of directors of the prefectural dental association, and devotes himself to cooperating and consulting with the administration and exchanging information with the mayor and city council members.
Dr. Akiko, on the other hand, is a school physician at a day-care center for disabled children and a special-needs school, as well as a commissioned physician at a day-care center. She also serves on the prefectural board of education, which is extremely rare for a dentist, and again generously cooperates with related organizations.
They are also keenly aware of the importance of education, and for the past 20 years, Dr. Hisashi has taken a phase contrast microscope to the junior high school where he works as a school doctor and has been giving classes on dentistry to all first-year students. Dr. Akiko has been giving classes on how to see a dentist to all elementary and junior high school students at support schools for the past 15 years.
“It’s all volunteer work, and it’s a lot of work for us, but it’s a big advantage in the long run to help prevent oral diseases and to get people to see a dentist earlier.” Dr. Hisashi said.
Dr. Akiko says, “I’m also grateful to the principal of the support school at the time I proposed the class, who said ‘It is necessary for the children to live here.’ If they can go to the dental clinic, they can be prevented and treated. I would like to reduce the number of people whose mouths are falling apart,”
They plan to continue to provide sought-after dental care while staying close to the feelings of local patients and their families, without making spectacular claims of expertise or focusing solely on what is right as medical care.
“We work so hard together that we don’t have any hobbies, but that’s okay. We think this is our way to contribute to our community”, Dr. Hisashi’s words and Akiko’s smile are both very calm. However, in their hearts, there is a passionate determination and passion to do their best for the community.
Dr. Akiko provide dental treatment in the appropriate speed for each patients.
The guidance and training for Feeding and swallowing in Feeding and Swallowing Room.
Their treatments are supported by 4 dental hygienists and 3 dental assistants.
They say “We could not be more grateful to our staffs.”
