Christa Gianfrancesco'17: Improving Population Health, Starting from the Mouth

Christina (“Christa”) Gianfrancesco’17 never expected that a college sociology class would set her on a path to dentistry, but that’s exactly what happened.

“My professor was lecturing about the societal impact of various health issues, and used oral disease in Appalachia as an example,” says Christa, who earned her BA at Tufts. 

“He discussed how poor oral health impacts seducation, socioeconomic status, overall health and wellness, and so much more." she says. “It opened my eyes. Until that day, I’d never thought about oral health beyond my own cleanings and a couple fillings.”

Moved by that sociology class, Christa realized that she wanted to help address overall health and wellness for the underserved. And she could do that by starting with the mouth. On May 17, 2017,  she will graduate with a DDS/MPH dual degree on and will stay on for the next four years through her residency in pediatric dentistry.

“I’ve had such great mentors at Columbia,” she says. “They really pushed me to explore my interests and forge my path through international work. I’m so glad I get to continue on here around familiar faces.”

Christa’s drive to improve oral health for the underserved has been on full display around the globe, often under the mentorship of Kavita Ahluwalia, DDS, MPH, associate professor of dental medicine in CDM’s Section of Population Oral Health, and Burton Edelstein, DDS, MPH, section chair. Through their support, she has conducted service and scholarly work in New York, India, Kenya, and Uganda, all aimed at building sustainable oral health care and disease prevention measures. In Uganda and Kenya, she worked to integrate medical and dental care.

In the summer after her first year, she worked with Dr. Ahluwalia in a New York City Meals-on-Wheels partnership. Dr. Ahluwalia’s research found that 40 percent of New York City Meals-on-Wheels recipients could not eat all or part of their meals because of mouth pain or missing teeth. To help address the disease that hindered basic nutrition for so many, Christa worked to offer a resource to help connect seniors to dental care. She developed a comprehensive directory of the city's dental services. With a lack of data to start with, she surveyed every dental office then categorizing them by location, languages spoken, insurance accepted, and elder friendliness.  The project, which included a toolkit for case workers, was supported by the NYC Department for the Aging (NYCDAC), the nation's largest federal area agency on aging. The impact of such work was broad and sustained; the materials are now used by the New York City Department of Health as well as the NYCDAC.  

She loved that work, but Christa’s path was about to take another turn. Just as unexpectedly as sociology led her to dentistry, work with elders led her to children.

“Many times, Meals-on-Wheels recipients had grandchildren living with them. They would often ask about getting these children to a dentist,” says Christa. “I was moved by how desperate they were to find resources for kids.”

Christa became interested in pediatric dentistry, and this change of course brought her to India. She spent eight weeks with Dr. Ahluwalia working with children and teens with neurological deficiencies. Christa interviewed 60 caregivers of patients who couldn’t brush or floss their own teeth and worked to create sustainable ways to support oral health care and disease prevention. The interventions they designed, developed through a partnership with the Indian Head Injury Foundation, aimed to work with existing health care resources. 

“We partnered with therapists to integrate exercises into their routine therapy sessions that would help improve the fine motor skills needed for brushing. I also worked with the children’s physicians to incorporate dental screenings into initial and follow-up evaluations.”

Along the way, Christa has racked up honors—her work with Meals-on-Wheels was honored at the National Oral Health Conference. A photo essay from her work in India won second prize at Columbia’s IFAP Global Health Conference and was also presented at the Consortium of Universities for Global Health, a Washington D.C.-based organization composed of 145 universities. This spring, after a competitive and rigorous application process, Christa became the first ever dental student elected to serve on the consortium’s trainee Advisory Committee. 

As she had always planned, all of her work has focused on sustainable solutions, not one-time care. And once she completes her pediatric dentistry residency, she hopes to continue working with the underserved, perhaps through practice at a community health center. In settings like this, many children get their first opportunity to learn about preventative health measures from their dentists.  She is also considering research at some point down the line, and perhaps teaching. But the future is uncertain.

"One of the biggest lessons dental school has taught me is that you never quite know what’s in store,” she says. “I hope I continue to be as lucky in my career as I have been in my education.”




Campus News, Dentistry, Public Health, Global Health