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ATSU-MOSDOH faculty member improves language access to dental care

Dr. Romana Muller at the St. Louis Dental Center

Romana Muller, EdD, MSDH, RDH, ’22, assistant professor, ATSU-MOSDOH, was born in Czechoslovakia, a country once under a communist regime. When she was just 11 years old, her family had to make the difficult, and potentially dangerous, decision to flee the country. In doing this, Dr. Muller’s parents could have been sent to prison. However, they got lucky when, on their last try, a guard allowed them to cross the border between Yugoslavia and Austria. From there, they immigrated to Canada.

Although necessary, this transition to a new country was hard on Dr. Muller. She experienced a huge language barrier as she did not yet know English and faced challenges assimilating to a new society.

“I remember the first day I was at school. I didn’t know what people were saying,” Dr. Muller says. “I could hear and see that people were talking to me, but I couldn’t understand, and I could not respond. It felt like I didn’t have a voice.”

Because of her experience, Dr. Muller is working to make sure other immigrants are able to find their voice when it comes to oral health.

“I have a passion in my heart for individuals who don’t speak English because I was there, in their shoes,” Dr. Muller explains. “As a child, I had to interpret for my parents during healthcare appointments. So, I know these barriers exist.”

Dr. Muller, along with her team of ATSU students, is breaking down language barriers between immigrant patients and their dental care providers at the St. Louis Dental Center. She is determined to increase access to written materials in languages other than English. To achieve this, the team is actively translating clinical forms necessary for patients to receive dental care, into as many languages as possible.

“I always say that when we get patients who come in from linguistically diverse communities, we need to do what we can to give them a voice,” Dr. Muller says. “Our clinic has close to 4,000 patients on record who speak a language other than English. There are currently 48 different languages spoken. We have always provided free interpreter services, and now, with this project, we are growing our portfolio of translated documents.

“I had a vision to tap into the diversity of our students and faculty who have the ability to communicate, read, and write in different languages. I envisioned utilizing those talents to build a library of forms in different languages for our patients.”

So far, the team has successfully translated forms into 12 different languages, but there is still work to be done. Dr. Muller will continue to recruit students to join her translation team as long as support and funding are available.

“We’re doing what we can; it’s an improvement to what we had before,” Dr. Muller says. “I look at this project as if we are building a library of bilingual forms. Whenever we translate a form, we put it onto the bookshelf, so it’s always going to be there. When I get students on the team who can speak, read, and write in another language, then I can add to the library.”

Dr. Muller’s team is also developing and implementing assessments to test literacy in oral health terminology. So far, they have tested Spanish speakers and English speakers. In addition, the team developed educational components to teach patients what certain dental terms mean. Currently, these components are being prepared for translation into more languages.

Translation team members
Dr. Romana Muller meets with past and current members of the translation team. From left to right, along with the languages in which they are fluent, Svyatoslav Danylyk, DMD, ’23, Ukrainian; Khoa Dang Vincent Nguyen, DMD, ’23, Vietnamese; Sinhareeb Emara, D4, Arabic; Dr. Romana Muller, Czech; Zohal Alizai, OMS IV, Dari and Pashto; and Pedram Majbuleh, D4, Japanese.

Community service is an important part of the project. The team has delivered translated oral health education materials and intake forms to community events organized by the International Institute of St. Louis and the St. Louis Give Kids A Smile organization’s Tiny Smiles program.

“One of the biggest barriers in the lack of language access in healthcare is that the cost of translations is enormous,” Dr. Muller explains.

To complete this project, Dr. Muller has been awarded two separate grants, the most recent one being an ATSU internal grant, the ATSU Underserved Community Scholarly Improvement Grant. The first grant she received, In Any Language, Improving Oral Health Translates into Better Lives, was an external grant from the Lutheran Foundation of St. Louis, which does not usually give grants to schools.

“They just took a chance on us,” Dr. Muller says. “My dream came true when I got that grant. I have always wanted to do something like this, and I never thought that it would happen.

“My vision for the long term, if I had continued funding and support, would be to take our forms that we are developing and make them available on a website where every dental school in the U.S. could access and utilize them with their patients. I think it is much needed.”

Dr. Muller is proud of what she and her team have done and will continue to do. She recognizes she couldn’t do any of this work without the help from her student translation team. She also has a team of reviewers, who are native speakers of languages included in the project, to ensure quality control.
Some of them are recent ATSU-MOSDOH graduates who have previously contributed to the project as student translators and volunteered to stay on as reviewers.

In addition, Dr. Muller appreciates the support from ATSU- MOSDOH Dean Dwight McLeod, DDS, MS, and Vice Dean Poonam Jain, BDS, MS, MPH; ATSU staff; Affinia Healthcare administrators and staff at the St. Louis Dental Center; and other volunteer reviewers. She is grateful to those with ATSU Sponsored Programs, grant support teams, and Research Support, along with the Lutheran Foundation of St. Louis.

“I think we’re making these people feel like they are welcomed, considered, and included, and I think that’s what means so much to them. Having been there myself, I understand how significant that is,” Dr. Muller says. “It’s just so groundbreaking and so life-changing. I hope this project can continue.”

STUDENT TRANSLATION TEAM

Larisa Macedo, DMD, ’21
Reyberto Guzman Elias, DMD, ’22
Hanan Kayali, DMD, ’22
Julianna Phan, DMD, ’22
Svyatoslav Danylyk, DMD, ’23
Sharon Murza, DMD, ’23
Khoa Dang Vincent Nguyen, DMD, ’23
Lisandra Nodarse, DMD, ’23
Syeda Zehra, DMD, ’23
Parisa Ebrahimi, D4
Sinhareeb Emara, D4
Pedram Majbuleh, D4
Zohal Alizai, OMS IV

REVIEW TEAM

ATSU-MOSDOH faculty
Hanan Omar, BDS, PhD, MSc
Shaista Rashid, BDS, MS, MPH
Ahmed Zarrough, DDS, DSc, BDS

ATSU-MOSDOH alumni and students
Larisa Macedo, DMD, ’21
Sima Shakiba, DMD, ’21
Julianne Phan, DMD, ’22
Svyatoslav Danylyk, DMD, ’23
Sharon Murza, DMD, ’23
Khoa Dang Vincent Nguyen, DMD, ’23
Lisandra Nodarse, DMD, ’23
Syeda Zehra, DMD, ’23
Jannette Covarrubias, D3

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