At the dental school, the dietitian is in

What was your training and path to Penn?

I grew up in South Louisiana, the heart of Cajun country. I struggled with obesity as a child and eating disorders, which led me down a path toward helping others through healthy eating and cooking.

I ended up coming up to this area around 2013. I’ve worked on a farm, I’ve worked in school lunch programs, I've worked at community food access programs. And right before I came here, I was working at a supermarket as a retail dietitian, which was great because the customers were right there; it was like ground zero for health and wellness. I have a culinary arts degree in addition to being a registered dietitian, so I was always creating healthy recipes for the customers to try.

What’s the difference between a dietitian and a nutritionist?

Depending on where you live, some states do require certification or licensure to call yourself a nutritionist. But a lot of states don’t regulate that, so you could just be someone on Instagram who calls yourself a nutritionist.

But as dietitians, we have the training, we have the background, we have the education. So, we use an evidence-based approach. We do an internship that's 1,200 hours, we do clinical food services management, community rotations, we have to take an examination, and then once we’ve passed that we become accredited. And we have to maintain that certification and licensure with continuing education as well.

Can you give a window into your day-to-day at the dental school?

My main priority is working with patients. Typically, when we’re seeing patients here at the dental school, they’re coming in for several different reasons. Many of them don’t have access to a private practice. It could be for financial reasons because of access or transportation. We also see a lot of recent immigrant families.

Many of our clients have underlying disease states going on, like diabetes, cardiovascular disease, obesity, kidney disease, blood disorders, you name it. Or I might get called in to talk about it something as simple as cavities. Either way, it’s a huge opportunity to bring in the topic of nutrition. 

We try to make it as convenient as possible for the patients, and I will add that we are providing this service free of charge. The patients don’t have to make an additional appointment to see me; I see them while they’re in the chairs in the clinic. I’ll come down, look at the chart, talk to the student who is providing their care, look at the medical history, talk to the patient, and we can do some kind of education or intervention right there.

I’m also there educating the dental students about nutrition and how to incorporate that kind of counseling into their care. 

What are some of the common nutritional issues that come up when you meet with patients?

One of the biggest things we see is trying to get patients to maybe not eliminate but cut down on their consumption of sweetened beverages. That is a major contributor to tooth decay. Someone might, let’s say, put a Coke next to their computer and take little sips throughout the day. What you’re doing is you’re constantly creating that low pH that’s going to exacerbate those symptoms and conditions. So, I’ll say, Maybe try having a glass of water instead. Or if someone is snacking throughout the day, we’re making sure they’re not snacking on things that are too sticky or chewy or abrasive.

I’ve learned a lot since starting here at the dental school. Before, I might have recommended something like dried fruit and almonds as a snack, but now I might say, If you’re having that, we need to make sure you’re rinsing your mouth afterward, or maybe have a whole piece of fruit instead.

We see a lot of dry mouth as well, related to a medical condition or a medication. The patients may say, ‘I hate drinking water,’ and I say, ‘Hey, if you eat fruits and vegetables like tomatoes and cucumbers, they’re mostly water so that’s another way to hydrate. And by chewing those foods you’re actually going to stimulate your mouth to produce saliva.’

On the whole, fewer people want to cook these days; they want convenience. So, I work with them to figure out healthy swaps we can do because we don’t want to radically change what people are doing because that’s not going to stick. So, it’s simple solutions like, ‘When you stop at Wawa for a hoagie, how about a whole wheat hoagie roll instead of that white roll, or how about having those meatballs over some greens?’

People often think of dietitians as the food police. I’m not the food police. I’m trying to help you. And I’m not going to be there when you go home and make these decisions, so we try to give them easily achievable goals. That’s how you find the most success with patients.

How does working in a dental school make nutrition education unique?

You know people have heard since they were little kids, ‘Eat your fruits and vegetables!’ to the point that they almost tune it out. Our students and I can bring in a different approach, talking about the link between oral health and nutrition. That’s a message that people might not have heard before. So, it’s refreshing, it’s a different perspective. 

Also, with dentistry as compared to a lot of the other health professions, you do have the patient there for a fair amount of time, so there are a lot of opportunities to start those conversations.

Besides providing education to patients and students, what other kinds of activities are you doing at the school?

Well, the monthly demonstrations, where I cook a healthy meal and then let faculty and students sample it, those go over very well. Let’s just say I’m a popular guy around here. For the most recent one it was Mardi Gras so I cheated a little bit and made something a little more indulgent, chicken and sausage gumbo.

We also have some research projects going on, like one studying behavioral approaches to working with our autistic pediatric patients. We have a disabilities clinic opening pretty soon so our findings will hopefully inform the work going on there. I also do work with several of the predoctoral students on various projects, on things like intake and assessment and childhood obesity.

I provide educational materials for social media channels run through the school, for the patient-facing sites and the student-facing sites as well. And we’ve created an e-book that patients can read, or people who aren’t patients yet can look at to learn more about the connection between nutrition and oral health.

What do you like to cook for yourself?

Just like everyone else in the world I don’t like to spend five hours cooking and then cleaning 25 pots and pans, so I’m all about the one pot, one casserole dish-types of meals that have all the layers of grains, the vegetables, the good lean protein, the flavor. I also like to do batch cooking, so I have all the meals I need for the week. I totally understand when I talk to patients and hear that they want convenience. I’m the same way.