Written by: Srinivasa Reddy Pathagunti, BDS, MS, MPH, CCHP
If you had asked me early in my career to define a “good dentist,” I would have answered without hesitation: clinical skill. Molar endo, surgical extractions, complex prosthodontics, and implantology—I believed mastery of the handpiece was the foundation of everything.
And in many ways, it still is.
But over the past decade, my career path has led me through environments that challenged that singular belief: private practice, community health centers, research labs, and now, correctional healthcare.
Each setting reshaped not only how I practice dentistry but how I see people, systems, and the future of the profession I love. This is the story of how those experiences converged into a new understanding—one that blends clinical excellence with public health, data literacy, and a deep commitment to equity.
The Moment Clinical Skills Weren’t Enough
I remember the shift clearly. I was working in community practice, treating a patient with a tooth fractured down to the gumline. Clinically, the solution was straightforward: extract, discuss replacement, and move forward.
But her story wasn’t straightforward.
She had missed appointments not because she didn’t care, but because she lacked childcare. She had untreated diabetes and lived in a food desert where healthy options were scarce. She hadn’t seen a dentist in nearly a decade because she was constantly choosing between healthcare bills and rent. The fracture I was treating was only the final symptom of a much larger failure. That day, I realized clinical excellence wasn’t enough—not when the true sources of disease lived outside my operatory.
Public Health: Seeing the Patterns
That realization pushed me toward the Eastman Institute for Oral Health to pursue dental public health. Epidemiology and biostatistics ceased to be abstract concepts; they became the tools I needed to understand why patients like mine were falling through the cracks. During outreach in WIC clinics and Head Start centers, I met children who had never held a toothbrush and parents who were forced to prioritize survival over oral care. I began to see patterns where I previously saw only isolated cases. I learned that education, policy, and environment are inseparable from clinical outcomes.
Correctional Dentistry: The Starkest Window
My current work as a unit dentist and certified correctional health professional (CCHP) has been the most powerful chapter of my career. The level of disease in correctional settings is unlike anything seen in private practice: severe decay, advanced periodontal disease, and trauma, all fueled by years of untreated mental illness or substance use.
In a correctional facility, dentistry becomes urgent, raw, and deeply human. Treatment plans must be practical. Pain relief and infection control come first.
Yet, despite the constraints, the gratitude is profound. We are often the first providers in decades to treat these patients with dignity. This work reinforced a hard truth: the people with the highest disease burden often have the least access to care.
Technology as an Equity Tool
With a background in information systems, I have always been drawn to the digital side of dentistry. However, my journey taught me that technology is not just about efficiency; it is an equity tool.
- AI-supported diagnostics ensure consistent care standards regardless of the setting.
- Tele-dentistry brings triage and counseling to isolated populations.
- Data analytics allow us to identify high-risk groups before emergencies arise.
The challenge ahead is not innovation, but adoption. As dentistry evolves, “tech literacy” will become as vital as hand skills in bridging the access gap.
The Data-Driven Clinician
My involvement in research—from salivary biomarkers to e-cigarette effects—demonstrated that dentistry’s future belongs to clinicians who are comfortable with data. Data literacy is no longer a niche skill for academics; it is essential for the everyday practitioner to make evidence-based decisions and recognize the population-level trends that affect their chairside work.
The Skill That Changed Everything: Cultural Competence
Speaking Spanish, Hindi, and Telugu has allowed me to connect with patients who might otherwise struggle to express their pain. But I’ve learned that cultural competence goes far beyond language. It means understanding a patient’s trauma, social reality, and beliefs.
When a patient feels understood, trust follows. And where there is trust, compliance, and prevention, long-term health becomes possible.
A Profession Ready to Evolve
After moving through these varied environments, I believe deeply that dentistry’s future must be integrated. We can no longer afford to keep clinical care, public health, and technology in separate silos.
Our profession will be strongest when we:
- Treat oral and systemic health as interconnected.
- Use technology to expand access, not just revenue.
- Measure equity as a key component of quality.
- See the patient’s story, not just their symptoms.
The more I learn, the more I realize dentistry is not just about treating teeth. It is about systems, stories, and opportunities. The future of dentistry isn’t waiting somewhere ahead—we are building it right now. Let’s build it better, together.
ABOUT THE AUTHOR
Dr. Pathagunti is a general dentist and dental public health professional serving with Texas Tech University Health Sciences Center Correctional Health Care. He is a selected fellow in the AIDPH Nonprofit Management Fellowship and focuses on improving access to implant dentistry for high-needs populations in rural Texas. He can be reached via email at [email protected].
Disclosure: Dr. Pathagunti reports no disclosures.
FEATURED IMAGE CREDIT: Rubén González from Pixabay.
