Carole Nese, RDH, BS, CFP, is always working on ways to become a more effective preventive dental health provider, developing new ideas and seeking creative solutions. Creativity is the key word to describe Nese and her "dual career."
In addition to working as a consultant for nonprofit dental programs and oral health community outreach programs in Los Angeles, Calif., Nese also works with money managers for a small boutique group of clients specializing in financial/retirement and money management. Additionally, she conducts seminars in financial planning and has taught financial planning classes at Mt. St. Mary's College and to University of Southern California (USC) dental hygiene students.
The dental field is part of Nese's family tradition. "My mother's older brother was a graduate of the USC School of Dentistry. My mother worked for him in the front office before she was married, and one of her sisters worked as his dental assistant when he started his practice. He was a well-respected, highly regarded dentist in Los Angeles/' Nese explained. "When I asked questions about working in a dental office, both my parents and my aunt encouraged me to go into the dental field."
Nese's parents had stressed the importance of oral and overall health to their children. "Neither one of my parents had the luxury of going to the dentist very often when they were young, so it was important to both of them that my brother and I had good dental care/' she said. "We both had braces, and when I was a freshman in high school I was chosen as a participant for smile of the year. After that, I really took notice of nice teeth and pretty smiles and 1 still do. A person's smile is one of the first things I notice."
After high school, Nese went directly to USC and graduated from the dental hygiene program. "Becoming a dental hygienist gave me the opportunity to go to college for four years, get a degree, have a career that was people-oriented, and get a job right after graduation," she said. About a year after graduating, Nese volunteered as a dental hygienist at hospitals and schools to help children with their dental health. She settled in at the Providence St. Joseph Children's Dental Clinic in Burbank and volunteered there once or twice a month for over 20 years.
"When the clinic closed, all the volunteer dentists and hygienists wanted to continue, so I found myself spearheading a campaign to open a new children's dental clinic in Burbank," she said. After writing grants, appealing to legislators, attending city council meetings to ask for money, creating a nonprofit entity, applying for the IRS nonprofit status, creating a board of directors, and with the help of many people--including dental, medical, legal and accounting professionals -- the Kids' Community Clinic of Burbank opened about 10 years ago.
Nese was the president of the board and the first administrator of the clinic, and enlisted students from the local dental hygiene programs to help. "The clinic was growing by leaps and bounds," she said. "We hired some full-time staff to run the clinic, and I went on to help set up preventive dental and community outreach programs for public and private schools in and around Los Angeles."
Nese has been active in her professional associations on all levels: national, state and local. She acted as representative to ADHA meetings, journal editor, and chair of various committees for the California Dental Hygienists' Association (CHDA). She also held various offices in the Los Angeles Dental Hygienists' Society (LADHS), including president.
"One of the hygienists I met through CDHA wanted to start a business in preventive oral health care, so we put together a homecare preventive dental care catalogue," Nese said. "It was a great accomplishment, but we real-ized that we did not have any financial, business or market-ing background. Our dental hygiene education is very comprehensive but gives us none of that. So, I went back to school and took some business classes. I enrolled in a program at the College for Financial Planning, completed two years of classes and tests, and became a Ce-tified Financial Planner (CFP) in 1988. I started working with dental hygienists, helping them with their financial planning needs."
A typical day for Nese includes working on projects with community partners and organizations to promote preventive dental care programs in schools, clinics and community outreach centers. "If there are appropriate grant opportunities out there (which ave. few and far between at present), I research and write grants for nonprofit dental programs, " she said. "As a CFP, I work with clients, hone my seminar materials, write financial articles and educate individuals and groups about finances and money."
In addition to essentially creating a nonprofit and sup-porting many others, Nese considers one of her major achievements to be creating "the most comprehensive, detailed dental referral guide of low- or no-cost dentists and dental clinics in Los Angeles County." According to Nese, the list is available on the Internet for easier access, and is used by many health care service organizations in the area, as well as parents who can use it to choose a local dental facility for their child.
"I have helped raise money and written grants to pay for many of these programs. The problem with grant-driven projects is that when the money is gone the program ends," Nese said. She is working on a non-grant-driven, self-sustaining, very low-cost preventive oral health program for school children and their parents called "Kids Can Be Cavity Free" (KCBCF).
KCBCF emphasizes prevention and requires the parents to pay and take an active role in their children's oral health. There is even a take-home project for the entire family. KCBCF also educates parents as to the real value of the dental care their children are receiving free or at a very low cost.
"For some [people] 'free' means there is no value to the service. This is a way of getting them to realize what the rest of us pay for dental services for our children. It is a different approach yet to be proven," Nese said. She added that many families have lost jobs and health care benefits including dental benefits, creating a greater need for care. She stressed that dental professionals can help by finding better ways to enhance patients' at-home preventive oral health care.
"Preventive care should come before treatment. If prevention came before treatment there would be very little or no need for treatment. Most of the families I serve need a great deal of treatment. Preven-tive health care is health care for the 21st century, which includes new innovative ways to promote prevention," she said. Nese said that service "is a small way of giving back to those who are not as fortunate. ... It matters little whether it is a small gesture or a grand effort, and often the small gestures can make the biggest impact."
Nese strongly emphasized the importance of oral health, especially among children. "Dental disease in children is epidemic and it is preventable. Even though the Surgeon General declared dental disease epidemic in children in 2000, with children of low-income families particularly vulnerable,  years later we are still fighting the fight and we are no better off. This is the 21st century, a time for new thinking and new ideas. ... We give away screenings, fluoride and parent education, yet free dental treatment programs can go begging for children patients. Despite the tons of educational literature about dentistry and preventive oral health care, families often take only the child in pain to the dentist, fail appointments and don't complete treatment. We are doing something wrong," Nese said.
"If we had proven methods for preventing cancer, health care workers and facilities would be inundated, and people would pay almost any price. Cancer is life-threatening, scary and the treatment can be brutal. Yet poor oral health, dental disease and infection can be just the same. Maybe dental disease and infection do not kill or debilitate enough people to give them a high priority. Readers may consider that statement to be upsetting and shocking, but we need to upset and shock children, parents and the public into action. We need to approach the problem in a new and different way and think differently."
Nese encourages her colleagues to promote and build their knowledge and skills by actively participating in their profession. "Join the association for your future professional career, to make lifelong friends, find a job, start a dental care business, or become a leader in public health preventive dental care. Step up and jump in. There are opportunities in public health and there will be more in the future," she said. "Promote your expertise; you are the experts in preventive oral health care."
For more information on Nese or her career, please email her at email@example.com.
This edition of Working was prepared by Mariam Pera.
Nese (standing) at a local school oral health education day. Marsha Center, RDH (seated) has worked with Nese for many years on school-based projects.
"Preventive health care is health care for the 21st century, which includes new innovative ways to promote prevention. [Service] is a small way of giving back to those who are not as fortunate. It matters little whether it is a small gesture or a grand effort, and often the small gestures can make the biggest impact"
--Carole Nese, RDH, BS, CFP