Dentist Feels At Home in a Small Town Environment

For Jacqueline Hughes, D.D.S., being a dentist in the small Pennsylvania town of Chambersburg (pop. 17,000) feels familiar-she was once a dentist in a rural Philippine village where she grew up.

Hughes attended dental school in her country, becoming the first dentist in the family, and returned to her village to practice after graduation. While dental practice there was personally rewarding, conditions were difficult and she was poorly paid-Hughes received 10 cents for a tooth extraction. "My mom would often send a letter with a patient indicating that he or she didn't have any money to pay me, and I would receive chickens and eggs instead. But you can't live on chickens and eggs alone!" Hughes laughs.

She met her American husband in the Philippines where he was working for the Peace Corps. They were married after Hughes moved to the United States. She then decided to go back to school at New York University so she could practice dentistry in America.

Hughes learned about the NHSC from her brother-in-law who is also a dentist. "He applied for NHSC's Loan Repayment program when he left the Air Force," she explains. "He really liked the program and ended up spending 10 years in West Virginia with NHSC." Her husband was from Pennsylvania and wanted to return to the State to be near his family. Keystone Health Center in Chambersburg happened to be one of the approved practice sites on NHSC's Opportunities List.

"I was lucky that I was accepted by Keystone," Hughes notes. "Not only do I like where I am and the people I work with, but I'm treating people who might not normally receive care. That's who I treated in the Philippines, so it feels good to me. My mom, who still teaches there, is also happy that I'm taking care of people in need."

More than 40,000 people in the Franklin County, Pennsylvania area rely on the Keystone Dental Center division of the Keystone Health Center. Hughes is one of three general dentists, who staff the center along with three dental assistants. The team provides almost all forms of dental care, except orthodontics, to adults and children from all backgrounds and income levels, including patients with special needs.

Until Keystone opened their dental clinic, low-income adult patients did not have access to some dental procedures, such as dentures. The clinic now offers cleanings, fillings, crowns, root canals, and even gum surgery, Hughes notes.

"People in the United States are lucky because your government and NHSC help people get access to these benefits," Hughes continues. "In the Philippines, you can be in pain but have to travel very far just to get dental treatment, and the government doesn't help with the payment."

NHSC also provided opportunities for her. "For someone like me, who had a lot of school loans, the NHSC was a huge help," Hughes explains. "I also would not have learned about this area and this position if I had not applied to the NHSC. And although my loan has been paid off, I'm planning to stay here."

One thing that surprised Hughes was the poor dental health of many of her patients, especially the children. "Although this area has fluoridated water, I was shocked at how many cavities the children have, especially the older ones," she recalls. "They seem to drink a lot of sugary sodas. But I love working with children. Some I have treated since they were little, and when they first came, they were scared of the dentist. Their only dental care was when they came in for an emergency. But now they are the best patients and they are growing up with good teeth."

To Hughes, an important facet of her practice is teaching both parents and their kids about the need for oral health. "We teach them about diet, flossing and brushing regularly, and how important it is to visit the dentist, especially because they have access to one," she explains.

Because many patients did not previously have access to a dentist, many came to Hughes believing that the best way to handle tooth decay or other dental problems was to have their teeth pulled, and get dentures. "A patient might say, 'Well, my grandmother had dentures that looked good'," Hughes notes. "But I'll say that 'They may have looked fine, but did you ever ask your grandmother how the dentures felt or what it was like to eat with them?'"

Hughes gets to practice all types of dentistry. Her workday may include performing regular dental exams, root canals, and tooth extractions. "We have the best facility and equipment here-the facility is JCAHO- (Joint Commission on Accreditation of Healthcare Organizations) approved, so everything is up-to-date," she says. "That's why we get both private pay and public patients because they like our office."

Chambersburg has also been a good place to raise a family for Hughes and her husband. The pace of life is slower and she knows many of the people. In addition, the community has lots of activities for her children such as baseball, and her family is close to her in-laws. "Unlike some of my coworkers who find this area too rural, I really like it here," Hughes says. "I always wanted to live in a small, quiet community." She laughs, "And this town is still bigger than the one I grew up in!"

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