Edgar Martinez

Ashoka Fellow
Cette description du travail de Edgar Martinez a été rédigée lors de sa sélection comme Fellow Ashoka en 2013

Introduction

Edgar Martínez is redefining dental clinics, particularly in rural and low-income communities, by proactively intervening in schools and communities to teach dental hygiene. Edgar thereby reduces the need for extensive dental care and makes high-quality dental care more accessible through his franchise network of low-cost dental clinics located in poor rural areas.

L'idée nouvelle

Edgar has taken the traditional dental clinic model and evolved it into a dental health authority in marginalized communities. His methodology expands the reach of a dental clinic through public education, broadening access, and the changing of the infrastructure in the dental sector. Through his in-school education program, Edgar intervenes in public education institutions to teach children, parents, and teachers about dental health. This approach changes dental health from a topic normally only accessible to those who can afford to see a dentist, to a common public school subject like history or math.

Through his efforts, Edgar is creating adults with healthy life-long dental habits in communities that may have never come to understand dental health in the first place. Edgar recognizes the need for occasional dental work to treat dental problems that prevention cannot fix, which is why he established a low-cost clinic model that offers top-quality dental work at accessible prices. Furthermore, Edgar is working within the dental profession to sensitize practitioners and change the perceptions of their role in society through university relations and professional development opportunities. After starting in the southern state of Oaxaca, one of Mexico’s poorest, Edgar’s success has led him to reproduce his work through a social franchise approach. Through Edgar’s integral strategy, dental health is changing from a luxury of the few to a necessity for all.

Le problème

Dental care in Mexico has long been an important public health issue because dental care is limited to higher economic classes in society. As a consequence, most healthcare development initiatives either ignore dental health because of its perception as a luxury and focus on general medical health issues, or they only provide quick fixes to dental health issues, such as a free filling or extraction. This traditional, reactive approach continues to only treat the effects of the root cause: the lack of dental healthcare knowledge, particularly for the lowest economic classes of society. Mexico, as a country, maintains a culture that does not recognize dental health as a necessary aspect of overall well-being, which is why almost 100 percent of adults 28 years and older have some type of gum infection and 95 percent of 15 year olds have over three cavities. This culture permeates family dynamics for generations and prevents the diffusion of dental care information in a continuous cycle. As a result, a shocking 61.8 percent of children in Mexico are in need of cavity repair by the age of six. By age 12, this percentage skyrockets to 70 to 85 percent. This in turn creates adults with extremely poor dental hygiene where 80 percent of all adults in Mexico over the age of 60 having less than ten teeth.

Three implications manifest as consequences of the lack of dental education, beyond an unpleasant smile. First, dental health maintains a strong relationship with overall health. Poor dental health has been long associated with cardiovascular diseases, diabetes, and bacterial pneumonia. By ignoring dental health education, the general health of these populations, which often suffer from a range of health issues, can never be expected to improve. Second, without a solid knowledge base of dental health fundamentals, low-income populations become trapped in a cycle of treatment that negatively impacts their personal finances. The lack of sufficient dental care results in a need for repeated fillings, or root canals that could all have been prevented with proper education. Finally, insufficient dental care indirectly affects an individual’s quality of life by way of discrimination, self-esteem, or the various health issues that arise in states of poor dental health. Altogether, these issues present a clear need for community actors working in prevention.

Finally, the dental profession does not introduce social career paths when preparing dentists and oral healthcare professionals for the real world, resulting in a lack of sensitivity to Mexican’s social needs. Currently, dental professionals are taught one single career path, working in or starting a private practice that attends a few patients a day at a relatively high cost. This pedagogy results in professionals seeing dentistry only as a practice for those who can afford it. Those who independently decide to take on a social component later in their careers do so by performing free dental work when time permits. This pattern keeps a crucial portion of the population that could have potentially dedicated their careers to the social sector without having had the option to do so. This means that while a market of people who can pay for dental services exists, albeit at much lower prices, most dental professionals have not been offered the paths to reach them.



So, while medical healthcare has been extended to most Mexicans, through various insurance plans and government clinics, dental care is accessible only to the few who can pay higher prices and government clinics rarely offer dental care.

La stratégie

While packaged under one name, Biodent is comprised of three programs six years in the making. These are: a low-cost dental clinic that offers high-quality treatment using advanced technologies, an in-school education program that teaches dental health to students, teachers, and parents, and a program for professional development with local universities. Edgar believes that only through the coupling of these three lines of work will marginalized areas fully achieve dental health on a communal scale.

With the purpose of reducing the need for extensive dental treatment, Edgar is primarily invested in Biodent’s education program. The program emphasizes teaching information that prevents dental health issues and the formation of life-long, healthy dental habits. All programs utilize materials co-developed by his wife, a dentist. Through his initiatives, such as the Toothbrush Club, Edgar is creating in-school cultures that revolve around the importance of dental health. In schools that have implemented Biodent’s education program, the prevalence of cavities in students is between 60 to 65 percent, whereas non-member schools in the area maintain a percentage between 85 to 95 percent. Currently, Biodent’s education program is being implemented in ten schools, reaching 3,500 school children this year alone. Edgar has also begun to establish a network of community promoters who distribute dental education materials throughout their communities to augment Biodent’s reach.

Despite how effective prevention efforts may be, the need for dental treatments will almost always arise, if even on a small scale. Edgar is meeting this need through Biodent’s clinic initiative. Edgar has cut costs and reinvented traditional dental clinic operations to provide high-volume, high-quality service with the latest technologies at lower costs. Both the aforementioned promoters and the in-school programs not only serve as high-impact methods to disseminate dental health information, they also bring Biodent a steady flow of patients. Additionally, because a majority of Biodent’s patients are children from rural, indigenous, or low-income communities who have never received dental treatment, Biodent’s staff is given supplemental training to address the discomfort and nervousness that accompanies these children on their visits.

Surprisingly, despite these added components to Edgar’s model, the prices for treatment at Biodent are extremely accessible. To generate a profit, traditional dental clinics charge for the cost of materials and service operational costs, plus an additional 80 to 300 percent. Biodent only charges a 30 to 40 percent profit. For example, a filling using laser technology at a traditional clinic can cost up to $1,000 pesos (about US$75) However, Edgar charges $250 pesos (less than US$20) for the same work. The small profit generated is used to pay salaries, operational costs, and Biodent’s education program. Money that remains after these costs is reinvested in the community as dental scholarships for those below the poverty line. Edgar is developing a sliding scale of prices based on monthly income for his clients to extend his services. The success of Edgar’s model relies on quantity; Biodent sees over 200 patients a month and motivates its dentists through a franchise system that gives the best graduating dentists the chance to start their own clinic using Biodent’s methodology and financing for equipment. While traditional clinics attend four to five patients a day, Biodent treats ten to twelve daily. However, the speed does not lower the quality of treatment, as Biodent maintains an industry-competitive retreatment rate of 4 percent.

Edgar has also established strong ties with the University of Oaxaca dental school. This pilot program offers dental students the chance to complete their dental residencies at Biodent to help sensitize them to low-income populations. He is working to implement social themes throughout coursework to introduce the option of social sector careers to these students. Edgar hopes that many students will then either, open their own Biodent clinic, or work for a Biodent clinic, at the very least, for an early part of their career to gain dental experience and credibility.

Edgar is working to systemize the model and materials of Biodent to create a scalable social franchise. Last year Biodent opened its second clinic in Oaxaca, and plans to grow its education program to serve thousands of patients and hundreds of schools in the poorest southern states in Mexico in the next few years, gradually opening franchises in other poor areas within five years.

La personne

Having grown up in a poor rural area of Oaxaca, Edgar witnessed the various ways in which poverty and poor public health education could affect a community. By 16, Edgar was volunteering in various health-related groups to improve the lives of youth in his area. However, his attention was significantly drawn to the defined line between those who could economically access health services and those who couldn’t, particularly in indigenous and low-income communities.

After studying business, Edgar followed the steps of his parents, both of whom are teachers, and took a position at a university in education programming. During this time he realized the potential impact that the intersection between education and business could have in his home state of Oaxaca. Edgar then returned to Oaxaca vowing to create an organizational model that granted everyone the equal opportunity for a dignified quality of life.

For three years, Edgar paid all operational costs for the education program that eventually became Biodent. At the moment he nearly finished his resources, he was approached by a woman who desperately needed dental treatment for her child. It was then Edgar recognized his efforts couldn’t be sustained only in the form of preventive actions. From this point, Edgar aimed to redesign the role of dental clinics, creating the proactive social business, Biodent. Using his experience in education and knowledge in business, Edgar is determined to expand his enterprise until his integral vision of dental health is accessible to everyone.