Cultural Competency

By Jessica A. Rickert, DDS

Ideal dental health is possible now, more than at any time in history. Poor patient outcome, jeopardized patient compliance and compromised clinical management often result from biases in doctors and other medical staff. This puts our patients’ health at risk. ‘Culture’ refers to integrated patterns of human behavior that include the language, thoughts, communications, actions, customs, beliefs, values, and institutions of societal groups. ‘Competence’ implies having the capacity to function effectively

Photo courtesy of Native News Online

Cultural competency training is education about a set of congruent behaviors, attitudes, and policies that come together in a system, agency or among professionals and enable that system, agency or those professions to work effectively in cross-cultural situations. The possession of the knowledge and of the skills required to manage cross-cultural relationships results in an ability to understand, communicate with, and effectively interact with people across cultures.

For American Indians/Alaskan Natives, past painful events shape current reality; these traumas still impact everyday life today through memories & stories. The roots originate from cultural genocide; anguish to past inhumane events can be transferred to offspring.

“Historical trauma” is the cumulative emotional and psychological wounding over the lifespan and across generations, emanating from massive group trauma experiences; historical trauma response is the constellation of reactions to this trauma.

“Intergenerational Trauma” is the repercussions on a population whose ancestors suffered cruel cultural trauma, leading to cumulative wounding that spans generations in American Indian/Alaskan Native families. In addition to the genocide of thirteen million people, the treatment of the survivors, including forced relocation, starvation, disease, poverty and destruction of the family unit have contributed to the intergenerational trauma that still exists today.”

Historical Trauma Response symptoms include:

  • lack of trust
  • elevated suicide rates
  • depression
  • self-destructive behavior
  • substance abuse
  • fixation to trauma
  • anxiety
  • guilt
  • chronic grief
  • identification with the pain ancestors endured

The science behind the maladies is not fully understood but can explain the many health disparities in the American Indian /Alaskan Native population.

Poor tribal dental health is connected to other American Indian/Alaskan Native issues. Healing and reconciliation are a continuous and sometimes difficult process. These issues can start to be rectified by fostering diverse, inclusive, accurate and equitable cultural competency. As dentists start to celebrate all people and their talents, perspectives and experiences, the goals of effective communication and improved dental health can result. This is a starting place toward the greater goal of a unified society for all people.

The entire dental profession can join in the commitment to strengthen our profession by advancing diversity and inclusion in the dental profession. Cultural Competency training is especially applicable on these dates:

  • January, the third Tuesday is the National Day of Racial Healing
  • March is National Women’s month
  • October 12 is Indigenous People’s Day
  • October, the third Monday is Multicultural Day
  • November is National Native American Heritage Month


Jessica Ann Rickert, DDS is the first female American Indian Dentist in the world. Her tribe is the Prairie Band Potawatomi Nation, located in Mayetta, Kansas, because President Andrew Jackson forcibly removed these Potawatomi from Michigan.

Dr. Rickert attended the University of Michigan from 1968 to 1975. In 1975 she established a private dental practice; she also provided dental care for the Children’s Aid Society, the Department of Corrections in the State of Michigan and the Family Health Care Organization (FQHC). Recently retired, she is the Anishinaabe Dental Outreach Specialist with Delta Dental of Michigan.

As the eldest in a family of 9, attending a small public school in the 1960’s, Dr. Jessica A. Rickert excelled. She desired to attend the University of Michigan but did not understand how this could happen. Through scholarships and perseverance, she arrived at U of M in 1968, often the only girl in her math and science classes. Accepted in the Dental School in 1975, she did graduate in with a Doctor of Dentistry degree in 1975.

View Dr. Rickert’s full bio