Why does periodontal disease hit South Asians harder?
By Varsha Mantravadi
“Flossing widens the gaps between my teeth. Besides, these teeth aren’t even my own.”
Absolutely no one can convince my grandmother that flossing is important. Notorious in our family because all of her teeth are now implant crowns, she feels an increased disconnect with these “fake” teeth and doesn’t feel the need to take care of them. Many of her relatives in India confirm her beliefs by misguidedly advising against visiting the dentist and flossing regularly. For them, why should she waste time and money now that her teeth aren’t even “hers” anymore?
What is periodontal disease?
Periodontal disease, or gum disease, is a chronic infection of the tissues supporting the teeth, including periodontal ligaments and bone surrounding the teeth. A range of studies show that adults with South Asian origin have disproportionately high rates of diabetes and prediabetes, which are both powerful accelerators of periodontal disease. A similar relationship exists with periodontal disease and cardiovascular disease – bacteria from infected gums can enter the bloodstream, causing inflammation that promotes plaque buildup in blood vessels and increasing stroke and heart attack risk. With the right oral health practices and clinical monitoring, gum disease can be detected and maintained in its early stages. However, among South Asian immigrant populations, periodontal disease often goes undetected until it becomes severe.
This isn’t a coincidence. Beliefs like my grandmother’s are far from unique among South Asian immigrants; many arrive in the United States with deep cultural traditions but limited exposure to preventative dental practices. It can be hard to understand that your gums can suffer even if your teeth are fake, and that flossing may cause bleeding initially but is ultimately a prevention strategy. A psychology study performed at La Trobe University found that South Asians tend to underutilize dental services, choosing only to seek care when symptoms become severe, despite alarming statistics indicating that South Asians represent 64% of global periodontal disease cases.
As a dental assistant in Seattle, I see patients of South Asian descent almost every day who rarely report flossing at all, let alone regularly. I’ve also noticed that many South Asian patients react to diagnoses of periodontal disease with a reluctance to pursue treatment, often facing multiple barriers to care. One patient I worked with left the clinic without treatment despite a detailed explanation of his x-rays and periodontal disease diagnosis from the dentist. His concerns centered around the cost of the scaling and root planing treatment, questioning whether it was necessary if he was not experiencing pain. Since periodontal disease lacks obvious daily symptoms, it is easy for many patients to dismiss it as “fake” and forgo treatment.
Cultural understandings of oral hygiene in South Asia clash with Western preventative practices, leading to hesitation and confusion surrounding routine care. Language barriers also exacerbate the oral health literacy gap within this community. Despite being one of the fastest-growing immigrant groups in the US, South Asians routinely lack access to linguistically appropriate services. Although 92% of healthcare facilities include Hindi/Urdu as a language option on Video Remote Interpretation, as much as 45-50% of South Asians in the US speak a language other than Hindi/Urdu and would need specialized interpretation services. Understanding periodontal disease is already a confusing concept for many patients; compounded with limited English, it becomes particularly challenging to understand the disease’s implications and how to prevent it from getting worse.
How can we help?
Data from community-based oral health interventions have demonstrated significant improvements in periodontal health when education and screening programs are culturally tailored and linguistically accessible. In 2017, the National Institutes of Health conducted the Sikh American Families Oral Health Promotion Program in gurdwaras (Sikh places of worship) across New York and New Jersey. Sikh educators explained the risk factors associated with oral health problems such as periodontal disease, higher cavity risk, and other factors like diabetes and predisposition to heart disease. They spoke in Punjabi, a language that many Sikh families speak at home, and used examples that related directly to what the families were experiencing – unfamiliarity with their new home, nostalgia for their childhood and where they grew up, and how to navigate something unknown.
Preventative dental programs like Sikh American Families Program offer a successful template for future interventions for immigrant communities. Meeting communities where they are could include expanding public health programs that offer free or low-cost periodontal screenings in cultural centers or places of worship. Since diabetes, cardiovascular health, and periodontal disease are intricately linked, medical departments focusing on diabetes and cardiovascular care should also refer at-risk patients to dental clinics for periodontal screenings. Expanding insurance coverage for preventative dental care, especially in states with large South Asian immigrant populations like New Jersey and California, would bring these communities much closer to accessing the fundamental healthcare they need.
What can you do?
Systemic change requires community action. Talking to relatives, neighbors, and friends about oral health can get them thinking about their own oral hygiene habits, and how cavities are not the only oral issue you can have. Proposing dental education events to local clinics and cultural organizations and supporting policies can help expand preventative dental coverage. By challenging the misconception that dental care is optional, we can educate about the connection between teeth, natural or implanted, and overall health. The ultimate goal is to bridge the gap in oral health literacy and attack the root of the periodontal disease problem in South Asians and other immigrant populations, especially given the US’ current political climate. Expanded programs and frequent conversations will make it harder for people like my grandmother to avoid their dentists and chip away at the cultural beliefs that keep too many South Asians from seeking proper care. With time and better outreach, families like mine won’t need to debate whether flossing widens gaps – they’ll simply see it as a part of being healthy. But for now, I’ll keep nagging my grandmother.
Co-posted on KevinMD
Author Bio
Varsha Mantravadi is an undergraduate Public Health Honors student at the University of Washington who plans to pursue a career in dentistry. She is also an avid writer with a strong interest in oral health research. Her research focuses on the public health implications of periodontal disease and its connections to systemic health, with additional interests in health equity, education, and the integration of oral health into broader public health policy.
Interested in submitting an Op-Ed? See the FAQ section on our main Op-Eds page for more information.
Katie Chan, South Regional Conference Committee Member
Network Director
Katie Chan is a sophomore at Rice University in Houston, Texas. Born in Ho Chi Minh City, Vietnam, and raised in Honolulu, Hawaii, Katie grew an interest in epigenetic research since high school. She is currently exploring ways to apply this research to her broader interest in cancer care. Beyond the lab, Katie is deeply passionate about advocating for Asian American populations and improving their healthcare experiences. Following medical school, she hopes to return to her hometown to serve her community as an oncologist or intensivist.
Nhu Bui, Midwest Regional Conference Committee Member
Network Director
Nhu is currently a second year medical student at the University of Kansas School of Medicine. She was born in Cam Ranh, Vietnam and immigrated to the US when she was 5 years old. She completed her undergraduate degree in Molecular Cellular Developmental Biology at the University of Kansas.
Her specialty of interest right now is OB/GYN. She joined APAMSA to remain connected to her cultural heritage and contribute to a community that supports and empowers AANHPI medical students and future physicians. Her passions include spending time with my loved ones, gaming, baking and pickleball.
Richita Roy, Midwest Regional Conference Committee Member
Network Director
Richita is a second-year medical student at the University of Kansas School of Medicine. Born and raised in Tsukuba and later Tokyo, Japan, she moved to the U.S. during her grade school years, first living in Michigan before eventually settling in Kansas. Growing up at the intersection of Japanese, Bengali, Indian, and American cultures has shaped her cultural identity and given her an appreciation for the different ways people stay connected to their heritage while finding a sense of belonging within new communities. She later returned to Michigan to earn her B.S. in Biopsychology, Cognition, and Neuroscience from the University of Michigan.
Her current specialty interests include neurology and psychiatry. Her experiences across different cultures are also what drew her to APAMSA, where she hopes to help create a community that celebrates the many identities and experiences represented within AANHPI medicine. When she’s not busy with school, Richita enjoys Kathak dance, traveling, trying new café spots, and spending time with friends and family.
Women in Medicine Conversations: Dr. Rachel Lee on Service and Military Medicine
Welcome to Season 3! This episode of White Coats and Rice features Dr. Rachel Lee, a board-certified allergist, immunologist, and internal medicine physician who is a professor in the Department of Medicine at UC San Diego School of Medicine and a professor of medicine at the Uniformed Services University of the Health Sciences in Bethesda, Maryland. As a retired U.S. Navy medical officer, Dr. Lee reflects on her 20+ years in military medicine through the HPSP pathway, her transition into allergy and immunology, and her experiences balancing clinical practice with military leadership. She also shares insights on mentorship, resilience, and navigating identity as an Asian woman in academic and military medicine, emphasizing advocacy and support for trainees. This episode highlights her perspective on building a meaningful, adaptable career across service, academia, and specialty practice.
For listeners who would like to continue the conversation or reach out, Dr. Lee can be contacted at ral026@ucsd.edu
Listen here:
Spotify
Apple Podcasts
YouTube
This episode was produced by Grace Kim, hosted by Madeline Pan, and graphic by Romi Sheng.
00:07 — Opening
01:38 — What led Dr. Lee into medicine and HPSP
03:48 — How the Health Professions Scholarship Program works
07:05 — Branch options and different paths into military medicine
09:00 — What to consider before choosing military medicine
12:22 — Advice about purpose and preventing burnout
14:16 — Unexpected opportunities from the Navy
17:46 — How the Navy shaped Dr. Lee personally and professionally
21:14 — Choosing allergy and immunology
24:59 — Identity, bias, and navigating stereotypes
29:36 — Advice for women advocating for themselves
31:55 — Myths about allergists
33:45 — Closing remarks
00:07 — Opening
Madeline Pan: Welcome back to White Coats and Rice and the APAMSA podcast from roundtable discussions on current health topics to recaps of panels with distinguished leaders in healthcare to conversations with student leaders across the organization. This is White Coats and Rice. My name is Madeline Pan, and I am the Woman in Medicine Director this year and a fourth-year medical student at the University of Texas Medical Branch. I am joined today with one of my committee members.
Carolyn Vo: Hi, my name is Carolyn Vo. I am currently a second-year at Touro Nevada. We will be your host today.
Madeline Pan: We are really excited to introduce a very special guest for this episode, Dr. Rachel Lee. Dr. Lee is a board-certified allergist, immunologist, and internal medicine physician who started her medical school journey as a part of the Health Professions Scholarship Program. After completing residency training at Naval Medical Center San Diego and fellowship training at Scripps Clinic, she served for over 20 years as a medical officer in the United States Navy before retiring as a captain. Today she is a professor in the Department of Medicine at UC San Diego School of Medicine and a professor of medicine at the Uniformed Services University of the Health Sciences in Bethesda, Maryland. We are grateful to have you today with us, Dr. Lee. How are you doing?
Dr. Lee: I’m doing well. Thanks so much for inviting me to speak on this forum here.
01:38 — What led Dr. Lee into medicine and HPSP
Madeline Pan: Since we are filming this episode with the pre-health audience in mind, could you start by telling us what initially inspired you to pursue medicine and when did the Health Professions Scholarship Program, or HPSP, first come onto your radar?
Dr. Lee: Yeah, so I will say that when I was younger, this is way back before Google and social media, so back in the nineties when I was finishing college. I was really, you know, everybody goes through that journey of figuring out what do we want to do when we grow up, right? And I definitely wanted to do something in healthcare.
03:48 — How the Health Professions Scholarship Program works
Madeline Pan: For students who may not be familiar with the program, can you explain how the Health Professions Scholarship Program works and what it offers to aspiring healthcare professionals?
Dr. Lee: Yeah, so the Health Professions Scholarship Program is a military-sponsored program where they are training future medical officers. For medical school, they offer a full scholarship for all four years of medical school, and during that time you get a stipend for living expenses and they pay for all your books and supplies and everything.
07:05 — Branch options and different paths into military medicine
Carolyn Vo: Do students have preferences for different branches, or is it kind of like a self-finding journey about which branch?
Dr. Lee: Yeah. So there’s actually several ways into military medicine. Mine was before med school I applied and I got accepted before starting med school. Some people are already in residency and they realize they have all this debt, and they’ve actually joined during residency.
09:00 — What to consider before choosing military medicine
Carolyn Vo: For pre-health students interested in this program, what are the biggest considerations that they should keep in mind when deciding if it’s a good fit? And you may have already answered this previously, but what was the deciding factor for you?
Dr. Lee: So I think personally it was really just not having a huge debt at the end and just having that burden. But looking back and looking at current students and residents and fellows and kind of young junior staff attendings, I think everybody in medicine is very like probably type A personality. The military really will say they don’t really care too much about your plans. It’s mission first.
12:22 — Advice about purpose and preventing burnout
Madeline Pan: Looking back on your journey, what is the most significant piece of advice you heard as a pre-health student that has shaped your journey the most?
Dr. Lee: I think one of the biggest things that helped me figure out what I want to do and going into medicine and figuring out my career and various jobs that I’ve had along the way really is choosing a career where we can serve our community. I think that even though it sounds very obvious in medicine, there are a lot of people in medicine as you’ve probably seen that that’s really not the reason they choose it. But choosing a career that ultimately gives you a reason to get up every day helps prevent burnout.
14:16 — Unexpected opportunities from the Navy
Madeline Pan: I’d love to hear about some of your experiences in the HPSP program. Were there any unexpected opportunities or perspectives that came from being in the Navy that you would not have had otherwise?
Dr. Lee: There are so many, I don’t even know where to start. My whole family, my parents and relatives and all the people I knew, I never knew anybody in the military. And I didn’t know anybody in medicine actually growing up. But along the way, the military is going to offer a lot of opportunities that you just never even knew existed.
17:46 — How the Navy shaped Dr. Lee personally and professionally
Madeline Pan: How did your experience in the US Navy shape you both professionally and personally?
Dr. Lee: Professionally, I spent my entire early medical life in the military. So I did my internship, residency. I was an internist for a while and then I went back to fellowship and did my fellowship in allergy. The military is very big on education and they will pay for almost any kind of educational opportunity if you want it.
21:14 — Choosing allergy and immunology
Madeline Pan: I also really liked hearing about your personal life and different roles in your family. Your advice and your experiences are going to help a lot of students who are considering the program. So just to change the topic, I’m curious about your specialty. How did you decide on your specialty?
Dr. Lee: I knew nothing about allergy when I went into allergy. I had initially planned to go into infectious disease. But when I was an internist for a few years, I really wanted to be able to go home for dinner every night, or at least most nights. The more interesting thing was why some people got really sick from the same pathogen, whereas other people never got sick.
24:59 — Identity, bias, and navigating stereotypes
Madeline Pan: How has your identity as an Asian woman shaped your experience in medicine? How did you encounter stereotypes in medicine and navigate them?
Dr. Lee: Everybody has biases, right? We all have whether implicit or explicit. As an Asian woman, people didn’t always see a military officer or a doctor. I used to be very mad when I was younger, but now I don’t take it personally.
29:36 — Advice for women advocating for themselves
Carolyn Vo: With being in the HPSP program and the US Navy, what advice would you give to women in medicine advocating for themselves in environments where they may feel outnumbered or less represented?
Dr. Lee: Always making friends, networking, getting advocates, advocating for other people. I think all those create a network of people who will support each other. Ultimately you’re there. Fitting versus belonging. We belong wherever we are.
31:55 — Myths about allergists
Carolyn Vo: As we’re nearing the end of the episode, we had one more fun, lighthearted question for you. What is one myth about allergists that you’d like to debunk?
Dr. Lee: There’s a myth. But I will say several times when I’ve actually talked to other doctors and when they find out I’m an allergist, they are surprised. There are very few allergists out there, and allergy is a very small field, but it’s a great field if you’re interested in it.
33:45 — Closing remarks
Madeline Pan: Is there anything else that you might want to add before we end?
Dr. Lee: Well, I know we have very little time left, but I want to focus on one last thing: the four pillars of well-being in medicine and life — physical, intellectual, emotional, and spiritual. Keeping those in balance can help prevent burnout and keep you grounded.
Madeline Pan: Thank you so much for sharing. You gave us a lot to think about today, and I’m really grateful that I got to hear your advice and listen to your stories. And to our listeners, thank you so much for joining us for this episode of White Coats and Rice. Be sure to follow the podcast and stay connected with the APAMSA.
Dr. Lee: Yeah, so my I can send my email address to you if people want to send me an email if they have questions about HPSP or other things about allergy in general. So I’m happy to respond to emails.
Madeline Pan: Thank you so much again. I think that concludes the session. And to our listeners, we hope you’ve enjoyed today’s episode as much as we did. Thank you for tuning in and keep an eye out for future episodes. Until then, take care.
June 2026: Pride Month
June 2026: Pride Month
From our APAMSA family to you: Happy Pride Month! 🏳️🌈✨
The intersection of being queer, Asian, and in medicine can carry layers of identity, resilience, generational complexity, and joy. This month, we’re celebrating and uplifting queer Asian voices in medicine by centering identity, visibility, and community across healthcare and medical education. We are here, and we matter!
We are launching the Queer Asian Health Equity Series, a programming series held throughout the year dedicated to exploring the intersections of queer Asian identity and health equity in medicine. Our first event in the series is the Queer Asian Voices in Medicine panel, featuring physicians and medical students discussing how their queer and Asian identities shape their journeys, professional development, and approaches to patient care.
A national needs assessment will be launched to better understand and advocate for queer Asian pre-medical and medical students. We want to hear from you!
We will also issue a call to queer Asian physicians to connect queer Asian pre-medical and medical students with mentorship opportunities.
Finally, we will launch our national “Queer Asian Stories in Medicine” digital storytelling project, open to submissions from all, highlighting lived experiences throughout the year.
Together, these initiatives aim to empower the next generation of queer Asian leaders in medicine. While these efforts begin in June in recognition of Pride Month, they will continue throughout the year to support ongoing celebration, visibility, and community-building. We encourage you to participate and engage with these efforts throughout the year.
June 3, 2026
We are launching the Queer Asian Health Equity Series, a programming series that will be held throughout the year dedicated to exploring the intersections of queer Asian identity and health equity in medicine.
Our first event in the series is the Queer Asian Voices in Medicine panel, featuring physicians and medical students discussing how their queer and Asian identities have shaped their journeys in medicine and approaches to patient care and leadership in healthcare. Participants will also have the opportunity to connect with other queer Asians in medicine and engage in meaningful conversation and community-building.
Dr. Elaine Hsiang, Stanford Emergency Medicine Fellow
James Chua, APAMSA President, MS3
Audrey Lam, APAMSA LGBTQIA+ Director, MS3
Day: Wednesday, June 3, 2026
Time: 5 PM PT (8 PM ET)
June 8, 2026
This Pride Month, National APAMSA’s LGBTQIA+ Committee is highlighting Queer Asian Voices in Medicine, a year-long initiative inviting queer Asians in medicine and healthcare to share their stories and experiences.
We want to hear from you! Visit the link below to submit your story. The form will remain open year-round, but please submit by June 22nd to be featured during Pride Month.
June 15, 2026
National APAMSA’s LGBTQIA+ Committee is conducting this needs assessment to better understand the experiences, needs, interests, and priorities of queer Asian pre-medical and medical students. The goal of this survey is to guide future programming, educational content, advocacy efforts, mentorship opportunities, and community-building initiatives that are meaningful, inclusive, and representative of our members.
We want to hear from you! Visit the link below to complete the survey. Responses will be reviewed on a rolling monthly basis, but we encourage early submissions. Your responses are anonymous unless you choose to provide contact information.
Estimated completion time: 5-10 minutes
June 22, 2026
This Pride Month, National APAMSA’s LGBTQIA+ Committee is launching a Queer Asian Physician Mentorship Project to help queer Asian pre-health and medical students connect with physicians and trainees across specialties.
This directory is designed to support conversations around medicine, identity, career development, and community. Visit the link below to view the mentor list.
Response to ICSD Shooting
On May 18, 2026, a shooting at the Islamic Center of San Diego claimed the lives of three members of the mosque community and left others traumatized in the aftermath of this act of hate-based violence. We mourn the lives lost and extend our deepest support to the victims, their families, and the broader Muslim community affected by this tragedy.
National APAMSA strongly condemns Islamophobia, hate-driven extremism, and all forms of violence targeting religious and marginalized communities. Consistent with our previous statements and APAMSA policy compendium, National APAMSA recognizes gun violence as a preventable public health crisis and urges legislators to implement stronger gun safety measures. Places of worship should remain spaces of safety, healing, and community, not fear. We also recognize the courage and heroism displayed by those who acted to protect others during the attack.
As an organization committed to health equity and advocacy, APAMSA stands in solidarity with Muslim communities in San Diego and across the nation. We remain committed to supporting communities impacted by hate, violence, and discrimination, and to advocating for a safer and more compassionate future for all.
Resources
- Islamic Center of San Diego Community Support Fund
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- Donations will support victims, families, and community recovery efforts following the shooting
- bit.ly/supportICSD
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- National Suicide & Crisis Lifeline
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- Call or text 988 for immediate confidential support
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- Disaster Distress Helpline
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- 1-800-985-5990 or text “TalkWithUs” to 66746
- Immediate emotional support after traumatic events
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- Council on American-Islamic Relations (CAIR)
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- https://ca.cair.com/community-resources/
- Community advocacy, reporting resources, and support for those affected by anti-Muslim discrimination and violence
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- Asian Mental Health Collective
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- https://www.asianmhc.org/
- Therapist directory and mental health resources for AANHPI communities
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- APAMSA Mental Health Initiative
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- https://www.apamsa.org/mental-health-initiative/
- APAMSA Resource list
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For questions regarding this statement, please contact the Rapid Response Director, Pehr Williamson at rapidresponse@apamsa.org
Ethan Minh Nguyen, Sponsorship Committee Member
Network Director
Ethan Minh Nguyen is an incoming fourth-year (MS-2) at the University of Missouri-Kansas City School of Medicine in their six-year BA/MD program. Ethan was born and raised in Las Vegas, where he found his passions for minority, rural, and global health advocacy. He joined APAMSA in his first year at UMKC and has since served as the Chapter Junior Publicity Chair (2024-2025) and Co-President (2025-2026).
Ethan is an aspiring Otolaryngologist, where he hopes to work in improving hearing care access across the globe. He currently serves on the executive board with organizations such as Remote Area Medical, Global OHNS Initiative, Global Surgery Student Alliance, and Global Medical Brigades.
Outside of school, Ethan runs a successful vintage wholesale business (@thriftbohue) that curates clothing for vendors across Kansas City and Las Vegas. He is an avid collector of old t-shirts and sweatshirts. He also enjoys rock climbing, updating his Beli, and finding new genres of music.
Jude Nathaniel Saarenas, Sponsorship Committee Member
Network Director
Jude Nathaniel Saarenas is a fourth year pre-medical student at the University of Arizona in Tucson. Born in Cagayan de Oro, Philippines, he immigrated to the U.S. at a young age, now living in Phoenix, Arizona. He is majoring in Physiology & Medical Sciences with minors in Biochemistry and Asian Pacific American Studies. Outside of classes, he also volunteers with a rehabilitation program for the elderly and works as a STEM tutor on campus. He fell in love with APAMSA being Treasurer Intern and later serving as Treasurer for UA Pre-Health APAMSA his sophomore year. His favorite memories included traveling for the annual national conference as well as participating in the Big-Little program. His passion lies in giving back to the AANHPI community, which he aims to integrate into his future medical career. Beyond his studies, he is interested in trying out new restaurants, picking up a good book, and dancing in K-pop covers!
Allison Peng, Sponsorship Committee Member
Network Director
Allison Peng is a first-year medical student at the Yale School of Medicine. She is originally from the Bay Area, CA and studied Neuroscience at UCLA. Through past partnerships, she’s worked with Taiwanese-American and AANHPI communities to advance community-centered care, with a focus on cardiovascular health and nutrition education. She’s excited about neurology and radiology, with a focus on improving stroke diagnosis and treatment. Outside of school, she enjoys developing cafe drink recipes, attending live music events, and exploring the local food scene.