Helen H. Lee, MD, MPH
- Pediatric Anesthesiology
When Helen Lee, M.D., M.P.H., was a new attending at Seattle Children's Hospital, she noticed an interesting trend. Operating room time was regularly dedicated to providing general anesthesia for healthy children with really severe cavities. This caught her attention because she was accustomed to caring for children with indications that are not preventable, like appendicitis or scoliosis. Cavities are preventable. The severity of disease was like nothing she had seen before. What was happening that led to such severe disease? Why was intervention occurring so late in the disease process? Why were racial and ethnic minorities overrepresented in this patient population?
Dr. Lee understood, vaguely, that social determinants of health were a large factor in the supply of the pediatric dental surgical population, but the health disparities were to a degree that she had never noticed with other diseases or surgical indications. Dr. Lee started educating herself about this silent epidemic, and she was struck by the disconnect between medicine and dentistry in the care for these children. She was shocked by the fact that childhood cavities, globally, are the most prevalent chronic disease of childhood.
Dr. Lee became a T32 research fellow to focus on how pediatric oral health disparities manifest at the intersection of medicine and dentistry, specifically, when children present for treatment under general anesthesia, moderate sedation or in emergency departments.
She learned that pediatric dental surgery is, in many respects, an ineffective intervention to change population oral health. As a clinician, that was a revelation. The idea that removing disease did not result in a cure seemed like a cultural shift.
Limited access to general anesthesia services can put pressure on existing systems to treat children under moderate sedation. Dr. Lee studied media reports of children who died at the dentist office, and it became apparent to her that there are several systems-level factors that contribute to safety. The state-to-state variation of these factors, such as minimum clinical training required to qualify for a sedation license, is troubling. Dr. Lee studied patterns and outcomes when children and adults went to the emergency department for a toothache. Toothache pain is treated differently for non-Hispanic Black adults, who are less likely to receive narcotics compared to white patients. Oral health disparities, particularly when medicine and dentistry intersect, represent health inequality and inequity.
Dr. Lee's recent work, which was supported by a FAER mentored research training grant, studied public health interventions as levers to improve population oral health and reduce utilization of pediatric dental surgical services. She looked at Medicaid policy aimed at increasing access to preventive dental care and also studied community access to fluoridated water. Dr. Lee did not observe changes in surgical utilization in association with either of these interventions.
This has led to her current focus on factors that could be changed at the household level. Dr. Lee has interviewed families who present for their child's dental surgery under general anesthesia. What these families have shared with her has completely altered her research perspective.
More About Me
- American Board of Anesthesiology, Anesthesiology, Pediatric Anesthesiology
- American Board of Anesthesiology, Anesthesiology, Anesthesiology - General
University of North Dakota
University of Chicago
United States of America
MEDEX - University of Washington
United States of America
University of Washington
University of Illinois
- 2020-Present: Director of Anesthesia Services, Pediatric Dentistry, University of Illinois at Chicago
- 2019-Present: Admissions Committee, UIC College of Medicine
- 2019: Committee on Diversity, Equity, and Inclusion, Society for Pediatric Anesthesia
- 2019: Steering Committee, Women's Enhanced Leadership Initiative, Society for Pediatric Anesthesia
- 2019-Present: Scientific Advisory Board, JDR Clinical & Translational Science
- 2018-Present: Reviewer, Journal of Dentistry for Children
- Visiting Professor: Department of Anesthesiology, Case Western Reserve University, Cleveland, Ohio - Improving Outcomes for Surgical Patients (3/2021)
- Panel Moderator: Society for Pediatric Anesthesia - What Would SPA Members Do: Clinical (2/2021)
- Speaker: Equitable Professional Advancement Workshop, Diversity, Equity, and Inclusion Committee, Society for Pediatric Anesthesia - Barriers to Professional Success for Women and Underrepresented Minorities in Medicine (2/2021)
- Invited Speaker: Institute for Healthcare Improvement Conference, Orlando, FL - Open Wide: Dental Safety and Quality, From Sealants, to Scaling, To Sedation (12/2019)
- Creator/Speaker: World Cafe Discussion, International Anesthesia Research Society, Montreal, Ontario, Canada - Exploring Healthcare Disparities in Perioperative Medicine: Why Do We Care? (5/2019)
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