Dr. Ashley Brede Ciapciak (pronounced: “chap-chack”), D.M.D, gave an interview informing us about everything from her path into dentistry, her work with AGAPE, a grassroots organization for children affected by HIV/AIDS in India, and her experience on “Dentist TikTok.”
By Malena Peters
Introduce yourself/tell me a little bit about yourself and your path to becoming a dentist!
I’m Dr. Ashley Ciapciak, DDS. I graduated dental school in 2020 My bachelors degree was in biology with a minor in psychology. My grandfather was a dentist, my father was a dentist— it’s hereditary at this point.
When did you get into dentistry?
I trained under my dad starting at age 13 in 8th grade. I worked chair side with him, learning how to suction, clean rooms and sterilize instruments every summer. I first worked for him as a dental assistant and was able to get certified and licensed simply through chair side hours. That’s no longer possible— nowadays, you have to go through a chair side course. I applied to dental school— I didn’t even really have a backup plan! I was so sure I was going to become a dentist. I graduated and now work in a private practice together with my father outside of Boston.
You also run a clinic in India that provides dental care for HIV-diagnosed orphans, which is amazing. Can you tell me a little bit about that?
Sure! So I originally started dental assisting because Dr. Brede, my father, needed someone to come with him to an orphanage, AGAPE, in Hyderabad, India, in around 2008 or 2009.
AGAPE is an orphanage for children afflicted with or affected by AIDS. It’s a small, grassroots organization that was established in 2004. The orphanage was created by a woman my family knew in the finance sector, and she had my father as her dentist— so she essentially just invited him to come along, and we took the opportunity. The health care disparity in India is very large at the moment: essentially, if you’re an orphan and have no one to care or pay for you, you’re not guaranteed healthcare. When we go, we hire local dentists to work alongside us, and we’re in touch with two local dental schools to sort of act as a buffer for whatever problems we might run into. Our clinic is up to the standards of american healthcare— we can do full x-rays, full exams, but at no cost to the kids. We don’t bill for anything.
What does a typical day at AGAPE look like?
We’ll be on site, in the orphanage, for 6 clinic days. We end up only treating kids for 4.5-5 of those clinic days, which sounds nuts, because we have 300 kids to see. We have a team of 8. The kids are in a school up to 10th grade, with 2 years of a precollege program, and we’ll pull them from their class— so, for example, we’ll take all the second graders, which is about 30 kids. They’ll show up on our stoop at 8am. The first thing we do is give them a chlorhexidine mouthwash and go over brushing instructions as a group. Then we start a triage team— I usually try to have dental students do this if they’re any with us. Depending on the issue (i.e. teeth messing, big cavities), we’ll coordinate them with the doctor they’re supposed to see. Every kid gets x-rays done, which is great. Not every child needs to see the dentist, about 40% get away with just a cleaning. Once we work through the second graders, we send them back, and we start the whole process allover again. We typically work 8am to 8pm with staggered lunch, so the clinic is running all day. At 9, we’ll go back home and eat dinner, go to bed, and then we do it all again. We try to spend one day in Hyderabad itself, and on our last day the kids prepare a send-off ceremony for us— it’s adorable.
That sounds incredibly eventful– how do you manage to fit everything into 3.5-5 days?
Well, if there’s a child that really needs a lot of work— if they have a dental disease or need multiple fillings or extractions, we break it down over multiple days, and have them come back 3 to 4 times a week. That way, it’s not too overwhelming for the kids, and you avoid reaching toxicity levels in lidocaine dosage. If more kids need to come back repeatedly, we also end up working more.
What are some of the more common dental issues you treat there?
We used to see a lot more really bad cavities. In the earlier years, the children didn’t really know much about dental upkeep and healthy. We used to have to do a lot of extractions, both primary and adult teeth, just because the teeth are so decayed. By now, the dental state of the kids in the orphanage has significantly improved— they’re more educated, they know how to brush and take care of their teeth, so we’ve had to work a little less more recently than when we first stated. We find ourselves doing way more cleanings and fillings, and orthodontics if we can. Pathology wise, there are some things you see there that aren’t as common in the United States. We see a lot of fluorosis because the well water they drink is so high in fluoride. If you have too much fluoride in your water while your teeth are developing, the teeth become chalky and spotty. We’ll also see more congenitally missing teeth, which seems to be a common genetic component.
AGAPE sounds incredible and like a lot of hard work. As a student who harbors an avid interest for humanitarian work as well as pre-med, this is a perfect examination of the culmination of those two interests. How would you suggest getting involved in humanitarian events like this?
There’s probably more formal ways to get involved in things like this than AGAPE— it’s a very small clinic that we run. I do most of it: I email volunteers, I put flights together, I run the social media sites… there’s only eight of us, since we can only fit that many people in the clinic at a time. However, there’s larger organizations and a lot of Dentists Without Borders type groups that aim to bring dental care to underserved areas and populations of the world. Lack of dental care a problem everywhere, including in our own back yards— I used to work in federal prison and there’s lots of problems that should be addressed in that system as well.
Yeah, you mentioned this in a virtual shadowing session you gave (via Club Med)— I remember you saying that the U.S. incarceration system refuses to pay for dentures if inmates aren’t going to be in the system for a long time.
Oh yeah, that too— I was thinking more about the fact that inmates also make dentures for other inmates. Obviously, this means that the dentures never fit well and do not uphold a professional standard in any way, shape or form. When someone has to keep that denture for 10 years and you start asking yourself “Why doesn’t this fit? Why is this bite crooked?” the answer is that it comes from an inmate-funded or inmate-based lab. There’s many issues there, so there’s definitely more “local” ways to get involved too.
As to other humanitarian programs— most dental schools offer programs to their students where you can go for a week and serve an underserved population while you’re in dental school. But before that, as a pre-dental student, you legally can’t do too much— for example, in India, we could have a pre-dental student clean rooms and instruments, but only the older kids are really allowed to practice and learn on sight. It might be difficult to do anything or find opportunities as an unlicensed, pre-dental student. It’s probably something you have to wait on until you’re in school.
Once you’re in dental school, do you have any tips on where to look for get involved?
When you get to dental school, it’s typically offered it to third and fourth year students, which are the years you’re doing clinical care. You almost get inundated with these things! However, it’s a very competitive application process to qualify for these trips, because the schools often fund them—I didn’t apply to any because I had been to India 10 times and felt like I shouldn’t take the opportunity away from someone else. Outside of school, once you’re licensed, there’s different trips offered to you at almost every dental conference you go to.
Those sound like great opportunities. Thank you so much for answering all those questions and all the information regarding further humanitarian opportunities for aspiring dentists! AGAPE sounds like such an incredible institution.
Now, in a complete 180º pivot— I have a couple of questions about your TikTok, @drciapciak! You’re part of this ever-growing community of “healthcare TikTok.” I feel like TikTok is really unique in the sense that there’s a professional presence that doesn’t exist on other mainstream social media platforms.
Yeah, I’ve definitely noticed that too. I honestly don’t know why people follow me! I try to make it fun and give out information that I feel like people don’t necessarily have the most immediate access too. I try to do a lot of Q and As, since dental insurance isn’t required in the United States, not everyone can afford dentistry— so I started my TikTok as a way to try and bridge that gap for people that might not be able to afford care. I didn’t expect people to actually follow me! Now I have to put out content and stuff.
How did you get started? Did any one of your TikToks blow up?
I stared getting about 2000 views a video, and then I had one that got several hundred thousands of views, and I gained a lot of followers from that. There’s definitely some issues with TikTok though: for one, female dentists are really underrepresented compared to the amount of male dentists. Also, some healthcare professionals will recommend things with little to no sources, which bugs me so much— I hate that. I feel like that’s common on TikTok, to claim things with little to no sources. It’s so dangerous because you’re on a platform where there’s just a lot of younger kids and impressionable minds. I try to communicate with people if I feel like what they’re saying is false or if they’re unqualified.
Jumping off of that— what’s the community like between healthcare providers on TikTok? Do people often disagree with each other?
It’s really interesting, because I often find myself more frustrated with content creators in my field than hate comments or other TikTok users. Sometimes I see dental students post TikToks that just aren’t true, and it’s just because they’re probably not up to that part in their curriculum yet. I feel like you can’t really tell people what to do as a first year dental student or suggest that you’re licensed yet. I try to give everyone the benefit of the doubt— everyone comes from a different perspective, everyone has a different lens, and there’s a reason the doctor believes what they’re saying. I still try to make counter videos or intervene whenever I can to clear up misinformation, and there’s more communication than I thought there would be. I’m generally one of the smaller accounts on that whole spectrum though— there’s people that have hundreds of thousands of followers.
It’s sometimes mindblowing to see how many followers some dentists amass. As a student, I feel like it’s a really interesting niche: this generation spends lots of time on phones and social media anyways, and through communities like the medical side of TikTok, there’s the opportunity to actually learn from it. I also feel like connecting with healthcare professionals on social media provides this really personal introspection that you otherwise wouldn’t really get, and it’s so easily accessible! However, as we just discussed, you’re also quite susceptible to misinformation. Are there any dental myths that you’d like to bust?
I’ve made some videos on this. One of them is that getting dental work hurts. It doesn’t need to! This is something that festered from my grandfather’s generation of dentistry. It’s a stigma at this point. Dentistry used to hurt, but there’s such good technology nowadays that you won’t feel anything. Another one is that implants are the saviors of all things. They fail 1 in 20 times, which is still sort of a lot. Another one would be that dentists aren’t doctors— we do the same exact basic training, med students and dentistry students only divulge curriculum in years 3 and 4. I had to know the same exact amount about the body and diagnosing it.
Thank you so much for your time and this incredibly informative interview. Where can people reach you if they’re interested in seeing more of what you do?
Yeah, no problem! My Tiktok is as aforementioned @drciapciak. My private practice’s instagram, where you can see more of my work, is @bredeciapciakdental, and the instagram for AGAPE is @agape_orphan_care.