Spring 2013 - Tufts University School of Dental Medicine
Spring 2013 - Tufts University School of Dental Medicine
Spring 2013 - Tufts University School of Dental Medicine
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MAGAZINE OF THE TuFTs uNIvErsITy dENTAl AluMNI AssOcIATION<br />
SPring <strong>2013</strong> voL. 17 no. 1<br />
<strong>Dental</strong> meDicine<br />
a daughter <strong>of</strong> maine on a<br />
mission to care for rural kids<br />
PLUS: mexican PartnerShiP n bio rePair Kit n 2020 viSion
first impression<br />
A Handy Craft<br />
During the 19th century, sailors aboard the “lightships” (floating lighthouses)<br />
<strong>of</strong>f the Nantucket South Shoals developed the craft <strong>of</strong> weaving rattan baskets<br />
with a solid wood base. Now known as Nantucket lightship baskets, they are<br />
prized as examples <strong>of</strong> American folk art. Lauren Murphy, D13, started making<br />
the baskets when she was 9. Later, when she was weighing which branch <strong>of</strong><br />
the health sciences to pursue, the baskets <strong>of</strong>fered a clue. “I thought about<br />
medicine, veterinary, everything,” says Murphy, <strong>of</strong> Hingham, Mass. “But I love<br />
working with my hands, so dentistry was the perfect fit.” The patience and<br />
attention to detail needed to complete a basket are the same skills needed in<br />
the clinic, she says. “I say the baskets led me to dentistry.”<br />
photo: john soares
contents<br />
SprINg <strong>2013</strong> voLuMe 17 No. 1<br />
features<br />
10 Grassroots Dentistry<br />
Former environmental activist Corie Rowe, G05, D11,<br />
sees dentistry as yet another way to bring social justice<br />
to underserved communities. By David Levin<br />
14 Strength in Numbers<br />
More dentists, especially recent graduates, are choosing<br />
to join large group practices. Economics and the search<br />
for work-life balance are just some <strong>of</strong> the reasons why.<br />
By Helene Ragovin<br />
cover STory<br />
18 Northern Light<br />
Norma Desjardins, D92, the daughter <strong>of</strong> Maine potato<br />
farmers, knows firsthand about the great need for oral<br />
health care in her state’s rural regions. Her children’s clinic<br />
is meant to remedy that. By Jacqueline Mitchell<br />
24 True Grit<br />
What does a feisty German governess do when the Great War<br />
leaves her stranded in America She goes to dental school.<br />
By Julie Flaherty<br />
14<br />
departments<br />
30 Full Circle<br />
When Thanh-Trang Nguyen, D01, was a teenager newly<br />
arrived from Vietnam, Boston’s Dorchester House <strong>of</strong>fered<br />
her a lifeline. Now she’s the dental director there.<br />
By Linda Hall<br />
2 LeTTerS<br />
3 From THe DeAN<br />
4 worD oF mouTH<br />
A ScAN <strong>of</strong> peopLe, pLAceS & eveNTS<br />
8 LAb NoTeS<br />
A reporT oN LeADINg-eDge ScIeNce<br />
33 oN CAmpuS<br />
DeNTAL ScHooL NewS<br />
43 uNiverSiTy NewS<br />
THe wIDer worLD <strong>of</strong> TufTS<br />
44 ADvANCemeNT<br />
gIvINg. growTH. grATITuDe.<br />
37<br />
46 ALumNi NewS<br />
STAyINg coNNecTeD<br />
cover photo: Norma Desjardins, D92,<br />
is filling a void in rural Maine.<br />
photo by patrick McNamara
letters<br />
good reading<br />
I enjoyed the Fall 2012 issue <strong>of</strong> <strong>Tufts</strong> <strong>Dental</strong><br />
<strong>Medicine</strong> on many levels. It was nice to learn<br />
more about Nadeem Karimbux, our new<br />
associate dean for academic affairs and his<br />
interest in the relationship <strong>of</strong> oral health and<br />
systemic disease, which I believe will be the<br />
center <strong>of</strong> our dental universe in the future.<br />
Also our new associate dean for admissions<br />
and student affairs, Robert Kasberg (“A Life<br />
in Balance”), has a very interesting personal<br />
history and commitment to diversity, specifically<br />
seeking prospective students from<br />
rural and urban areas to fill the need for the<br />
shortages in the underserved populations<br />
<strong>of</strong> our cities and rural locations alike. And<br />
finally, the articles about government subsidy<br />
for graduate education (“Will the Safety<br />
Net Hold”) and the cost <strong>of</strong> emergency room<br />
dentistry were informative for many outside<br />
<strong>of</strong> the public health arena, I am sure. A terrific<br />
issue—my compliments to the writers<br />
and staff.<br />
mark r. buttarazzi, d83,<br />
m13p, m15p<br />
Anna Q. Churchill, right<br />
scarborough, maine<br />
remembering dr. churchill<br />
I was sorting through an accumulation <strong>of</strong><br />
60-plus years <strong>of</strong> slides and pictures when<br />
I came across some shots <strong>of</strong> Dr. Anna Q.<br />
Churchill, our microanatomy teacher. She<br />
was an unusual lady. She had helped me<br />
and quite a few other students with her own<br />
revolving student loan fund. No paperwork,<br />
no interest; you paid it back after you<br />
graduated, and it would go to other needy<br />
students.<br />
Dr. Churchill was also a Smith College<br />
graduate. I found this photo (below)<br />
that was taken in 1957 at her 50th Smith<br />
reunion. (She was known for carrying a<br />
parasol on and <strong>of</strong>f campus.) At the time, I<br />
lived and practiced in Northampton, Mass.,<br />
and Dr. Churchill contacted me to ask if I<br />
had an extra room to put up a friend <strong>of</strong> hers<br />
who had accompanied her to the reunion.<br />
(Housing at graduation time is just impossible!)<br />
I was delighted to help her—a small<br />
thing to do after she came through for me<br />
when I was in dire straits. She was a truly<br />
outstanding person.<br />
peter laband, d50, a76p, j80p,<br />
a89p, m93p<br />
south yarmouth, mass.<br />
laurels<br />
<strong>Tufts</strong> <strong>Dental</strong> <strong>Medicine</strong> has been recognized<br />
for writing, graphic design and<br />
overall excellence. The International<br />
College <strong>of</strong> Dentists gave the magazine the<br />
Platinum Pencil Award for Outstanding<br />
Graphic Design for the issues published<br />
in <strong>Spring</strong> 2011 (“Treat the Child, Treat<br />
the Parent”) and Fall 2011 (“Inside Job”).<br />
In the <strong>2013</strong> Council for Advancement and<br />
Support <strong>of</strong> Education (CASE) District I<br />
Communications Excellence Awards contest,<br />
the publication was awarded a Gold<br />
Medal for Best Magazine Writing and a<br />
Bronze Medal for Best Overall Magazine<br />
with a circulation under 25,000.<br />
talk to us<br />
<strong>Tufts</strong> <strong>Dental</strong> <strong>Medicine</strong> welcomes<br />
letters, concerns and suggestions<br />
from all its readers. Address your<br />
correspondence, which may be<br />
edited for space and clarity, to Helene<br />
ragovin, editor, <strong>Tufts</strong> <strong>Dental</strong> <strong>Medicine</strong>,<br />
<strong>Tufts</strong> university <strong>of</strong>fice <strong>of</strong> publications,<br />
80 george st., medford, mA 02155.<br />
You can also fax us at 617.627.3549<br />
or email helene.ragovin@tufts.edu.<br />
dental medicine<br />
volume 17, no. 1 spring <strong>2013</strong><br />
executive editor<br />
huw F. thomas<br />
Dean, <strong>School</strong> <strong>of</strong> <strong>Dental</strong> <strong>Medicine</strong><br />
editor helene ragovin<br />
editorial Director Karen bailey<br />
Alumni editor Vangel r. Zissi, D62, Dg67<br />
Design Director margot grisar<br />
senior Designer betsy hayes<br />
Contributing Writers<br />
gail bambrick, Julie Flaherty, Linda hall,<br />
marjorie howard, David Levin, Jacqueline<br />
mitchell, heather stephenson<br />
Contributing editor bob sprague<br />
editorial Advisors<br />
mark gonthier, executive associate Dean<br />
maria gove tringale, senior Director,<br />
<strong>Dental</strong> Development and Alumni Relations<br />
susan ahearn, senior associate Director,<br />
Alumni Relations<br />
<strong>Dental</strong> Alumni Association<br />
president<br />
John J. millette, D91, a15P<br />
vice president<br />
Joseph P. giordano, D79, Dg84<br />
Assistant secretary/Treasurer<br />
cherie c. bishop, D94<br />
Treasurer nicholas t. Papapetros ii, D91<br />
secretary<br />
Janis moriarty, D94<br />
Directors<br />
michelle anderson, D07, Dg09; rustam<br />
K. DeVitre, Dg76, Di77, D12P; Joanne<br />
Falzone-cherubini, D80; Peiman mahdavi,<br />
D91, Dg94; raina a. trilokekar, Dg88, Di91;<br />
Derek a. Wolkowicz, D97, Dg00<br />
past presidents<br />
Peter a. Delli colli, a69, D73; mostafa h.<br />
el-sherif, Di95; t<strong>of</strong>igh raayai, Dg77, Di82<br />
<strong>Dental</strong> m Club<br />
mary Jane hanlon, D97, chair<br />
mary c. Demello, D86, vice chair<br />
Historian charles b. millstein, D62, a10P<br />
Chapter and Club presidents<br />
steven Dugoni, D79, a08P, a12P, California<br />
robert berg, D03, New York<br />
William n. Pantazes, D90, Dg08, Florida<br />
John a. Vrotsos, Dg82, Greece<br />
Lino calvani, Dg91, Italy<br />
<strong>Tufts</strong> <strong>Dental</strong> <strong>Medicine</strong> is published twice<br />
annually by tufts university school <strong>of</strong> <strong>Dental</strong><br />
medicine, the tufts university <strong>Dental</strong> alumni<br />
association and the tufts university <strong>of</strong>fice<br />
<strong>of</strong> Publications. the magazine is a publication<br />
member <strong>of</strong> the american association<br />
<strong>of</strong> <strong>Dental</strong> editors.<br />
send correspondence to:<br />
editor, <strong>Tufts</strong> <strong>Dental</strong> <strong>Medicine</strong><br />
tufts university <strong>of</strong>fice <strong>of</strong> Publications<br />
80 george st., medford, ma 02155<br />
© <strong>2013</strong> trustees oF tuFts uniVersity<br />
2 tufts dental medicine spring <strong>2013</strong><br />
<strong>Tufts</strong> prints green<br />
Printed on 25% postconsumer waste<br />
recycled paper. Please recycle.
from the dean<br />
No Simple Issue<br />
greetings! i have <strong>of</strong>ten<br />
commented in this column<br />
on the tremendous<br />
sense <strong>of</strong> family that characterizes<br />
the <strong>Tufts</strong> <strong>School</strong><br />
<strong>of</strong> <strong>Dental</strong> <strong>Medicine</strong> community.<br />
This was nowhere<br />
more apparent than during<br />
the events surrounding<br />
the terrorist attacks at the<br />
Boston Marathon, which have reminded us all <strong>of</strong> the<br />
importance <strong>of</strong> our friends and family in very challenging<br />
times. I have been so moved and impressed<br />
with the way our school, university and the people<br />
<strong>of</strong> this great city have responded. Our thoughts and<br />
prayers remain with all those affected by this tragedy.<br />
That sense <strong>of</strong> caring about the communities in<br />
which we live is highlighted in our lead story in this<br />
issue, which explores many <strong>of</strong> the challenges facing<br />
our pr<strong>of</strong>ession. Access to oral health care, especially<br />
in rural areas, presents a significant national problem.<br />
The situation in Maine illustrates this issue—<br />
a shortage <strong>of</strong> dentists, low reimbursement policies<br />
and a patient population that is largely unaware <strong>of</strong><br />
the benefits <strong>of</strong> sound oral hygiene to their oral and,<br />
indeed, general health until a problem arises. We are<br />
all grateful to dentists like Norma Desjardins who<br />
choose to practice in underserved areas. Through<br />
our externship programs we seek to educate and<br />
encourage our graduates to consider these underserved<br />
regions as possible sites for their future<br />
careers. But if that is all we do, we will allow others<br />
to determine the future <strong>of</strong> oral health-care delivery,<br />
a situation that is unfortunately playing out in many<br />
areas <strong>of</strong> the country.<br />
The theme <strong>of</strong> increasing access to care, especially<br />
among low-income populations, is continued<br />
in our story about another alumnus, Corie Rowe,<br />
who is opening an <strong>of</strong>fice on Chicago’s South Side.<br />
This article illustrates the multifaceted issues that<br />
we deal with in our understanding <strong>of</strong> access issues.<br />
Simply providing access to care does not ensure that<br />
individuals will take advantage <strong>of</strong> it. Education in<br />
sound oral health-care practices is essential if we are<br />
to make progress in reducing disease.<br />
Our current students are featured prominently<br />
in this issue <strong>of</strong> the magazine and help us appreciate<br />
the outstanding group <strong>of</strong> young women and men in<br />
our dental school classes. For the second year in a<br />
row, our students have been recognized as contributing<br />
the largest number <strong>of</strong> abstracts to the annual<br />
meeting <strong>of</strong> the International Association <strong>of</strong> <strong>Dental</strong><br />
Research, held recently in Seattle.<br />
By the time many <strong>of</strong> you read this, the Class <strong>of</strong><br />
<strong>2013</strong> will have graduated. Let me take this opportunity<br />
to congratulate the graduates on their many<br />
achievements and wish them the very best as they<br />
embark on the next phase <strong>of</strong> their careers.<br />
huw f. thomas, b.d.s., m.s., ph.d.<br />
dean and pr<strong>of</strong>essor <strong>of</strong> pediatric dentistry<br />
huw.thomas@tufts.edu<br />
PHOTO: alOnsO nicHOls spring <strong>2013</strong> tufts dental medicine 3
word <strong>of</strong> mouth<br />
a scan <strong>of</strong> people, places & events<br />
Good Zzzzzs<br />
Mexican students tap into <strong>Tufts</strong>’ dental sleep medicine curriculum<br />
by Helene Ragovin<br />
he field <strong>of</strong> dental sleep medicine was barely out <strong>of</strong> its<br />
infancy when <strong>Tufts</strong> faculty realized the importance <strong>of</strong> training<br />
students to screen, diagnose and treat sleep disorders. In 2009,<br />
the school became the first in the U.S. to incorporate dental<br />
sleep medicine into its curriculum.<br />
But Americans aren’t the only ones whose nights are upended by conditions<br />
such as obstructive sleep apnea, which not only deprive their sufferers <strong>of</strong><br />
much-needed rest but pose significant health risks. So when the <strong>Tufts</strong>-trained<br />
dean <strong>of</strong> a Mexican dental school realized his country could benefit from dentists<br />
with sleep medicine expertise, he reached out to Boston. The result is a<br />
collaboration between <strong>Tufts</strong> <strong>School</strong> <strong>of</strong> <strong>Dental</strong> <strong>Medicine</strong> and the <strong>University</strong> <strong>of</strong><br />
Monterrey (UDEM) that allows students in Mexico to take the <strong>Tufts</strong> class in<br />
dental sleep medicine using distance-learning technology.<br />
“I knew that I had to bring something that would have an impact for our<br />
community,” says Hector Martinez, DG08, dean <strong>of</strong> the UDEM dental school.<br />
“So I turned right back to <strong>Tufts</strong> and asked for help to develop this program.”<br />
The UDEM dental sleep medicine program, now in its second year, is the first<br />
<strong>of</strong> its kind in Latin America.<br />
The course is taught by Leopoldo Correa,<br />
DG11, an associate pr<strong>of</strong>essor <strong>of</strong> diagnosis<br />
and health promotion and head <strong>of</strong> the dental<br />
sleep medicine section at <strong>Tufts</strong>’ Crani<strong>of</strong>acial<br />
Pain, Headache and Sleep Center. UDEM<br />
associate pr<strong>of</strong>essor Hector Cuellar provides<br />
hands-on instruction on his end in Mexico.<br />
With a generation <strong>of</strong> students accustomed<br />
to using Skype and Facetime, the virtual<br />
attendance <strong>of</strong> the Mexican students is fairly<br />
easy to handle, Correa says.<br />
The 24 UDEM students are in their final<br />
year <strong>of</strong> a five-year dental program, all specializing<br />
in a track known as growth and<br />
development. UDEM is a bilingual university,<br />
and the students are tested to assure<br />
their fluency in English.<br />
The prevalence <strong>of</strong> sleep disorders in Latin<br />
America has not been measured extensively,<br />
but a 2008 study in the Journal <strong>of</strong> Clinical<br />
Sleep <strong>Medicine</strong> that examined sleep issues<br />
in four Latin American cities, including<br />
Mexico City, found a “high prevalence <strong>of</strong><br />
sleep-related symptoms and undiagnosed<br />
obstructive sleep apnea,” ranging from 2.9<br />
percent to 23.5 percent <strong>of</strong> the study subjects.<br />
In the U.S., it’s estimated at least 40 million<br />
people have some sort <strong>of</strong> sleep disorder,<br />
and up to 5 percent <strong>of</strong> the population may<br />
have obstructive sleep apnea, in which the<br />
airways consistently become blocked during<br />
sleep. The result, in addition to loud<br />
snoring or gasping, can be sleep that is disrupted<br />
anywhere from a few times to several<br />
hundred times a night. Along with daytime<br />
sleepiness, the periodic lack <strong>of</strong> oxygen can<br />
create a risk for cardiovascular conditions,<br />
such as high blood pressure or stroke, as<br />
well as diabetes and depression. The firstline<br />
treatment is usually a nighttime device<br />
known as a Continuous Positive Airway<br />
Pressure (CPAP), which uses mild air pressure<br />
to keep the airways open during sleep.<br />
For many patients, an oral appliance to help<br />
prevent the collapse <strong>of</strong> the tongue and s<strong>of</strong>t<br />
tissues in the back <strong>of</strong> the throat is used along<br />
with, or instead <strong>of</strong>, the CPAP.<br />
Martinez’s wife, Gabriela Garza, DG09,<br />
works at UDEM’s or<strong>of</strong>acial pain clinic,<br />
4 tufts dental medicine spring <strong>2013</strong><br />
IllustratIons: marc rosenthal
where patients thought to have sleep disorders<br />
are evaluated and diagnosed.<br />
“Most <strong>of</strong> the time patients don’t know<br />
what the problem is,” Martinez says. “In<br />
Mexico, patients don’t visit the dentist to<br />
try and take care <strong>of</strong> sleep problems. All they<br />
know is they are not having good sleep.” If<br />
nighttime restlessness or daytime sleepiness<br />
prompts anyone to take action, the choice is<br />
usually a trip to a physician. So the task for<br />
Martinez and his colleagues was not only<br />
to train dentists in sleep medicine, but to<br />
enlighten physicians and dentists outside<br />
UDEM about the relatively new field.<br />
“Word started to spread about what we<br />
are doing for sleep disorders, and after that<br />
we started growing. We try to give physicians<br />
and dentists guidance on how to manage<br />
their cases,” Martinez said.<br />
“The <strong>University</strong> <strong>of</strong> Monterrey is trying to<br />
take the lead in public awareness <strong>of</strong> the medical<br />
consequences <strong>of</strong> untreated sleep apnea<br />
and sleep disorders,” Correa said.<br />
Mexico’s public health plans do not cover<br />
treatment for sleep disorders, nor do most<br />
private Mexican dental insurance plans,<br />
Martinez said. At UDEM, a private university<br />
where there is an emphasis on community<br />
service, “we can give service to the<br />
low-income community, those who cannot<br />
pay for dental insurance and those who are<br />
not being treated by a government program,<br />
and give them very high-quality dental<br />
treatment, and a type <strong>of</strong> treatment that is<br />
very rare in Mexico,” he says. “People are<br />
now coming from outside Monterrey, from<br />
distant parts <strong>of</strong> Mexico, to have diagnoses<br />
here on sleep medicine. So we’re having an<br />
impact on the whole country.”<br />
Tuning Out the Pain<br />
f you’ve gotten lost in a book or found yourself “in the zone” at<br />
the gym, you’ve been in a kind <strong>of</strong> hypnotic trance, so focused on<br />
the task at hand that time passes unnoticed. Dentists can take<br />
advantage <strong>of</strong> that state <strong>of</strong> mind to help their patients manage<br />
or<strong>of</strong>acial pain, says Teresa Sienkiewicz, a physical therapist who<br />
uses clinical hypnosis to manage her patients’ pain and stress.<br />
A simple technique known as guided imagery is one way healthcare<br />
providers can “manipulate patients’ experiences and alter<br />
their perceptions,” said Sienkiewicz, who spoke at <strong>Tufts</strong> <strong>School</strong> <strong>of</strong><br />
<strong>Dental</strong> <strong>Medicine</strong> last fall as part <strong>of</strong> a speaker series hosted by the<br />
Crani<strong>of</strong>acial Pain Center. Practitioners might ask patients to imagine<br />
physically pushing away the pain or visualize<br />
it swirling down a bathtub drain.<br />
With guided imagery, patients<br />
who can easily reach a deep<br />
trance state can “set their pain<br />
to zero,” said Sienkiewicz, who<br />
specializes in the treatment<br />
<strong>of</strong> facial pain and headaches.<br />
But even for the control freaks<br />
among us—those who are<br />
generally less susceptible to<br />
hypnosis and are capable <strong>of</strong> only<br />
shallow trances—hypnosis can<br />
still help modulate pain.<br />
She recommends using these<br />
techniques in conjunction with<br />
other pain-management strategies,<br />
including medication and cognitive<br />
behavioral therapy. Anyone can become certified in hypnosis, and<br />
some training sessions are specifically designed for health-care<br />
pr<strong>of</strong>essionals. The techniques can also help patients manage their<br />
fear <strong>of</strong> going to the dentist and help improve compliance. “As with<br />
any discipline,” says Sienkiewicz, “the real learning happens when<br />
working with patients.”<br />
Sienkiewicz cited peer-reviewed research, published in 2009 in<br />
the European Journal <strong>of</strong> Pain, which found that hypnosis can help<br />
patients manage the pain associated with fibromyalgia. Though<br />
it’s not known exactly how it works, the same study found that<br />
hypnosis induces measurable physical changes in the thalamus,<br />
prefrontal cortex and insular cortex,<br />
all regions <strong>of</strong> the brain associated<br />
with emotions, suggesting that<br />
hypnosis reduces pain by altering<br />
those brain structures.<br />
Ironically, it can be tough<br />
to assess the effects <strong>of</strong> hypnosis<br />
in a controlled study. Any<br />
kind <strong>of</strong> caring attention from<br />
a health-care provider seems<br />
to have a positive effect on<br />
pain management and patient<br />
compliance with follow-up<br />
care, Sienkiewicz said. It turns<br />
out that good chairside manner<br />
can be as powerful as the<br />
power <strong>of</strong> suggestion.<br />
—jacqueline mitchell<br />
spring <strong>2013</strong> tufts dental medicine 5
word <strong>of</strong> mouth<br />
Why Do We Avoid Health Care<br />
Brain science may <strong>of</strong>fer answers by Gail Bambrick<br />
ear <strong>of</strong> pain and general anxiety about the dentist cause<br />
many patients to neglect their oral health. Kelly Kimiko<br />
Leong, D14, is conducting basic research at the National<br />
Institutes <strong>of</strong> Health to identify what parts <strong>of</strong> the brain<br />
are activated when we make such decisions—science that could<br />
lead to a better understanding <strong>of</strong> the issues that prompt patients<br />
to avoid seeing a dentist or physician.<br />
“I have always been interested in what motivates or prevents<br />
people from taking care <strong>of</strong> their health,” Leong says. “In dentistry,<br />
we <strong>of</strong>ten focus on maintenance, or correcting a problem, such<br />
as filling the cavity. But if you’re scared to come to the dentist<br />
because you have anxiety, how can we alleviate these worries so<br />
you will want to take care <strong>of</strong> yourself”<br />
Leong, one <strong>of</strong> only four dental students in the country selected<br />
for the inaugural class <strong>of</strong> the National Institutes <strong>of</strong> Health (NIH)<br />
Medical Research Scholars Program, is spending this year at the<br />
NIH campus in Bethesda, Md.<br />
She’s working at the National Institute <strong>of</strong> Mental Health, in<br />
the lab <strong>of</strong> cognitive neuroscientist James Blair, where researchers<br />
are using functional magnetic resonance imaging (fMRI) to<br />
determine which neural pathways are activated when we face a<br />
decision involving a moral component<br />
While an MRI produces images <strong>of</strong> internal body structures,<br />
such as bones or organs, an fMRI measures brain activity by<br />
detecting changes in blood flow. When an area <strong>of</strong> the brain is<br />
active, blood flow to that region also increases.<br />
Blair’s lab focuses on understanding children with psychological<br />
disorders and behavioral problems. While this may seem a<br />
far cry from dental anxiety in adults, the basics <strong>of</strong> how the brain<br />
functions when we make decisions could have implications for<br />
many kinds <strong>of</strong> human behavior.<br />
Leong’s assignment is to establish a baseline range <strong>of</strong> responses<br />
<strong>of</strong> mentally healthy adult subjects confronted with a series <strong>of</strong> moral<br />
issues. She presents them with scenarios that illustrate “care-based”<br />
morality (someone inflicting harm on another person) as well as<br />
“social convention” morality (a boy going into a girl’s bathroom).<br />
While undergoing an fMRI, study subjects are asked to decide, on a<br />
scale <strong>of</strong> 1 to 4, if an action is acceptable or unacceptable.<br />
These kinds <strong>of</strong> decisions usually prompt activity within the limbic<br />
system and temporal cortex regions <strong>of</strong> the brain. Leong and her colleagues<br />
use the fMRI to look even more closely to identify the specific<br />
neural pathways that show increased blood flow and oxygen, a signal<br />
known as the BOLD (Blood Oxygen Level Dependent) response.<br />
Once these adult baselines have been established, researchers can<br />
compare them with the responses <strong>of</strong> children with psychological and<br />
behavior problems who will undergo similar tests.<br />
Leong says she’s always been equally intrigued by research and<br />
human behavior (she did her undergraduate work in psychology and<br />
molecular and cell biology at the <strong>University</strong> <strong>of</strong> California, Berkeley).<br />
Before coming to <strong>Tufts</strong> <strong>School</strong> <strong>of</strong> <strong>Dental</strong> <strong>Medicine</strong>, she was a student<br />
researcher at the <strong>University</strong> <strong>of</strong> California, San Francisco’s Marshall<br />
Laboratory, where she investigated dental implant materials that promote<br />
maximum bone healing around the implant.<br />
She is hoping to find a niche in the dental pr<strong>of</strong>ession that will<br />
allow her to meld her interests in psychology, neuroscience and<br />
dental research. Her mentors at NIH have advised her to let her<br />
career evolve in line with her passions. She sees research as key<br />
to eliminating the emotional and technological barriers that can<br />
hamper the delivery <strong>of</strong> accessible, state-<strong>of</strong>-the-art dental care.<br />
“To make a mark on how we work, to change the way we look at<br />
procedures and to innovate dental technology is really something<br />
very special,” Leong says. “I think if we can encourage dental students<br />
in their research pursuits, it could have a great impact on the<br />
whole pr<strong>of</strong>ession.”<br />
Gail Bambrick, a senior writer in <strong>Tufts</strong>’ Office <strong>of</strong> Publications, can be<br />
reached at gail.bambrick@tufts.edu.<br />
Kelly Kimiko Leong,<br />
D14, wants a career that<br />
melds her interests in<br />
psychology, neuroscience<br />
and dental research.<br />
6 tufts dental medicine spring <strong>2013</strong> Photo: chrIs hartlove
the<br />
A smattering<br />
<strong>of</strong> dentistry tidbits<br />
to inform, amuse<br />
and amaze<br />
dlist<br />
emergency dentist<br />
23-29 DecembeR<br />
Week when Google searches<br />
for the term “Emergency<br />
Dentist” hit their highest point<br />
during 2012, almost double<br />
that during the rest <strong>of</strong> the year.<br />
20%<br />
Percentage <strong>of</strong> u.s. dental<br />
<strong>of</strong>fices that closed an<br />
average <strong>of</strong> two days after<br />
hurricane sandy, according<br />
to Baird equity research.<br />
$153 milliOn<br />
size <strong>of</strong> the market for dental<br />
services in Boston, according to<br />
dentaltrends—the largest <strong>of</strong> 15<br />
major u.s. cities examined by the<br />
online dental research service.<br />
1982<br />
Publication year <strong>of</strong> the children’s<br />
book Doctor De Soto, by William Steig, about a clever<br />
mouse dentist who outwits a sneaky fox patient.<br />
11%<br />
Respondents to a dentek oral<br />
care survey who said they will<br />
floss anywhere. the majority<br />
(75%) said they floss at home<br />
in the bathroom.<br />
300+<br />
virtual bulletin boards<br />
titled “dental” on the<br />
website Pinterest.<br />
how dentists fared in a 2012<br />
gallup poll that asked the<br />
public to rate 22 pr<strong>of</strong>essions<br />
based on their honesty and<br />
ethical standards.<br />
minutes<br />
How long the Tooth Tunes<br />
toothbrush plays music by<br />
the boy band One Direction<br />
to encourage young fans to<br />
brush longer.<br />
Aspiring bakers<br />
who entered the<br />
valentine’s day<br />
bake<strong>of</strong>f sponsored by<br />
the tufts chapter <strong>of</strong> the<br />
american dental education<br />
association. First place went<br />
to avanthi tiruvadi, d16, for<br />
a t<strong>of</strong>fee cake; second place<br />
to Julia caine, <strong>of</strong> research<br />
administration, for her<br />
mousse cake.<br />
6<br />
PROOF<br />
alcohol content<br />
<strong>of</strong> bourbon- and<br />
scotch-flavored<br />
toothpastes that<br />
went on sale in<br />
1954, and were<br />
written about in<br />
Life magazine.<br />
1,050<br />
Number <strong>of</strong> false teeth<br />
in “Apex Predator. Oxfords Shoes,” a 2010<br />
sculpture by the London artists Mariana<br />
Fantich and Dominic Young.<br />
Photos: Book, kelvin ma; shoes, Fantich and young; istockPhoto<br />
spring <strong>2013</strong> tufts dental medicine 7
leading-edge science<br />
regeneration<br />
multipurpose cells could act as biological repair<br />
kits, treating diseases that won’t get better on<br />
their own by David Levin<br />
for most <strong>of</strong> us, minor<br />
wounds are just an inconvenience.<br />
We endure the minor<br />
pain <strong>of</strong> a cut or scrape, stick on<br />
a bandage and within a week,<br />
our skin looks like nothing ever<br />
happened.<br />
In some cases, though,<br />
healing isn’t so simple.<br />
Somewhere along the way,<br />
the complex chain <strong>of</strong> events<br />
that lets the body repair itself<br />
breaks down, and a wound<br />
remains open, raw. Such is<br />
the case with those who suffer<br />
from chronic foot ulcers, a<br />
nonhealing wound common<br />
in diabetics.<br />
“For these foot ulcers,<br />
there are a variety <strong>of</strong> therapies,<br />
but they are only successful<br />
in roughly half the cases,<br />
and [the ulcers] have a high<br />
recurrence rate,” says Jonathan<br />
Garlick, head <strong>of</strong> the Division<br />
<strong>of</strong> Cancer Biology and Tissue<br />
Engineering at <strong>Tufts</strong> <strong>School</strong> <strong>of</strong><br />
<strong>Dental</strong> <strong>Medicine</strong>. If the wound<br />
doesn’t heal, sometimes the<br />
only recourse is to amputate<br />
the limb.<br />
Garlick’s research could one<br />
day help patients avoid that<br />
kind <strong>of</strong> traumatic outcome.<br />
He studies pluripotent stem<br />
cells—a type <strong>of</strong> all-purpose<br />
A microscopic view<br />
<strong>of</strong> fibroblast cells<br />
grown from a patient’s<br />
nonhealing, diabetic<br />
foot ulcer.<br />
cell that has the potential to<br />
become any type <strong>of</strong> tissue in the<br />
human body. Once cells like<br />
these are harnessed in the lab,<br />
he says, researchers can implant<br />
them directly into damaged<br />
tissue to stimulate healing.<br />
It’s a radical new way<br />
<strong>of</strong> thinking about treating<br />
disease, and it <strong>of</strong>fers possible<br />
cures for chronic conditions<br />
that may not otherwise heal<br />
on their own‚ from diabetic<br />
foot ulcers to heart disease<br />
and even periodontal disease,<br />
where lingering inflammation<br />
can lead to bone and gum loss.<br />
“There are millions <strong>of</strong><br />
patients suffering from chronic,<br />
nonhealing conditions like<br />
these,” says Garlick, a pr<strong>of</strong>essor<br />
<strong>of</strong> oral and maxill<strong>of</strong>acial<br />
pathology. “That suggests that<br />
we have a lot <strong>of</strong> work to do.”<br />
The challenges he and other<br />
pluripotent stem cell researchers<br />
face, however, have <strong>of</strong>ten<br />
been more political than scientific.<br />
Until several years ago,<br />
the only way to obtain such<br />
cells has been to harvest them<br />
from human embryos that are<br />
several days old; those tiny<br />
balls <strong>of</strong> cells ultimately grow<br />
into muscle, nerves, skin and<br />
bone in the womb. Because<br />
embryos develop from fertilized<br />
human eggs, opponents<br />
<strong>of</strong> their use in research argue<br />
that scientists should not be<br />
allowed to work with them<br />
in the lab, a stance that has<br />
sparked heated debate over the<br />
embryo’s role in the quest for<br />
stem cell therapies.<br />
Garlick’s research, however,<br />
might allow scientists to sidestep<br />
these moral conundrums.<br />
Using a process Japanese<br />
researchers developed in 2006,<br />
he and his team “reboot” cells<br />
from freshly removed foreskins<br />
(yes, foreskins), forcing<br />
them to revert to an embryonic<br />
cell-like state by adding four<br />
genes to the cells’ DNA. The<br />
resulting cells, called induced<br />
pluripotent stem (iPS), acquire<br />
the ability to develop again<br />
into different kinds <strong>of</strong> cells.<br />
“These alternative cells are<br />
really at the crux <strong>of</strong> our scientific<br />
questions,” says Garlick.<br />
“Are induced pluripotent<br />
stem cells the equivalent to<br />
embryonic stem cells in terms<br />
<strong>of</strong> their potential therapeutic<br />
value Do they hold the same<br />
promise for human therapies<br />
in the future”<br />
To find out, Garlick and<br />
his colleagues are trying to<br />
better understand some <strong>of</strong> the<br />
biochemical processes that let<br />
the cells “reboot” in the first<br />
place. He says it all goes back to<br />
DNA—or rather, the myriad<br />
ways that cells interpret DNA.<br />
Genetic Recipes<br />
As you may remember from<br />
high school biology, the information<br />
in a DNA molecule is<br />
a master plan for the entire<br />
body. It’s a genetic cookbook<br />
<strong>of</strong> sorts—inside, it contains<br />
recipes for creating bone cells,<br />
muscle cells, skin cells or any<br />
other type <strong>of</strong> cell. Somehow,<br />
though, in the face <strong>of</strong> all this<br />
raw information, cells know<br />
exactly where to start reading.<br />
A healthy liver cell homes<br />
8 tufts dental medicine spring <strong>2013</strong>
“WHAT’SREALLYSPECIALABOUTTHEEPIGENOMEISTHAT<br />
ITGIVESCELLSTHEABILITYTOREGULATEWHICHGENESARE<br />
EXPRESSED,WITHOUTALTERINGINFORMATIONSTOREDIN<br />
THEDNAITSELF.”—Jonathan Garlick<br />
in on recipes relevant to liver<br />
cells, and a healthy nerve cell<br />
will focus only on recipes that<br />
make nerve cells.<br />
This selective reading <strong>of</strong><br />
DNA is made possible by a<br />
biochemical control system<br />
called the epigenome.<br />
Like a set <strong>of</strong> bookmarks, it<br />
highlights certain sections<br />
<strong>of</strong> DNA, allowing specific<br />
genes to “turn on” as a cell<br />
develops. The epigenome can<br />
also “mask” parts <strong>of</strong> DNA,<br />
effectively turning those genes<br />
<strong>of</strong>f. By selecting which genes<br />
can be activated at a given<br />
time, the system guides cells<br />
to develop into specific types.<br />
“What’s really special about<br />
the epigenome is that it gives<br />
cells the ability to regulate<br />
which genes are expressed,<br />
without altering information<br />
stored in the DNA itself,” says<br />
Garlick.<br />
The epigenome is also key<br />
to creating iPS cells. The four<br />
genes that Garlick’s lab add to<br />
skin cells can rearrange these<br />
DNA “bookmarks,” making<br />
only specific parts <strong>of</strong> the DNA<br />
cookbook (the parts needed<br />
to make an embryoniclike<br />
cell) available for browsing.<br />
As a result, the cell is reprogrammed<br />
back to its original<br />
embryonic state.<br />
Understanding the epigenome<br />
has big implications for<br />
understanding disease, Garlick<br />
notes. A patient may have flawless<br />
DNA, but if his or her cells<br />
are reading it wrong, well, there<br />
are going to be problems. He<br />
thinks these epigenetic glitches<br />
might cause some nonhealing<br />
disorders—and that iPS cells<br />
could <strong>of</strong>fer a tantalizing cure.<br />
“If we can understand the<br />
epigenome in iPS, we can think<br />
about using cells derived from<br />
them to treat a chronic wound<br />
or periodontal gum defect that<br />
doesn’t heal, and potentially<br />
reverse those defects,” he says.<br />
Although iPS cell therapy is<br />
promising, it’s not yet a magic<br />
bullet. Clinical trials, slated to<br />
begin in Japan by March 2014,<br />
haven’t yet been approved in<br />
the United States. The field<br />
is so new, Garlick notes, it’s<br />
unclear whether iPS cells can<br />
be used in humans without<br />
complications. “We have to<br />
be 100 percent sure that any<br />
cell derived from an iPS won’t<br />
give rise to a tumor,” he says.<br />
“That’s going to be a big challenge<br />
to the field.”<br />
In the meantime, he and his<br />
team are using tissues grown<br />
from iPS cells to study diabetic<br />
foot ulcers in the lab. “By using<br />
A colony <strong>of</strong> human-induced pluripotent stem cells. Each <strong>of</strong> the cells in this<br />
cluster has the potential to remain a stem cell or can be stimulated to<br />
become a more specialized cell type with therapeutic potential.<br />
iPS-derived cells to engineer<br />
skinlike tissues, it’s possible<br />
to examine the behavior and<br />
biology <strong>of</strong> diseases in ways we<br />
couldn’t do in humans,” he<br />
says. “Essentially, we have a<br />
surrogate for a human right on<br />
our lab bench.”<br />
In a dish filled with orange<br />
fluid, he points out a translucent,<br />
dime-sized puck. It’s<br />
human skin tissue grown<br />
from iPS cells. Garlick’s team<br />
is using it to examine how<br />
the cells might behave once<br />
transplanted into a patient. Up<br />
close, it looks like an insignificant<br />
blurry mass, yet what it<br />
represents is something much<br />
bigger. By using tissues like<br />
these to gain a deeper understanding<br />
<strong>of</strong> what makes new<br />
iPS-derived cells tick, Garlick<br />
says it may one day be possible<br />
to create a sort <strong>of</strong> biological<br />
“repair kit” to treat nonhealing<br />
diseases in the mouth and<br />
throughout the body.<br />
“<strong>Dental</strong> research like this<br />
contributes to an understanding<br />
<strong>of</strong> basic disease processes<br />
that are broadly relevant to the<br />
entire body,” he says. “After all,<br />
our mission as dentist-scientists<br />
is to advance both oral and<br />
systemic health—to reduce<br />
the burden <strong>of</strong> disease, and to<br />
improve quality <strong>of</strong> life.”<br />
David Levin is a freelance<br />
science writer based in Boston.<br />
IMAGES: IPSC CORE LAB/SCHOOL OF DENTAL MEDICINE<br />
spring <strong>2013</strong> tufts dental medicine 9
Former environmental activist Corie Rowe parlays his<br />
commitment to social justice into caring for an urban neighborhood<br />
grassroots<br />
By DaviD D Levin<br />
photographs by DaviD johnson<br />
the last thing corie rowe, g05, d11, wanted<br />
was to become a dentist. His first experience<br />
in the chair, as a young boy in Jamaica, was so<br />
dreadful that he swore it would be his last.<br />
After studying mathematics and environmental<br />
science at Bradford College in Massachusetts,<br />
Rowe test-drove some pretty diverse career paths,<br />
starting with grassroots community work with<br />
local and national environmental organizations<br />
in Boston (he holds a master’s degree in urban<br />
and environmental policy from <strong>Tufts</strong>). In the late<br />
1990s, during the dot-com heyday, he worked as<br />
a network engineer. Then it was public health: he<br />
studied access-to-care issues as a research associate<br />
at the <strong>University</strong> <strong>of</strong> California, San Francisco.<br />
A divergent path, for sure. Along the way, he<br />
went back to the dentist (his second experience<br />
was positive), and he started thinking that dentistry<br />
could be a powerful way to improve health<br />
in low-income African American communities.<br />
Now, nearly two years after earning his<br />
D.M.D., Rowe has obtained a loan and expects<br />
to open a clinic this spring on Chicago’s South<br />
Side. He talked to <strong>Tufts</strong> <strong>Dental</strong> <strong>Medicine</strong> about<br />
how his experiences helped shape his approach to<br />
dentistry.<br />
spring <strong>2013</strong> tufts dental medicine 11
<strong>Tufts</strong> <strong>Dental</strong> <strong>Medicine</strong>: So your first<br />
experience with dentistry almost drove<br />
you away from the field permanently<br />
Corie Rowe: Yes! At the time, I was a kid in<br />
Kingston, Jamaica, with a typical Caribbean<br />
upbringing—kites, soccer from dusk till<br />
dawn, hurricanes, running around barefoot.<br />
I was really independent, so when I<br />
had a toothache one day, I was just told to<br />
go find this clinic around this corner all on<br />
my own. I wound up with an extraction <strong>of</strong><br />
one <strong>of</strong> my molars—number 30, in the lower<br />
right. Knowing what I know now as a dentist,<br />
I’m sure it could have been saved with a<br />
root canal, but back in those days, they just<br />
did extractions. So I left the place with a<br />
lump <strong>of</strong> gauze stuck in my mouth, and when<br />
I went home, I fell asleep and woke up with<br />
blood all over the pillow. I was so freaked<br />
out that I wanted to kill the guy. That was<br />
it for dentistry, as far as I was concerned. I<br />
hated it for years.<br />
That’s not an auspicious start. How did<br />
you end up in dentistry<br />
I took kind <strong>of</strong> a circuitous route. I knew I<br />
wanted to stick with science, but I didn’t want<br />
to do purely academic stuff. I wanted it to<br />
apply to something, and I felt the best way to<br />
do that was in environmental science, where<br />
I could have an impact at a grassroots level.<br />
During undergrad, I started working<br />
for a program that the U.S. Environmental<br />
Protection Agency ran at the Franklin Park<br />
Zoo in Boston, helping expose urban youth<br />
to the environment around them, instead <strong>of</strong><br />
just concrete, which is just about all you see<br />
in the city. Later, I worked with Alternatives<br />
for Community and Environment, an outfit<br />
that gives legal assistance to low-income<br />
communities that are trying to prevent<br />
industrial waste facilities from being built in<br />
their neighborhoods. Most <strong>of</strong>ten you won’t<br />
find those sites in wealthy areas <strong>of</strong> a city.<br />
That experience drove home the idea that<br />
environmental issues are really social justice<br />
issues. That resonated with me and inspired<br />
me to start grad school at <strong>Tufts</strong> in environmental<br />
and natural resource management. I<br />
left school for a few years, though, because<br />
my experience with the EPA led to some disenchantment<br />
with the whole environmental<br />
process.<br />
Disenchantment How so<br />
Well, at the community level, you’re on the<br />
street, hearing people’s concerns in person.<br />
In order to do anything about them, though,<br />
you have to wade through the red tape <strong>of</strong> a<br />
government organization. You don’t always<br />
serve the community effectively. I got so<br />
frustrated that I eventually left the environmental<br />
movement and dropped out <strong>of</strong><br />
grad school at <strong>Tufts</strong> for a while. I wound<br />
up switching gears entirely, thanks to some<br />
computer skills I picked up in high school<br />
and college. I was a network engineer at a<br />
Building connections with low-income patients<br />
in 2007, corie rowe ran into a riddle: more children in america’s low-income<br />
communities had access to state-provided dental insurance than<br />
ever before, yet according to the National center for Health statistics,<br />
they also had more cavities.<br />
the problem wasn’t simply that they had no place to go for care.<br />
“even if there’s a clinic around the corner, low-income communities just<br />
don’t have the same education about preventive dental care as you’d<br />
see in more affluent communities,” he says, and so their oral health<br />
may not be as good.<br />
Perhaps something was getting lost in translation between the<br />
academic community and the patients and their parents. rowe, G05,<br />
d11, who at the time was a research associate at the <strong>University</strong> <strong>of</strong><br />
california, san francisco (Ucsf), had read dozens <strong>of</strong> studies that<br />
examined the effectiveness <strong>of</strong> treatments to prevent caries. “Yet very<br />
few <strong>of</strong> those studies examined which treatments community members<br />
actually preferred for their children,” he says. a better understanding<br />
<strong>of</strong> their preferences, he reasoned, could help dentists encourage more<br />
widespread use <strong>of</strong> the available treatments—and therefore lower the<br />
rates <strong>of</strong> decay in these communities.<br />
rowe decided to test his hypothesis in a formal study done through<br />
Ucsf. Based on similar research other Ucsf researchers conducted in<br />
nearby Hispanic communities, he helped design a 10-question survey<br />
examining three common cavity-prevention treatments for children: brushing,<br />
applying a fluoride varnish and using the proven cavity fighter xylitol,<br />
a dietary sugar substitute. Because parents ultimately decide what sort<br />
<strong>of</strong> dental care their children receive, rowe says, he included questions<br />
about two treatments for parents themselves (xylitol gum and chlorhexidine<br />
rinse). the questions directed toward the adults, he theorized, might<br />
tell researchers more about the parents’ own preferences, which could<br />
<strong>of</strong>fer insight into how family habits affect children’s oral health.<br />
rowe administered the survey to 48 low-income african american<br />
adults who lived in Berkeley, calif. they were asked if they felt any <strong>of</strong> the<br />
five treatments were appropriate for a toddler or young child, and then<br />
asked to rate their preferences for each treatment for their own kids.<br />
the 48 parents and guardians said all five treatments were “acceptable,”<br />
but the vast majority chose tooth brushing as the preferred<br />
treatment for their children. the study results were published last year<br />
in the Journal <strong>of</strong> Public Health Dentistry.<br />
rowe attributes the overwhelming preference for brushing to existing<br />
cultural norms. “that’s what their mom and dad taught them to do,”<br />
he says. “that’s what people in their community did, and that’s what<br />
you see people most <strong>of</strong>ten on tV doing.”<br />
a better understanding <strong>of</strong> these treatment preferences, he says,<br />
may give other dentists working in low-income african american communities<br />
an entry point to educate patients about a range <strong>of</strong> effective<br />
oral health practices.<br />
“existing treatment preferences, that’s your hook,” he says. “You<br />
say, ‘Well, i know you value using a toothbrush, and that’s great. But<br />
did you know about xylitol’ and if someone isn’t already comfortable<br />
with these other preventative measures, you can use their knowledge<br />
about their existing treatment preference to get them interested in<br />
that conversation.”<br />
—david levin
telecom start-up called Snapdragon in the<br />
late 1990s, and later moved on to Wired<br />
Business and Alcatel, two other telecom<br />
companies. It was a real dot-com experience.<br />
We were all drunk on the idea <strong>of</strong><br />
being millionaires overnight! But the dotcom<br />
boom went dot-bust pretty quickly, so<br />
things didn’t pan out the way we’d hoped.<br />
Corie Rowe is about<br />
to open a clinic on<br />
Chicago’s South Side.<br />
That’s a big career change. Was it hard<br />
to make the switch<br />
Sort <strong>of</strong>. It was great to get that big paycheck<br />
every two weeks, but I always missed the satisfaction<br />
that I got when I worked with lowincome<br />
communities. That was far more<br />
rewarding than any accolades I could get in<br />
the tech world. Luckily, after a couple years,<br />
I had an epiphany about dentistry.<br />
How did that happen<br />
I finally had a truly great dental experience!<br />
It was around the time I left grad school<br />
temporarily in the late ’90s. I had a cavity,<br />
throbbing pain—something wasn’t quite<br />
right. I hadn’t been to the dentist since I was<br />
a kid, if you can believe it, so I was pretty<br />
lucky that I didn’t have any other problems.<br />
I was nervous, <strong>of</strong> course, but this guy was<br />
fantastic. He gave me local anesthetic, and I<br />
didn’t even feel the needle because he shook<br />
my jaw. That was totally new to me. My perception<br />
<strong>of</strong> the pain was much less than the<br />
horrible experience I had as a kid, so I left<br />
the appointment thinking very differently<br />
about dentistry.<br />
Then, in 2000, the surgeon general’s<br />
report on oral health in America came out.<br />
It was pretty influential—it basically said<br />
that the state <strong>of</strong> oral health in low-income<br />
communities and communities <strong>of</strong> color<br />
was so bad, it was becoming a public health<br />
nightmare. That’s when it hit me: Those are<br />
the same populations I was working with<br />
doing environmental stuff, so if I became<br />
a dentist, I’d have an opportunity to really<br />
make a difference in those communities. So<br />
I got back in touch with <strong>Tufts</strong>, finished the<br />
last few credits on my master’s degree and<br />
applied to dental school.<br />
What was it like to be in dental school after<br />
years <strong>of</strong> doing environmental work<br />
It was like trying to drink water from a fire<br />
hydrant. That’s how fast and furious the<br />
information came at us. Ultimately, though,<br />
it was a blessing. I was talking with some <strong>of</strong><br />
my classmates recently—we’ve only been<br />
out in the real world for a year and a half,<br />
yet we all feel that <strong>Tufts</strong> prepared us really<br />
well for any challenge. Drinking from the<br />
fire hydrant helped us define the boundaries<br />
<strong>of</strong> our own knowledge and gave us the<br />
confidence we needed to teach ourselves<br />
anything we didn’t already know.<br />
How do you think all <strong>of</strong> your experiences<br />
have shaped your approach to dental care<br />
They’ve made me appreciate that dentistry<br />
isn’t just about white, straight teeth. It’s<br />
about total oral health, and systemic health.<br />
How you chew your food, for instance—<br />
that can affect your temporomandibular<br />
joint, which can cause headaches or pain<br />
from chewing. It can affect your whole life.<br />
So how will that translate into your work<br />
at the new clinic in Chicago<br />
The clinic on the South Side is in a predominantly<br />
African American area. My goal will<br />
be to educate my patients on a one-on-one<br />
basis to help them understand how their<br />
oral health ties in to their overall health.<br />
My negative experience with dentistry<br />
also informed my outlook, in that<br />
my practice will use a lot <strong>of</strong> technological<br />
advances to reduce a patient’s perception<br />
and apprehension <strong>of</strong> pain. I know what it’s<br />
like to be terrified when you’re in the chair.<br />
If you give the patient a couple <strong>of</strong> tablets <strong>of</strong><br />
a benzodiazepine, for example, it relaxes<br />
them and reduces their anxiety so you can<br />
get the work done that’s needed. Those are<br />
the individuals who <strong>of</strong>tentimes fall through<br />
the cracks within dentistry—the ones who<br />
are afraid <strong>of</strong> the dentist.<br />
As a new grad, however, one <strong>of</strong> the most<br />
important things we have to keep in mind is<br />
that a dental practice is a small business. The<br />
clinic will be in a storefront on West 95th<br />
Street, where there are a lot <strong>of</strong> other businesses<br />
that have been open for years, so I’m<br />
hoping that’ll help bring in patients. It’ll be<br />
a small practice at first—just me, an assistant<br />
and a front-desk person. But if things<br />
go well, I want to bring in an <strong>of</strong>fice manager,<br />
an insurance verifier and a hygienist. Right<br />
now, I’m just trying to promote the business<br />
the way other small businesses do—go out<br />
and make connections in the community,<br />
work with the local small business bureau,<br />
send out marketing pieces, the works. tdm<br />
David Levin is a freelance science writer in<br />
Boston.<br />
spring <strong>2013</strong> tufts dental medicine 13
Buoyed by economic and social changes,<br />
group practices pick up steam<br />
strength in<br />
numbers<br />
By Helene Ragovin illustration by Federico Jordan<br />
the neighborhood dental <strong>of</strong>fice—<br />
the wood-paneled waiting room stocked<br />
with Highlights magazines and a single<br />
contour chair staffed by a lone dentist—<br />
occupies a corner <strong>of</strong> most 20th-century<br />
memories.<br />
But that scenario has pretty much<br />
gone the way <strong>of</strong> the rotary telephone.<br />
One chair has become 10, 15 or even 20,<br />
with the number <strong>of</strong> dentists practicing as<br />
a group increasing as well. Following a<br />
trend already embraced by other branches<br />
<strong>of</strong> medicine, the number <strong>of</strong> large group<br />
practices and multilocation dental-care<br />
chains has been growing at a faster clip<br />
than ever before, and the new model<br />
<strong>of</strong> dental practice is likely to become as<br />
ingrained in the memories <strong>of</strong> the next<br />
generation <strong>of</strong> patients as the one-dentist<br />
show was to the previous one.<br />
“Solo practice is no longer the only<br />
point <strong>of</strong> entry for a new dentist,” says<br />
Kathleen O’Loughlin, D81, executive<br />
director and chief operating <strong>of</strong>ficer<br />
<strong>of</strong> the American <strong>Dental</strong> Association<br />
(ADA). While there have always been<br />
groups <strong>of</strong> anywhere from two to 10 doctors<br />
working together, O’Loughlin says,<br />
“the emerging model is multiple sites,<br />
sometimes in multiple states, all with an<br />
identical management system in place for<br />
economies <strong>of</strong> scale.<br />
“The solo practice is not going<br />
away—that’s not what the data shows,”<br />
O’Loughlin stresses. “What we’re seeing is<br />
a bifurcated model.”<br />
spring <strong>2013</strong> tufts dental medicine 15
ver the past 25 years, there has been a 10 percent increase in<br />
the number <strong>of</strong> dentists practicing in groups, from 25 percent to 35 percent, according to the<br />
ADA. Among specialists, that number has increased from 32 to 42 percent. The very largest<br />
group practices—those with anywhere from 20 to more than 200 locations—could account for<br />
up to 11 percent <strong>of</strong> the total dental market share by 2015, the ADA estimates.<br />
From a financial standpoint, large group practices make sense. They allow for reduced capital<br />
and operating costs and benefit from economies <strong>of</strong> scale: volume discounts with suppliers<br />
and labs, lower overhead and more attractive reimbursement rates from insurance companies.<br />
A chain <strong>of</strong>fers opportunities for widespread advertising and marketing. And having specialists<br />
within the group means that outside referrals don’t drain revenue from the practice.<br />
But the real efficiency, says Samuel Shames,<br />
D75, managing partner at Gentle <strong>Dental</strong> <strong>of</strong><br />
Massachusetts and director <strong>of</strong> practice management<br />
at <strong>Tufts</strong> <strong>School</strong> <strong>of</strong> <strong>Dental</strong> <strong>Medicine</strong>,<br />
“is that talented dentists are spending time<br />
in the <strong>of</strong>fice doing what they do best—dentistry—and<br />
not spending 20 to 25 percent <strong>of</strong><br />
their time doing other stuff.”<br />
It’s that other stuff—the tasks <strong>of</strong> managing<br />
a business—that can turn dentists,<br />
particularly younger ones, away from solo<br />
practice.<br />
“When you’ve been studying science and<br />
dentistry for eight to 10 years straight, you<br />
can emerge with no perspective as a business<br />
owner. And dentistry is a business,”<br />
says Joey Pedram, DG11, a pediatric specialist<br />
who works for the Pacific <strong>Dental</strong> chain in<br />
Southern California.<br />
At first, David Goldberg, D92, a periodontist,<br />
took the traditional route, buying into a<br />
practice. He discovered that networking to<br />
find patients and establishing relationships<br />
with referring dentists to build his part <strong>of</strong> the<br />
business was as stressful—maybe more so—<br />
than repairing gums and bone. Two years in,<br />
he started working part-time at Gentle <strong>Dental</strong><br />
<strong>of</strong> Massachusetts. “I quickly learned that as a<br />
specialist [in a group practice], I no longer<br />
had to beg to get patients,” he says. Goldberg<br />
eventually left solo practice and became a<br />
partner with Gentle <strong>Dental</strong>, where he now<br />
oversees periodontics for all locations.<br />
Then there’s the cost <strong>of</strong> dental care. “The<br />
ADA is beginning to see that price sensitivity<br />
has become more important” for patients,<br />
O’Loughlin says, as the number <strong>of</strong> people<br />
who have third-party dental coverage has<br />
declined, according to recent surveys. “As<br />
consumerism increases among the public,<br />
more and more patients look to cost as well<br />
as quality <strong>of</strong> care,” she says.<br />
And convenience, <strong>of</strong> course. “Americans<br />
want everything under one ro<strong>of</strong>,” says<br />
Shames. “They don’t want to leave Target to<br />
buy their groceries, and they don’t want to<br />
bounce from a general dentist to an endodontist<br />
to an oral surgeon. Today’s public<br />
is demanding multispecialty practices and<br />
extended hours.”<br />
t<br />
he growth in larger practices<br />
began with the spread <strong>of</strong><br />
employer-provided dental insurance<br />
in the 1970s, and received a boost in<br />
1979, when the Federal Trade Commission<br />
lifted the ban on advertising by dentists.<br />
Not long after, in 1981, Shames and his<br />
partner, Ronald Weissman, started Gentle<br />
<strong>Dental</strong>. Shames had been bringing specialists<br />
into his solo practice—“I was sick <strong>of</strong><br />
patients saying, ‘Can’t you do it here’ ”—<br />
and liked the idea <strong>of</strong> a multispecialty group.<br />
Weissman, meanwhile, was interested in<br />
how advertising and marketing could help<br />
expand a dental practice.<br />
It took some time for multispecialty<br />
practices to take hold with patients, both for<br />
Gentle <strong>Dental</strong> and its counterparts around<br />
the country. It also took time for these large<br />
group practices to be accepted within the<br />
pr<strong>of</strong>ession. Robert Girschek, D92, a partnerowner<br />
<strong>of</strong> Gentle <strong>Dental</strong> who is based at the<br />
Waltham, Mass., location, started working<br />
for the group as a hygienist while a student<br />
at <strong>Tufts</strong> and then joined the dental staff after<br />
graduation. “In 1992, it was still early on,<br />
and, as we’ll all admit, we were shunned by<br />
most dentists,” Girschek says. “But I thought<br />
it was an interesting model.” Gentle <strong>Dental</strong>’s<br />
growth reflects the industrywide trend. The<br />
company, in which the dentist-partners share<br />
equity, now has 26 locations in Massachusetts<br />
and one in New Hampshire.<br />
There are several models <strong>of</strong> group practice.<br />
State practice acts vary on the specifics<br />
<strong>of</strong> whether nondentists can own a dental<br />
practice, or what role a non-dentist can play<br />
in the operation <strong>of</strong> a practice.<br />
Group practices appear to be particularly<br />
attractive to new graduates. According to a<br />
2012 study <strong>of</strong> trends in group practice that<br />
appeared in the Journal <strong>of</strong> <strong>Dental</strong> Education,<br />
dentists who had completed their education<br />
less than 10 years prior were three times<br />
more likely to work for a larger company.<br />
A big driver is economics. Dentists are<br />
leaving school with increasing amounts<br />
<strong>of</strong> debt—the American <strong>Dental</strong> Education<br />
Association puts the average student debt<br />
at $203,000. In addition, since the start <strong>of</strong><br />
the recession, small private practices have<br />
not been hiring new graduates at the rates<br />
they once were, according to the ADA’s New<br />
Dentist Committee. The economic downturn<br />
has also cut into the number <strong>of</strong> older dentists<br />
who are retiring—and that, in turn, has created<br />
a seller’s market for practices and raised<br />
prices for new graduates looking to buy.<br />
But the appeal <strong>of</strong> group practice is about<br />
much more than money, says O’Loughlin.<br />
Young dentists, both male and female, like the<br />
quality <strong>of</strong> life that large group practices provide.<br />
“The Millennial Generation seeks balance<br />
in life,” she says. “They are different from<br />
previous generations—employers have been<br />
talking about that for a number <strong>of</strong> years.”<br />
Still, more women than men do work<br />
in large group practices, according to the<br />
2012 journal study. “When you talk to<br />
woman dentists, the most compelling thing<br />
for them is time,” O’Loughlin says. “They<br />
really value their time as much, or more,<br />
than money, especially when they’re in the<br />
position <strong>of</strong> bearing children and raising<br />
children. Many women dentists are married<br />
to other pr<strong>of</strong>essionals. When you have two<br />
16 tufts dental medicine spring <strong>2013</strong>
actively engaged pr<strong>of</strong>essionals, they really<br />
value their time, want time <strong>of</strong>f together.”<br />
When Nicholas Miller, D08, graduated<br />
from <strong>Tufts</strong>, he wasn’t sure whether he wanted<br />
to stay in the Boston area or return to his<br />
native Michigan. Either way, he needed a job.<br />
Through another <strong>Tufts</strong> alumnus, he got in<br />
touch with the Aspen <strong>Dental</strong> chain.<br />
“I was very honest with them about what<br />
my goals were,” says Miller. Among them<br />
was a steady income that would allow him<br />
to start paying back his loans while living<br />
a comfortable life. Working as an associate<br />
moving among three Aspen <strong>of</strong>fices in suburban<br />
Boston, he was able to do just that.<br />
When he returned to Michigan in 2010<br />
and started looking into buying his own<br />
practice, he weighed the choice <strong>of</strong> setting<br />
out on his own, or buying into the Aspen<br />
network. With private practices in the<br />
Grand Rapids area running anywhere from<br />
$400,000 to $1 million, Miller says, “I think<br />
it’s fair to say that Aspen’s price was two to<br />
three times less than purchasing a private<br />
<strong>of</strong>fice with comparable revenue.” Aspen also<br />
helped provide an attractive financing package<br />
through an outside lender, he said.<br />
In July 2010, Miller purchased an existing<br />
Aspen <strong>of</strong>fice. In the three years since,<br />
he bought another existing <strong>of</strong>fice and a<br />
start-up. “I manage the<br />
clinical end, and Aspen<br />
manages the business,”<br />
he says. “I own the dental<br />
practices and, along with<br />
my team <strong>of</strong> dentists, make<br />
all the clinical decisions in<br />
our <strong>of</strong>fices. What Aspen<br />
provides is the business<br />
framework—pr<strong>of</strong>essional<br />
training, accounting services,<br />
marketing strategy,<br />
insurance operations,<br />
facilities management,<br />
human resources, at my discretion.<br />
“It has given me work-life balance. I am<br />
able to go to work and concentrate on my<br />
patients and not worry about making sure<br />
that the mortgage payment is sent out or<br />
ordering supplies. Then I can go home and<br />
continue to have a life.”<br />
Those feelings are shared by dentists<br />
further along in their careers, too. “I like<br />
to pick and choose my headaches,” says<br />
Girschek, <strong>of</strong> Gentle <strong>Dental</strong>. “The older I get,<br />
the more quality <strong>of</strong> life is important.”<br />
Goldberg, the periodontist, says, “One<br />
<strong>of</strong> the things that stresses dentists out” is<br />
getting stuck on how to handle a difficult<br />
clinical case. “In a group practice, when<br />
you have the benefit <strong>of</strong> specialists working<br />
with you, the whole thing is more synergistic—you<br />
have more minds working on the<br />
same problem.”<br />
R<br />
ecently, more private equity<br />
firms and other corporate entities<br />
have invested in dental<br />
chains because their rapid growth makes<br />
them attractive in a sluggish economy.<br />
Some <strong>of</strong> these companies have come under<br />
scrutiny by various state and federal regulators<br />
regarding the extent to which the nondentist<br />
investors are involved in clinical<br />
decision-making, or, in some cases, in connection<br />
with Medicaid abuses.<br />
Perhaps publicity from those cases has,<br />
to some extent, cast a shadow over the entire<br />
segment <strong>of</strong> the industry—unfairly so, say<br />
O’Loughlin, <strong>of</strong> the ADA, and others.<br />
“You can’t generalize that that behavior<br />
happens just in corporate practices,”<br />
O’Loughlin says. “It happens anywhere people<br />
are not following the rules. It’s important<br />
people don’t make broad assumptions.<br />
If you’ve seen one DMSO [dental services<br />
management organization], you’ve seen one<br />
DMSO. Members <strong>of</strong> ADA agree to adhere<br />
to the ADA Code <strong>of</strong> Ethics that puts the<br />
patient’s best interest at the center <strong>of</strong> the<br />
doctor-patient relationship, and that code<br />
holds for an ADA member regardless <strong>of</strong> his<br />
or her career path,” she says.<br />
Miller, the Aspen owner in Michigan,<br />
says it’s important to confront such assumptions.<br />
“Sometimes dental service organizations,<br />
they do have a stigma,” he says. Both<br />
he and Pedram, <strong>of</strong> Pacific <strong>Dental</strong>, stress that<br />
they oversee all clinical decisions in their<br />
<strong>of</strong>fices. “I have complete autonomy,” Miller<br />
says. “Aspen has never told me how to treat<br />
a patient.”<br />
Another assumption, says Shames, <strong>of</strong><br />
Gentle <strong>Dental</strong>, is that large groups place<br />
inordinate pressure on their dentists to<br />
perform procedures to generate revenue.<br />
Private practice owners, he points out, aren’t<br />
immune to that. “If you buy a practice for<br />
$800,000 and have payroll to meet every<br />
week and rent and loans to repay, there is<br />
much more pressure to produce,” he says.<br />
Traditionally, large chains have seen<br />
high turnover, as young dentists gain<br />
experience and go <strong>of</strong>f to establish their<br />
own practices. Whether that will change<br />
in this fluid economic climate is unknown.<br />
O’Loughlin says the ADA is interested in<br />
collecting more data about turnover rates<br />
as well as other aspects <strong>of</strong> the large group<br />
practice phenomenon.<br />
Pedram, who splits his time between<br />
working at Pacific <strong>Dental</strong> and as an associate<br />
in a private pediatric practice, says his<br />
“<br />
americans want everything under one<br />
rooF. they don’t want to leave target to<br />
buy their groceries, and they don’t want<br />
to bounce From a general dentist to an<br />
endodontist to an oral surgeon.<br />
”<br />
—Samuel Shames, D75<br />
dual experience has allowed him to assess<br />
the benefits and drawbacks <strong>of</strong> each. While<br />
he’s not sure what direction he’ll go in, he<br />
makes this observation: “In a few years, if<br />
I finally want to open my own practice, the<br />
way it’s going now, competing against these<br />
corporations is going to be tough.” tDm<br />
Helene Ragovin, the editor <strong>of</strong> this magazine,<br />
can be reached at helene.ragovin@tufts.edu.<br />
spring <strong>2013</strong> tufts dental medicine 17
Norma Desjardins, D92, knows<br />
how tough it is to find dental care<br />
for kids in rural Maine. She’s on a mission<br />
to make it easier<br />
by jacqueline Mitchell<br />
photography by patrick mcnamara<br />
hen the 8-year-old girl climbed into<br />
the chair, hygienist Williams Rodriguez<br />
wasn’t prepared for what he was about to see.<br />
“Her 6-year molars were completely riddled<br />
with cavities, like a bomb went <strong>of</strong>f,” he says.<br />
The girl’s mother thought her young daughter’s teeth<br />
were all baby teeth, destined to fall out eventually. “I had to<br />
tell her, ‘No, those were supposed to be there forever. If your<br />
kids lose those, that’s a big problem,’ ” Rodriguez says.<br />
Rodriguez says he might well expect to see this kind <strong>of</strong><br />
extensive decay in his native Dominican Republic. He was<br />
stunned to find it in America. Children with rotted-out first<br />
molars, toddlers with tiny sepia-tinged incisors or teenagers<br />
with plaque so extreme it’s cemented along the gum<br />
line are not uncommon at St. Apollonia <strong>Dental</strong> Clinic in<br />
Presque Isle, Maine, where Rodriguez is the only hygienist.<br />
Just 12 miles from the U.S.–Canadian border, Presque<br />
Isle is about as far east and as far north as you can get<br />
and still be in the United States. The downtown <strong>of</strong> rural<br />
Aroostook County’s largest city is little more than an intersection<br />
surrounded by rolling potato fields that are blanketed<br />
by the plants’ white flowers in midsummer.<br />
Norma Desjardins,<br />
D92, on Presque Isle<br />
farmland.<br />
spring <strong>2013</strong> tufts dental medicine 19
ike many <strong>of</strong> the country’s<br />
rural regions, Maine doesn’t have enough<br />
dentists—the state estimates there are<br />
five for every 10,000 residents. The farther<br />
afield you get from cities such as Portland<br />
or Bangor, the more geography turns a trip<br />
to the dentist into an expedition instead <strong>of</strong><br />
a simple drive. Maine, which has the largest<br />
percentage <strong>of</strong> rural residents <strong>of</strong> any state in<br />
the country, could be the poster child for the<br />
access-to-care issues that confront patients<br />
who don’t live near urban areas.<br />
Presque Isle got lucky. It has a tooth fairy<br />
in Norma Desjardins, D92, who has made<br />
it her mission to provide dental care to the<br />
Mainers who need it most. Born in rural<br />
Van Buren, Maine, where her brothers still<br />
run the family potato farm, Desjardins has<br />
practiced general dentistry in the region<br />
for 20 years. With her own children grown,<br />
she opened St. Apollonia (named for the<br />
patron saint <strong>of</strong> dentistry), a low-cost pediatric<br />
dental clinic, in March 2012, to serve<br />
Presque Isle, which has just under 10,000<br />
residents, and neighboring towns. So great<br />
was the need that about 900 kids sought<br />
care in the new clinic in just the last six<br />
months <strong>of</strong> 2012, Desjardins figures.<br />
“It’s the old cliché, but I thought this<br />
could be my way to give back,” she says. “I<br />
feel like this is my mission trip, right in my<br />
own neighborhood.” Since the clinic opened<br />
in a former ob/gyn clinic just down the street<br />
from Aroostook Medical Center, so many<br />
kids have come through the doors—toddlers<br />
with cavities in every tooth, high schoolers<br />
who’ve never been to a dentist—that the twochair<br />
clinic is already operating at capacity.<br />
Desjardins estimates that the majority <strong>of</strong> St.<br />
Apollonia’s patients, about 600 <strong>of</strong> them, are<br />
younger than 10. Because the patient caseload<br />
is skewed toward the little kids, the staff<br />
(a full-time dentist, the hygienist and a dental<br />
assistant) focuses on education and prevention.<br />
“If we could really teach them the preventive<br />
philosophy early, there wouldn’t be as<br />
much work to do,” she says.<br />
Though Desjardins’ role at St. Apollonia<br />
is more CEO than dentist—she covers for<br />
the full-time dentist, Keely O’Connell, when<br />
“Ifeellikethisismy<br />
missiontrip,rightinmy<br />
own neighborhood.”<br />
—Norma Desjardins, D92<br />
O’Connell is away and consults on some<br />
cases—she is keenly aware <strong>of</strong> the desperate<br />
need <strong>of</strong> the patients who seek care at the nonpr<strong>of</strong>it<br />
clinic. Many toddlers come in with the<br />
extensive decay known as baby bottle caries,<br />
caused by putting a child to sleep sucking on<br />
a bottle <strong>of</strong> milk or juice. “I had hoped as a<br />
pr<strong>of</strong>ession we had done so well eliminating<br />
that problem, but it seems to be making a<br />
comeback for some reason,” says Desjardins.<br />
“We have to educate parents all over again<br />
and make the public aware again.”<br />
It’s not just the toddlers who suffer from<br />
poor oral health. Desjardins says the teenagers’<br />
situations are especially heartbreaking.<br />
Some teens make their own appointments<br />
and show up alone—clearly on their own<br />
already. Some have missing or misaligned<br />
teeth that she knows must make them selfconscious<br />
in social situations. Some have<br />
reached high school without ever seeing a<br />
dentist, including one 17-year-old boy who<br />
Above: Family checking in for services at<br />
St. Apollonia. Right: Norma Desjardins<br />
showing children films <strong>of</strong> their teeth.<br />
20 tufts dental medicine spring <strong>2013</strong>
Aroostook<br />
2,995<br />
Population-to-Dentist Ratio<br />
in Maine’s Counties<br />
3,670 – 4,450<br />
2,900 – 3,670<br />
2,130 – 2,900<br />
1,360– 2,130<br />
Piscataquis<br />
2,923<br />
Active dentists in<br />
Maine are unevenly<br />
distributed across the<br />
state. In 2011, 16 percent<br />
<strong>of</strong> Mainers lived in<br />
a “dental health pr<strong>of</strong>essional<br />
shortage area”<br />
(DHPSA), the 10th<br />
highest percentage<br />
<strong>of</strong> all states. Nationally,<br />
10.1 percent <strong>of</strong><br />
Americans live in a<br />
DHPSA.<br />
Franklin<br />
2,564<br />
Oxford<br />
4,419<br />
Somerset<br />
4,018<br />
Kennebec<br />
1,546<br />
BANGOR<br />
Waldo<br />
3,879<br />
Penobscot<br />
1,877<br />
Hancock<br />
2,177<br />
Washington<br />
2,527<br />
Knox 1,589<br />
Lincoln 2,871<br />
Sagadahoc 1,471<br />
Androscoggin 2,393<br />
Cumberland 1,361<br />
Above: Norma Desjardins treating Jenna<br />
Violette, 4, at the St. Apollonia Clinic.<br />
Left: “Helping Hands” recognize proud<br />
donors and sponsors <strong>of</strong> the clinic.<br />
SOURCE: CENTER FOR HEALTH<br />
WORKFORCE STUDIES, 2012<br />
PORTLAND<br />
York<br />
2,347<br />
had the hardened layers <strong>of</strong> tartar across and<br />
between all his teeth known as a bridge <strong>of</strong><br />
calculus, which occurs when teeth are not<br />
pr<strong>of</strong>essionally cleaned.<br />
“We have to educate [patients] about<br />
more than just brushing and flossing. We<br />
have to explain to them [that calculus hardened<br />
like cement] is not the way your teeth<br />
are supposed to feel,” she says.<br />
St. Apollonia is not the first clinic<br />
Desjardins has started from the ground<br />
up. Right after graduating from <strong>Tufts</strong>, she<br />
returned to her hometown <strong>of</strong> Van Buren<br />
and, after applying to seven banks, secured<br />
a loan to buy equipment and launch her own<br />
practice. The only dentist in town, Desjardins<br />
found herself working six days a week, sometimes<br />
seven. Seeking a better work-life balance,<br />
she decided to join Academy <strong>Dental</strong> in<br />
Presque Isle, about 45 minutes south.<br />
Today, on top <strong>of</strong> her administrative and<br />
supervisory roles at St. Apollonia, Desjardins<br />
maintains her practice at Academy <strong>Dental</strong>.<br />
Just up the street from St. Apollonia,<br />
Academy <strong>Dental</strong> is the pediatric clinic’s<br />
“big sister,” says Desjardins, who salvaged<br />
Rodriguez’s hygienist’s chair from the basement<br />
<strong>of</strong> the private practice. Together, she<br />
and her partners at Academy take care <strong>of</strong><br />
more than 7,000 smiles. Her husband, Paul,<br />
is Academy’s practice manager.<br />
<strong>Dental</strong> Deserts<br />
Since Desjardins left Van Buren 16 years<br />
ago, the town—home to fewer than 3,000<br />
people—hasn’t had its own dentist. Maine<br />
has fewer dentists per capita than most other<br />
states, according to a 2012 study commissioned<br />
by the state. With just five dentists for<br />
every 10,000 people, it’s lower than the average<br />
dentist-to-patient ratio in the United States<br />
(six dentists for every 10,000 people in 2007)<br />
and the lowest <strong>of</strong> the six New England states.<br />
As is the case in the rest <strong>of</strong> the country,<br />
dentists in Maine are clustered in the more<br />
populated regions, meaning that remote<br />
areas, such as Aroostook County, are dental<br />
deserts. While nearly two-thirds <strong>of</strong> Maine<br />
residents live in rural areas, according to the<br />
2010 U.S. Census, just 13.5 percent <strong>of</strong> Maine’s<br />
dentists practice in those regions. That leaves<br />
more than 200,000 Mainers in federally<br />
designated “dental health pr<strong>of</strong>essional shortage<br />
areas,” defined as regions with fewer than<br />
one dentist for every 5,000 residents.<br />
Larger than Rhode Island and Connecticut<br />
combined, Aroostook County has 72,000 residents<br />
and just 23 practicing dentists, according<br />
to the Maine Department <strong>of</strong> Health and<br />
Human Services. Before Desjardins opened<br />
her clinic, many Presque Isle residents drove<br />
three to four hours to see a pediatric dentist<br />
in Bangor or Augusta.<br />
Now Jacob, 15, Shyanne, 14, and Christopher,<br />
12, and their mother, Kathy, have a<br />
15-minute drive from their home in Fort<br />
Fairfield to St. Apollonia. “I had to take<br />
Christopher clear down to Bangor last time,<br />
really beat up my van,” says Kathy. “It’s good<br />
to have a dentist here.”<br />
Desjardins rolls her eyes as she imagines<br />
a long ride with a child with a toothache—<br />
a trip that’s possible only if patients have<br />
access to a car, money to fill the gas tank<br />
and the flexibility to be able to take most<br />
<strong>of</strong> the day <strong>of</strong>f work to get to and from the<br />
appointment. “It helps if we are their dental<br />
home,” she says. “Even if they have to go to<br />
spring <strong>2013</strong> tufts dental medicine 21
a specialist, they can come back here to have<br />
regular checkups. They can save the long<br />
distances for restorative care.”<br />
Desjardins’ teams, both at St. Apollonia<br />
and Academy, use technology to make obtaining<br />
dental care as convenient as possible.<br />
When a toddler bumped into a c<strong>of</strong>fee table<br />
and knocked a baby tooth out <strong>of</strong> place, staff<br />
from Academy emailed Jonathan Shenkin, a<br />
pediatric specialist in Augusta, a photo <strong>of</strong> the<br />
injury. Within minutes, Shenkin was able to<br />
advise them about how to proceed. “We did<br />
a little tele-dentistry,” says Desjardins. “It was<br />
great to be able to get his expertise that way.”<br />
While this happened at the private practice,<br />
Desjardins says she could easily see a similar<br />
scenario unfolding at St. Apollonia.<br />
Convenience is not the only reason<br />
Kathy brings her children to St. Apollonia,<br />
though. Each <strong>of</strong> them has a disability.<br />
Christopher is autistic and can be unpredictable<br />
at times. Other clinics, ill-equipped<br />
to manage his behavior, have turned him<br />
away. St. Apollonia “never hesitated to take<br />
him,” Kathy says.<br />
Yvonne Tardie is also grateful to have<br />
a dental clinic closer to home. It takes just<br />
10 minutes to get to St. Apollonia from her<br />
home in Washburn. Before, the Tardie family,<br />
who rely on the state’s public insurance<br />
program, known as MaineCare, had to travel<br />
an hour to Eagle Lake to find a clinic that<br />
would accept their insurance. “My husband<br />
had to take half a day <strong>of</strong>f from work,” she says<br />
in slightly French-accented English. “Not<br />
everybody takes MaineCare.”<br />
For some residents, even living next<br />
door to a dental clinic wouldn’t guarantee<br />
access to care. Beyond the scarcity <strong>of</strong> providers,<br />
many Mainers can’t afford to pay<br />
out <strong>of</strong> pocket, and few clinics accept public<br />
insurance. Maine’s rural residents tend to<br />
be older, sicker, poorer and less well educated<br />
than their urban counterparts. That<br />
demographic creates a perfect storm: residents<br />
<strong>of</strong> the state’s sparsely populated counties<br />
are more likely to have poor oral health<br />
and less likely to have dental insurance.<br />
The situation only worsened with the<br />
economic downturn. Even though a new<br />
report commissioned by the state <strong>of</strong> Maine<br />
found that a greater percentage <strong>of</strong> the total<br />
population had dental coverage in 2010<br />
than in 2006, fewer had it through a private<br />
insurer. That means MaineCare picked up<br />
the tab for more and more patients, covering<br />
about 20 percent <strong>of</strong> the state’s rural residents.<br />
Between 2006 and 2010, the public<br />
insurer paid out an average <strong>of</strong> $31 million<br />
annually for dental care, an amount that<br />
represents less than 2 percent <strong>of</strong> the public<br />
insurer’s total spending. (Eligibility requirements<br />
vary by age, circumstances and size <strong>of</strong><br />
family; for example, a family <strong>of</strong> four is eligible<br />
for free dental and medical coverage if<br />
its monthly income is less than $2,882. But<br />
TufTs ExTErnship siTEs in MainE<br />
uring their third or fourth year <strong>of</strong> school, all <strong>Tufts</strong> dental students<br />
embark on a required five-week Community Service<br />
Learning Externship at one <strong>of</strong> more than 30 sites nationwide.<br />
These <strong>of</strong>f-campus training periods are designed to give students<br />
real-world appreciation for access-to-care issues as they hone<br />
their clinical skills. Cynthia Yered, D90, associate clinical pr<strong>of</strong>essor<br />
<strong>of</strong> public health and community service, expects about a<br />
dozen members <strong>of</strong> the class <strong>of</strong> 2014 to be assigned to one <strong>of</strong> four<br />
such sites in Maine. Katahdin Valley Health Center in Millinocket is<br />
the northernmost clinic and is still more than 100 miles south <strong>of</strong><br />
Presque Isle, where Norma Desjardins, D92, operates her low-cost<br />
pediatrics clinic. As soon as she has another operatory, Desjardins<br />
hopes St. Apollonia <strong>Dental</strong> will be able to host <strong>Tufts</strong> externs. The<br />
other Maine extern sites are Caring Hands Maine, in Ellsworth;<br />
Penobscot Community Health Care Center in Bangor and Community<br />
<strong>Dental</strong> with five locations in southern Maine.<br />
Main Street, downtown<br />
Presque Isle.<br />
22 tufts dental medicine spring <strong>2013</strong>
even among the 110,000 children enrolled<br />
in the program, more than 53,000, just<br />
under half, went without dental care in<br />
2010, according to the Maine Department<br />
<strong>of</strong> Health and Human Services.<br />
That likely has to do with MaineCare’s<br />
low dental reimbursement rates, which<br />
rank 38th in the country. Desjardins<br />
estimates the public insurance pays about<br />
half <strong>of</strong> what she’d normally charge for many<br />
dental procedures; for some dentists, the<br />
reimbursement rate is as low as 25 percent.<br />
Small wonder then that fewer than half <strong>of</strong> the<br />
state’s dentists accept MaineCare, and twothirds<br />
<strong>of</strong> general dentists who do so limit<br />
the number <strong>of</strong> publicly insured patients they<br />
treat. That’s part <strong>of</strong> the reason Maine ranks<br />
34th among the 50 states and the District <strong>of</strong><br />
Columbia in the number <strong>of</strong> residents who<br />
have seen a dentist in the last year.<br />
the Big iDea<br />
It was in 2009 that Desjardins first thought<br />
about opening a clinic to serve children with<br />
no place else to go. She had been asked to<br />
serve on a health services advisory board <strong>of</strong><br />
the Aroostook County Action Program, an<br />
umbrella organization that helps connect<br />
low- and moderate-income families with<br />
such services as health care, job training and<br />
home repair assistance. Desjardins attended<br />
one meeting that focused on the difficulty <strong>of</strong><br />
finding dental providers for local children<br />
enrolled in Head Start, the federal program<br />
that promotes school-readiness among toddlers<br />
from low-income families. Federal law<br />
requires all Head Start children to have a<br />
dental exam within 90 days <strong>of</strong> enrolling in<br />
the program. With the shortage <strong>of</strong> dentists in<br />
Maine, that can be tough.<br />
“There just aren’t enough hands to do the<br />
work. It had really been that way for years,”<br />
says Desjardins, a former Head Start child<br />
herself. “Also, these little ones who have a<br />
hard time getting into an <strong>of</strong>fice, they also<br />
have the greater need.”<br />
Desjardins was never one to shy away<br />
from hard work—she was among the top<br />
students in her dental class, even though she<br />
gave birth to her two children, Emily, now 24,<br />
and Gerard, 22, while she was in school. She<br />
began laying the groundwork for the low-cost<br />
clinic, writing grants for funding and making<br />
presentations to local groups, including the<br />
Rotary Club, the Kiwanis and the Knights <strong>of</strong><br />
Columbus, in search <strong>of</strong> donations.<br />
Her big idea came along at the right time.<br />
Years <strong>of</strong> doing lengthy dental procedures had<br />
begun to take a toll on her health. The pain<br />
she had been experiencing in her neck, shoulders<br />
and arms began to worsen and affect<br />
her legs. Eventually, she was diagnosed with<br />
fibromyalgia, a nervous system disorder that<br />
can result in s<strong>of</strong>t-tissue pain well as fatigue.<br />
“I went from somebody who had endless<br />
energy to someone who couldn’t walk from<br />
the bedroom to the kitchen without feeling<br />
like I needed a nap,” she says.<br />
Realizing she would have to limit the number<br />
<strong>of</strong> hours she cared for patients, Desjardins<br />
was devastated, at first. “I had worked with<br />
pain for a long time. I was worried I wasn’t<br />
going to be able to practice anymore. Now I’ve<br />
learned I have something to <strong>of</strong>fer besides the<br />
way I was doing dentistry before.”<br />
She began devoting one day a week to getting<br />
the low-cost clinic up and running. After<br />
teaching herself to write grant applications<br />
to private foundations in Maine, she secured<br />
$65,000. She created a PowerPoint presentation,<br />
which she used with groups such as the<br />
VFW and the American Legion. The clinic<br />
became the Presque Isle Rotary Club’s special<br />
project, which helped raise another $38,000.<br />
“They presented us the check, and that’s how<br />
that first operatory became feasible,” she says.<br />
“From the beginning, this wasn’t going<br />
to be ‘Norma Desjardins’ clinic,’ ” she says.<br />
“This clinic is going to be the community<br />
dental health clinic.”<br />
Once St. Apollonia had an operatory,<br />
Desjardins, needed to hire a dentist, and<br />
one who embraced community service in a<br />
big way. A native <strong>of</strong> upstate New York, Keely<br />
O’Connell, a 2012 graduate <strong>of</strong> Creighton<br />
<strong>University</strong> <strong>School</strong> <strong>of</strong> Dentistry in Nebraska,<br />
answered the call. O’Connell moved to<br />
Presque Isle eager to take on lots <strong>of</strong> responsibility<br />
early in her career. “It has been wonderful<br />
to have her as our inaugural dentist,”<br />
says Desjardins.<br />
“This year has gone by so fast. I have to<br />
admit every day presents new challenges,”<br />
says O’Connell.<br />
A challenge for Desjardins is the reality<br />
that her dreams for St. Apollonia require<br />
dollars. She estimates the clinic needs an<br />
annual operating budget <strong>of</strong> $350,000. She<br />
wants St. Apollonia to become self-sustaining,<br />
like a private practice, running <strong>of</strong>f<br />
income from the services provided—a l<strong>of</strong>ty<br />
Whilenearlytwo-thirds<strong>of</strong>Maineresidents<br />
liveinruralareas,just13.5percent<strong>of</strong>the<br />
state’s dentists practice in those regions.<br />
goal, given MaineCare’s reimbursement<br />
rates. To get there, says Desjardins, “we have<br />
to create an environment where [patients]<br />
are coming in with less decay.”<br />
Amid all the new beginnings for Desjardins<br />
in 2012, there were endings, too.<br />
Between Thanksgiving and Christmas, her<br />
mother-in-law, Lorraine, and her father,<br />
Normand LaJoie, passed away. Now, more<br />
than ever, she sees the clinic as a tribute to<br />
the values her parents and her husband’s<br />
parents instilled in their children.<br />
“There are so many stories—so many<br />
things us kids don’t know—about our parents<br />
helping other families,” says Desjardins.<br />
“Now that my dad’s gone, I feel even more <strong>of</strong><br />
a sense <strong>of</strong> responsibility to honor him and<br />
my mom by continuing this work.<br />
Both her and her husband’s mothers took<br />
advantage <strong>of</strong> the Head Start program when<br />
their children were small, and both women<br />
remained deeply involved with the program<br />
well after their kids were grown. That’s one<br />
reason Desjardins remains committed to<br />
providing dental care for Head Start preschoolers,<br />
though she says she is equally<br />
steadfast about helping “anyone who is trying<br />
to make their way, anyone who is struggling<br />
for whatever reason.”<br />
St. Apollonia’s is “meant to be here as<br />
long as these kids need it,” Desjardins says.<br />
“Unfortunately, I think that’s going to be a<br />
long time.” tDm<br />
Jacqueline Mitchell, a senior health sciences<br />
writer in <strong>Tufts</strong>’ Office <strong>of</strong> Publications, can be<br />
reached at jacqueline.mitchell@tufts.edu.<br />
spring <strong>2013</strong> tufts dental medicine 23
A world war was raging, money was scarce and<br />
her family was an ocean away—still Erna Neumann<br />
was determined to finish dental school<br />
By Julie Flaherty
<strong>Tufts</strong> <strong>Dental</strong> <strong>School</strong><br />
Class <strong>of</strong> 1918 at<br />
Commencement.<br />
in the spring <strong>of</strong>1918, erna neumann was in her final semester at tufts<br />
College <strong>Dental</strong> <strong>School</strong>, and she was anxious. The 23-year-old feared that all the effort<br />
and money she had put into her education was about to come to nothing. The antipathy<br />
toward German students like herself had grown as World War I progressed. Her accent was<br />
a liability; playing German music was asking for trouble. Some <strong>of</strong> her classmates suspected<br />
she might even be a spy. “We thought she had bombs in her trunk,” one admitted later.<br />
Then, just a few months from finishing her dental studies, she learned that two nursing<br />
students she knew had been told to leave their school because they were German.<br />
So Neumann gathered her moxie and<br />
made an appointment to see Hermon<br />
Carey Bumpus, the president <strong>of</strong> <strong>Tufts</strong><br />
<strong>University</strong>. She told him that she was a<br />
good student, and that the war had nothing<br />
to do with her. “I have just my last<br />
semester,” she told him. “I have no money.<br />
I am only full <strong>of</strong> debt. Are you going to<br />
throw me out, too”<br />
No, he said, he would not. And a few<br />
weeks later, at an annual dinner for the<br />
dental class, he sought her out. She had<br />
had to borrow money for her white tulle<br />
dress; the blue and white flowers she wore<br />
were a gift from the family she was staying<br />
with. As the many men in her class<br />
angled to get Dr. Bumpus’ attention, the<br />
president came forward and spoke to her.<br />
“How is everything” he asked. “Are you<br />
all right”<br />
Neumann recalled the moment with<br />
pride and wonder. “This poor student, no<br />
place to go, no money in the bank, and the<br />
president picked me out,” she said. “And I<br />
had a beautiful dress and three orchids.”<br />
She would soon be one <strong>of</strong> the five women<br />
to graduate with the class <strong>of</strong> 1918 and go on<br />
to become one <strong>of</strong> the first women dentists<br />
in Vermont.<br />
Neumann’s story was unearthed recently<br />
in the form <strong>of</strong> a typed, six-page manuscript,<br />
written by her in 1976 and found in the<br />
drawer <strong>of</strong> a <strong>Tufts</strong> administrator who was<br />
changing <strong>of</strong>fices. But there was more.<br />
In the attic <strong>of</strong> the Burlington, Vt., home<br />
where Neumann lived most <strong>of</strong> her life were<br />
letters, yearbooks, reunion photos and<br />
audiotapes that fleshed out her story, one <strong>of</strong><br />
an adventuresome woman who had a deep<br />
affection for her alma mater. She provides<br />
evocative details <strong>of</strong> what it was like to be<br />
not just a dental student a century ago, but<br />
one <strong>of</strong> a handful <strong>of</strong> women amid hundreds<br />
<strong>of</strong> male students and an “enemy alien” in a<br />
foreign land.<br />
spring <strong>2013</strong> tufts dental medicine 25
Left, the exterior <strong>of</strong> <strong>Tufts</strong> College <strong>Dental</strong> <strong>School</strong>, 1918;<br />
below left, women students from the dental and medical<br />
schools in 1917, with Erna Neumann front row, far left;<br />
below right, Neumann at Commencement, June 17, 1918.<br />
Above, some<br />
<strong>of</strong> Neumann’s<br />
dental tools;<br />
right, the<br />
dental school<br />
infirmary, as<br />
shown in the<br />
1918 Dentufts<br />
yearbook.<br />
the governess<br />
goes to school<br />
Erna Neumann and her sister Kathe arrived<br />
in Boston on April 9, 1914. They had left<br />
Germany to spend a year in the United States<br />
as governesses. Their first stop after docking<br />
was for a drink, and Erna was able to give<br />
America a hint <strong>of</strong> her copious stores <strong>of</strong> pluck<br />
when the waiter refused to serve her a beer<br />
because she was not yet 20.<br />
“What” she asked incredulously. “And<br />
this should be a free country”<br />
Still, she found America intoxicating.<br />
“Everything was just so delightful for us,”<br />
she recalls on a scratchy audiotape, her accent<br />
only slightly mellowed with age.<br />
Just a few months later, though, war broke<br />
out in Europe. Their family thought it would<br />
be safer for the sisters to stay away for a while.<br />
After all, how long could the war last<br />
But the fighting dragged on, and the sisters<br />
were soon cut <strong>of</strong>f from their family.<br />
Neumann needed a plan for her future. She<br />
was interested in dental school, but she had<br />
only $225 in the bank from her governess<br />
job, an amount that would barely pay the first<br />
year’s tuition. A minister she had befriended<br />
encouraged her to apply anyway. Deciding<br />
which school wasn’t much <strong>of</strong> a problem.<br />
There were only two dental schools in the<br />
area, and only one accepted “girls.”<br />
“So,” the minister said, “your choice is<br />
<strong>Tufts</strong>.”<br />
Neumann didn’t sleep for a few nights<br />
after she was accepted. “I almost thought<br />
lightning struck me,” she writes. “Can you<br />
imagine the decision to make, all alone in<br />
this country” In the end she enrolled, with<br />
the understanding that she could stay with<br />
the minister’s family, sharing a bed with his<br />
sister-in-law and paying $3 a week for room<br />
and board while her money lasted.<br />
The 1918 dental class began as a group <strong>of</strong><br />
237 men and seven women. In the Dentufts<br />
yearbook, her classmates describe their first<br />
gathering, in September 1915: “When …<br />
each <strong>of</strong> us ran our eyes over the throng, all<br />
invariably stopped to rest a moment longer<br />
on the blushing countenance <strong>of</strong> our Erna; <strong>of</strong><br />
course she looked down quite demurely.”<br />
Yet soon, they wrote, she was known for<br />
her “assiduous application to her studies.”<br />
One <strong>of</strong> their first assignments was to carve<br />
teeth out <strong>of</strong> ivory in the “Technic” laboratory.<br />
She recounts the groans to be heard<br />
when an instructor put his calipers to the<br />
carvings and proclaimed, “Sir, this is just a<br />
trifle too deep here—start a new one!”<br />
The students were also charged with making<br />
their own dental instruments. Neumann<br />
recalled these tools being dark-colored<br />
(stainless steel not yet readily available) and<br />
not things they used in practice.<br />
Neumann writes fondly <strong>of</strong> Pr<strong>of</strong>essor<br />
George Bates, who taught histology, and<br />
Pr<strong>of</strong>essor Robert Andrews, who taught<br />
physiology. (Both men are honored every<br />
year at <strong>Tufts</strong> on Bates-Andrews Day, which<br />
celebrates and showcases the work <strong>of</strong><br />
ElEctric drills bEing not yEt common for studEnts,<br />
nEumann and hEr classmatEs had to purchasE<br />
hEavy, pEdal-drivEn machinEs—not unlikE<br />
spinning whEEls—to powEr thEir dEntal drills.<br />
26 tufts dental medicine spring <strong>2013</strong>
Exterior <strong>of</strong> the Forsyth <strong>Dental</strong> Infirmary, 1918.<br />
Erna Neumann’s<br />
alien registration<br />
card, issued during<br />
World War I.<br />
dental student researchers.)<br />
Bates, in particular, took her under his<br />
wing. During her first test in histology, he<br />
could see that she was staring blankly at some<br />
<strong>of</strong> the questions. Bates, whom she recalls as<br />
kind and fatherly, coaxed her: “Write it in<br />
German if it is too much for you in English.”<br />
She replied: “It’s too much for me in either<br />
language just now, Dr. Bates.”<br />
She enjoyed her classes, particularly anatomy,<br />
which she took in her second semester.<br />
She was grateful that after her labs, she had<br />
a 45-minute walk home across Harvard<br />
Bridge, “where the prevailing wind eliminated<br />
the formaldehyde and other odors <strong>of</strong><br />
Anatomy which clung to my clothing…”<br />
Summers gave her an opportunity to<br />
save money by working as a governess;<br />
her sister and a friend generously <strong>of</strong>fered<br />
to front her the other money she needed<br />
for school. And she did indeed have many<br />
expenses in her second year: “an instrument<br />
case, plus more laboratory equipment<br />
and books, besides tuition,” she writes.<br />
Another major expense was the footengine.<br />
Electric drills were not yet common<br />
for students, so Neumann and her classmates<br />
had to purchase heavy, pedal-driven<br />
machines—not unlike spinning wheels—to<br />
power their dental drills. She writes: “We carried<br />
the instrument case in one hand and the<br />
foot-engine in the other from floor to floor<br />
where it was needed: Crown and Bridge Lab,<br />
Prosthetics, Infirmary and the back <strong>of</strong> the<br />
locker. It would have been eye-opening to the<br />
advocates <strong>of</strong> Women’s Lib—we had it then,<br />
and we were too busy for analyzing our position<br />
or worrying about our status. Everyone<br />
was on his or her own—no discrimination<br />
either or favors.” The one difference <strong>of</strong> being<br />
a female dental student, she writes, is that<br />
when the men lost an instrument or broke<br />
an impression, they tempered their pr<strong>of</strong>anity<br />
around her.<br />
The dental school hours were from 9<br />
a.m. to 5 or 6 p.m., and Saturdays from 9<br />
a.m. to noon. “Strict attendance was taken<br />
at all classes and labs, and there was little<br />
time wasted,” she writes.<br />
The infirmary had a huge, communal<br />
boiling-water sterilizer, with individual, perforated<br />
metal holders for the instruments.<br />
Neumann notes that one had to watch that<br />
one’s instruments did not disappear. She<br />
writes: “A story evolved that ‘the Lord helps<br />
those who help themselves—the Lord is very<br />
busy in our Infirmary!’ ”<br />
WAr, then PeAce<br />
Once the United States entered the war,<br />
German students were required to register<br />
as enemy aliens. Neumann was issued a<br />
registration card that she had to carry with<br />
her at all times. She had to report to the<br />
registrar monthly and needed permission<br />
to travel or change her residence. Yet not<br />
everyone kept her at arms-length. She made<br />
strong friendships at <strong>Tufts</strong>, particularly with<br />
some <strong>of</strong> the other women in her class.<br />
Neumann was not the only student<br />
to notice that immigrants who had come<br />
to the clinic a few years prior with sound<br />
teeth now had extensive cavities. She suggested<br />
to some <strong>of</strong> her pr<strong>of</strong>essors that the<br />
problem might have something to do with<br />
the patients’ change in diet. The pr<strong>of</strong>essors<br />
just smiled at her, she wrote, and declared,<br />
“What is this youngster trying to tell us!”<br />
Her interest in nutrition, however, only<br />
grew with the research coming out <strong>of</strong> the<br />
Forsyth <strong>Dental</strong> Infirmary, which was<br />
studying nutrition among the thousands<br />
<strong>of</strong> Boston school children who were treated<br />
there for free. She hoped to work there<br />
after graduation, but the Massachusetts<br />
spring <strong>2013</strong> tufts dental medicine 27
Below, Erna and Alfred Heininger<br />
in Vermont in 1960; right, three<br />
generations on a summer day, 1963.<br />
Above, the<br />
prophylactic clinic<br />
at Forsyth, 1919;<br />
right, the interior<br />
<strong>of</strong> Forsyth from the<br />
1918 Dentufts.<br />
State Board <strong>of</strong> Directors would not give<br />
her a license to practice while the war continued.<br />
Instead, she took a position as an<br />
assistant to a dentist in Roxbury. “He and<br />
his wife treated me like a daughter, when<br />
no one would have given employment to a<br />
German enemy-alien, who had to report to<br />
the police every month.” They also gave her<br />
a “huge” salary <strong>of</strong> $12 per week.<br />
Peace finally came on November 11,<br />
1918. A few months later, she received her<br />
license, and in the spring <strong>of</strong> 1919 she was<br />
accepted at the Forsyth.<br />
She describes some <strong>of</strong> her experiences<br />
at <strong>Tufts</strong> and Forsyth in letters she wrote to<br />
Alfred Heininger, a law student she had met<br />
in 1917. He had moved back to work at his<br />
A letter from Neumann to her future husband, Alfred Heininger, in 1919.<br />
family’s construction firm in Burlington,<br />
Vt., but their romance continued. She<br />
writes <strong>of</strong> everyday events, including studying<br />
for an exam about Novocain, boycotting<br />
the trolley because the fare was raised<br />
a few pennies and watching the laying <strong>of</strong><br />
linoleum in one <strong>of</strong> the dental buildings,<br />
with an eye to detail that gives a glimpse<br />
into why she would make a good dentist.<br />
She writes to Heininger <strong>of</strong> a typical<br />
day at Forsyth: “It is 2:30 p.m., and for a<br />
moment I am resting peacefully in my<br />
chair. If I pressed the electric button, a<br />
signal for another patient, soon a little<br />
youngster would rush around the corner.”<br />
Later, she writes <strong>of</strong> the complexity <strong>of</strong> using<br />
Novocain, invented only 15 years earlier:<br />
“It was a very busy day, including 2 conductive<br />
[local] anesthesia cases, which take<br />
much work and time, and came out quite<br />
successful. I was just absorbed in my work,<br />
and the last one to leave the clinic.”<br />
When Erna wed Alfred in 1920, she was<br />
marrying into a veritable dental family:<br />
three <strong>of</strong> his brothers were dentists (and one<br />
was a doctor). She joined one <strong>of</strong> her brothers-in-law,<br />
Bruno Heininger, in his downtown<br />
Burlington practice. A photograph<br />
that Neumann took, circa 1924, shows that<br />
their second-floor dental <strong>of</strong>fice (above a<br />
striped-awning drugstore) overlooked a<br />
busy street filled with both motor cars and<br />
horse-drawn carriages.<br />
Her nephew, Calef Heininger, now 83,<br />
one <strong>of</strong> two cousins in the next generation<br />
who also became dentists, recalls he was<br />
too young to see Neumann at work, but<br />
he imagines the scene being similar to his<br />
father’s dental <strong>of</strong>fice in the 1930s. Even<br />
then, there were no X-ray machines, and the<br />
cable-driven drills were noisy and vibrated.<br />
Neumann practiced for five years before<br />
turning her attention to raising her three<br />
children. Her second daughter, Sylvia<br />
Holden, 83, lives in the house where she<br />
grew up, a roomy four-square in what was<br />
once a working-class, immigrant neighborhood<br />
<strong>of</strong> Burlington. She also is too young<br />
28 tufts dental medicine spring <strong>2013</strong>
Erna Neumann’s daughter, Sylvia<br />
Holden, in the attic where her<br />
mother’s papers were kept.<br />
Below, Neumann in 1989.<br />
to have seen her mother at work, but the<br />
family story is that whenever her Uncle<br />
Bruno would call to say, “You’ve got to<br />
come in immediately! The orphanage has<br />
just arrived!” her mother dropped<br />
everything and went.<br />
She says her parents were<br />
focused on their community,<br />
particularly when the Great<br />
Depression left so many people<br />
impoverished. Women<br />
in threadbare fox furs would<br />
come to the house, and the<br />
family would take care <strong>of</strong><br />
them in various ways.<br />
“My mother used to say my<br />
father had the biggest free law<br />
practice in the state <strong>of</strong> Vermont,”<br />
Sylvia Holden says. Her mother was always<br />
available to translate a letter for a German<br />
neighbor, or lend a sympathetic ear to any<br />
callers. “She would knit while she was listening<br />
to their troubles.”<br />
Neumann helped her husband with his<br />
political career, which was also focused on<br />
caring for the needy. He served six years in<br />
the Vermont Senate and even ran for governor<br />
in 1936. He is best known as the father<br />
<strong>of</strong> Vermont’s social welfare system, as he<br />
helped shuttle one <strong>of</strong> the nation’s first oldage<br />
pension laws through the Legislature.<br />
One <strong>of</strong> Neumann’s grandchildren, Alfred<br />
Holden, helped capture some <strong>of</strong> her stories<br />
when he was a teenager. “I would bring out<br />
the cassette recorder, and I would drop a<br />
date,” he says. “And she was so alert in<br />
her memory that she could pick up<br />
on that date and tell you things,<br />
specific things, about it.”<br />
The year 1934, for example,<br />
would be when she met<br />
another trailblazer, Amelia<br />
Earhart. The famous aviatrix<br />
was promoting her new<br />
airline for business travel,<br />
and she invited the wives <strong>of</strong><br />
local business leaders to fly with<br />
her. While it was exciting to meet<br />
Earhart, flying was old hat for Erna.<br />
She had frequently taken barnstorming<br />
flights at the Burlington airfield.<br />
“I don’t know if she was afraid <strong>of</strong> anything,”<br />
says Alfred Holden. “She was a live<br />
wire all through my life. Full <strong>of</strong> life and<br />
enjoyment. She was game for things. She<br />
wouldn’t say, ‘I’m not going to do that.’ ”<br />
Neumann’s nephew, Calef Heininger,<br />
became her dentist when she was in her 70s.<br />
(She managed to keep most <strong>of</strong> her teeth her<br />
whole life.) “She was quite a positive person,<br />
although she had her opinions,” he says.<br />
He also marveled that she would put<br />
her car away each winter and walk, almost<br />
daily, a couple miles uphill to visit friends.<br />
“Her motto was, ‘Down the road <strong>of</strong> life you<br />
get to the end much quicker in a car than<br />
you do on foot.’ ”<br />
She lived to be almost 97 (she died on<br />
February 15, 1991), and was lucid up until<br />
the last few days <strong>of</strong> her life. Her family<br />
has held onto the letters that speak <strong>of</strong> love<br />
and linoleum, the dental reunion photos<br />
that show her in a sea <strong>of</strong> men, as well as<br />
the enemy alien card that she had to carry<br />
with her during the war. They even have<br />
her old dental tools; her grandson <strong>of</strong>ten<br />
uses the little round mirror to check over<br />
his own teeth.<br />
Although she practiced dentistry only for<br />
a short time, she was very proud <strong>of</strong> her <strong>Tufts</strong><br />
education. She attended many reunions,<br />
including her 64th, in 1982. And the story <strong>of</strong><br />
her meeting with <strong>Tufts</strong> President Bumpus is<br />
family legend.<br />
“She had spunk; she used it very strategically,”<br />
says Alfred Holden, her grandson.<br />
“We’re proud, <strong>of</strong> course, that she would<br />
have made her case” to finish her dental<br />
studies. tDm<br />
Julie Flaherty, a senior health sciences writer<br />
in <strong>Tufts</strong>’ Office <strong>of</strong> Publications, can be reached<br />
at julie.flaherty@tufts.edu.<br />
spring <strong>2013</strong> tufts dental medicine 29
Thanh-Trang Nguyen, D01,<br />
with her mentor, Mark Doherty
Full Circle<br />
By linda hall PhotoGRAPhY bY kAthleen dooheR<br />
just weeks after immigrating to boston from vietnam<br />
in the summer <strong>of</strong> 1991, Thanh-Trang Nguyen, D01, settled<br />
into Mark Doherty’s dental chair at the Dorchester House<br />
community health center.<br />
A shy 18-year-old, Nguyen had an engaging smile but<br />
spoke only a few words <strong>of</strong> English. A social service agency<br />
had referred her there for a dental checkup, a standard part<br />
<strong>of</strong> the refugee resettlement process. It was the kind <strong>of</strong> preventative<br />
care Nguyen had not known in her native country.<br />
Early efforts to communicate with Doherty, the director<br />
<strong>of</strong> dental services at Dorchester House, were challenging,<br />
Nguyen recalls. After examining her teeth, Doherty<br />
said, “Not good, not good. You’ve got to clean your teeth<br />
better. Do you floss” Embarrassed to admit she didn’t<br />
understand, Nguyen replied, “Yes, yes, yes.” A skeptical<br />
Doherty followed up: “Do you know what floss is” A<br />
repentant Nguyen admitted she did not.<br />
As Doherty worked over that summer to fill her cavities<br />
and perform extra cleanings to restore her<br />
oral health, Nguyen’s English improved,<br />
and their relationship blossomed. “I was<br />
a tremendous teaser, and she was a great<br />
target,” Doherty says. “Tough as nails,<br />
but a great sense <strong>of</strong> humor.”<br />
Doherty found a patient as eager to<br />
learn about how to take care <strong>of</strong> her teeth as she was to<br />
understand his pr<strong>of</strong>ession. In her dentist, Nguyen found<br />
a mentor. By that fall, Nguyen had summoned the courage<br />
to ask whether she could learn to be a dental assistant<br />
under Doherty’s guidance.<br />
Their pr<strong>of</strong>essional journey together began with<br />
Nguyen volunteering after school a few days a week.<br />
Although she had graduated from high school the year<br />
before her family left Vietnam, Nguyen repeated her<br />
junior and senior years at Cathedral High <strong>School</strong> in<br />
Boston to learn English. Doherty <strong>of</strong>fered friendship and<br />
fatherly advice, wrote letters <strong>of</strong> recommendation and<br />
encouraged her each step <strong>of</strong> the way, from high school to<br />
Regis College to <strong>Tufts</strong> <strong>School</strong> <strong>of</strong> <strong>Dental</strong> <strong>Medicine</strong>.<br />
He encouraged Nguyen to apply for a postgraduate<br />
fellowship, remembering how much that experience had<br />
helped him improve his skills and confidence after he<br />
graduated from dental school. It provided “continuity<br />
and comfort,” he says.<br />
She received an Advanced Education in General<br />
Dentistry fellowship from Lutheran Medical Center,<br />
which places dental residents in community health<br />
centers. And so she returned to familiar ground, to<br />
Dorchester House, where, she says, “seeing Dr. Doherty<br />
and the staff helping the community inspired me.” She<br />
was hired for the dental staff at the end <strong>of</strong> 2002.<br />
Then in 2011, two decades after the shy teenager had<br />
come to Dorchester House for the first time, she took over<br />
her mentor’s old job, director <strong>of</strong> dental services.<br />
“Even though I always wanted to be a dentist,” says<br />
Nguyen, “I always doubted that I could make it.” She<br />
says unwavering encouragement from Doherty kept her<br />
strong. “I wanted to make him proud.”<br />
“She was tiny, extremely shy,” Doherty says <strong>of</strong> their first<br />
As a young immigrant, Thanh-Trang Nguyen found<br />
a mentor in her dentist at Dorchester House.<br />
Now she’s in the position he once held.<br />
meetings in the clinic. “Getting her to utter more than a<br />
couple <strong>of</strong> words was tough. But she was smart as a whip.<br />
There was no doubt in my mind she could do anything<br />
she wanted to do” once she cleared the language barrier.<br />
Nguyen already had an idea about what she wanted to<br />
do, and that was dentistry. It was a childhood ambition<br />
she had carried into adulthood. As an 8-year-old living in<br />
the town <strong>of</strong> DaLat in the Central Highlands <strong>of</strong> Vietnam,<br />
Nguyen had a painful toothache. “In Vietnam we only had<br />
access to emergency dental care,” she says. “There was no<br />
such thing as preventative care. You’d only go to the dentist<br />
if you can no longer bear the pain.<br />
“My mother gave me some money and told me to walk<br />
down the street to the dentist’s <strong>of</strong>fice. I found a young<br />
woman [dentist] all by herself. I don’t remember exactly<br />
what she did, but I remember walking out <strong>of</strong> the <strong>of</strong>fice<br />
spring <strong>2013</strong> tufts dental medicine 31
painless. That was the first time I wanted to become a dentist.”<br />
Her youthful aspirations strengthened as she watched Doherty<br />
at work. She repeated high school hoping to improve not only her<br />
English but also her chances <strong>of</strong> going to college.<br />
“In Vietnam, education was very much based around rote memorization,”<br />
Nguyen says. In the United States, “it was all about collaboration<br />
and independent thinking, something I had to get used to.”<br />
What a challenge that must have been, taking high school classes<br />
in a language that was foreign, says Doherty, who notes that Nguyen<br />
was quickly earning top grades. She was accepted to Regis College<br />
in Weston, Mass., where she earned her undergraduate degree in<br />
biochemistry. Then she headed to <strong>Tufts</strong> <strong>Dental</strong> <strong>School</strong>, a choice that<br />
allowed her to remain near her parents, who by then had moved<br />
from Dorchester to Roslindale—and still be close to her second<br />
home at Dorchester House.<br />
‘the bReAth <strong>of</strong> fReedom’<br />
When her family came to the United States, Nguyen says, Dorchester<br />
House, which provides health care and other services to residents<br />
<strong>of</strong> the low-income neighborhood, was one <strong>of</strong> the lifelines that sustained<br />
them. They had only $20, but received help from the New<br />
York-based International Rescue Committee, other immigrants and<br />
public assistance.<br />
“Life was unbearable [in Vietnam] after the war,” Nguyen says.<br />
Her father, an <strong>of</strong>ficer in the South Vietnamese army, had been<br />
imprisoned for seven years in the brutal “reeducation camps” where<br />
the new Communist regime banished many who had supported the<br />
old government. After his release, her family faced systematic discrimination,<br />
she says. “My father, once a captain, took odd jobs …<br />
from cutting grass to feeding horses to illegally holding night classes<br />
in physics and math at our home. My mother went from being a<br />
French teacher to a peddler. We craved the breath <strong>of</strong> freedom.”<br />
In 1989 the U.S. government established the Humanitarian<br />
Operation Program to assist former political prisoners still trying<br />
to flee Vietnam more than a decade after the war had ended. Those<br />
who had been imprisoned for more than three years were <strong>of</strong>fered<br />
asylum. Nguyen’s family was able to leave in 1991.<br />
“We were the lucky ones,” Nguyen says, avoiding the fate <strong>of</strong> hundreds<br />
<strong>of</strong> thousands <strong>of</strong> Vietnamese refugees who died at sea and in<br />
the jungles while trying to escape.<br />
Her parents were determined to succeed in America. They worked<br />
full time during the day—her father in a floor-sanding business and<br />
in manufacturing jobs, her mother as an <strong>of</strong>fice clerk; they took community<br />
college classes at night. Her father now runs his own dry<br />
cleaning business in Dorchester, and her mother is an assistant vice<br />
president at a financial company.<br />
Doherty says Nguyen’s life experiences add dimension to her<br />
skills as caregiver. “When you grow up in a culture that is a minority,<br />
you learn things” about challenges that others may not fully appreciate,<br />
he says.<br />
Today nearly one-third <strong>of</strong> the patients at Dorchester House are<br />
Vietnamese. “It feels good when I can speak their language,” Nguyen<br />
says, “and they are grateful they can address their concerns in a language<br />
they know.”<br />
No matter what language her patients speak, Nguyen’s “best<br />
quality is that she listens,” says Doherty, who now advises community<br />
dental health programs in his role as the executive director <strong>of</strong><br />
DentaQuest Institute’s Safety Net Solutions program. “She distills<br />
information and uses it in the best way for her program, her family,<br />
her patients, her staff. She’s learning all the time. She’s not afraid <strong>of</strong><br />
risks, but they are well-measured.”<br />
After Doherty’s successor as director <strong>of</strong> dental services at<br />
Dorchester House left in 2011, Nguyen was promoted. Joel Abrams,<br />
the center’s president and CEO at the time, said he chose Nguyen<br />
based on recommendations from Doherty and others about her<br />
clinical skills as well as his own observations about her potential<br />
for leadership—evidenced, he says, “in the way she relates to others,<br />
the respect she garners.” The history <strong>of</strong> Dorchester House, founded<br />
in 1887, contains numerous examples <strong>of</strong> those who once benefited<br />
from services there moving on to build new programs, Abrams says.<br />
Nguyen’s promotion resonates with that tradition <strong>of</strong> “consumers<br />
becoming overseers,” he says.<br />
The Dorchester House Multi-Service Center, as it is now called,<br />
has gone through its own transformation over more than a century.<br />
Founded as a settlement house in Boston’s Fields Corner neighborhood<br />
to provide cultural, recreational and educational activities,<br />
primarily to immigrants, the center has relocated, evolved and<br />
expanded multiple times. Now the center cares for more than<br />
26,000 people each year, providing services that range from primary<br />
and specialty care to educational programs and social services<br />
to recreation (there is a pool and a gym).<br />
Doherty and Nguyen still talk by telephone nearly every week,<br />
and they continue as colleagues. Since 2004 Nguyen has been a dentist<br />
for Commonwealth Mobile Oral Health Services, a program<br />
Doherty founded in 1979 to provide dental care at 250 sites throughout<br />
Massachusetts, including schools with low-income students.<br />
Nguyen treats elementary school children at the Boston Renaissance<br />
<strong>School</strong> in Hyde Park on her day <strong>of</strong>f. Students are taken out <strong>of</strong> class<br />
for examinations and cleanings, and, if a cavity is found, a filling is<br />
done immediately. “We grab them while we can,” she says.<br />
With a busy life—Nguyen has three children, ages 8, 3 and 1—she<br />
says it is difficult to imagine what’s next. But her goal at Dorchester<br />
House is to increase the number <strong>of</strong> dentists so that more patients<br />
who rely on subsidized care can be served. The center’s oral health<br />
department has a staff <strong>of</strong> 23, including 12 dentists who provide adult<br />
and pediatric care in general dentistry, periodontics, endodontics<br />
and oral surgery. Nguyen sees patients as well.<br />
When Nguyen talks about her life, she <strong>of</strong>ten interjects: “I’m a very<br />
lucky girl.” She says she is grateful for all the help she was given, from<br />
those who assisted her family’s resettlement to the support services<br />
she received during her education to the opportunities that have<br />
come her way. Above all, she treasures Mark Doherty’s guidance.<br />
“I can’t express enough my gratefulness to Dr. Doherty for having<br />
faith in a teenager who barely spoke any English and for persistently<br />
encouraging her to follow her dreams,” Nguyen says. “I can only<br />
hope for the opportunity to pay this forward someday.” tDm<br />
Linda Hall is a freelance writer in Hopkinton, Mass.<br />
32 tufts dental medicine spring <strong>2013</strong>
dental school news<br />
In His Father's Footsteps<br />
The end <strong>of</strong> one career leads to the beginning <strong>of</strong> another by Julie Flaherty<br />
entists have a history <strong>of</strong> going into the family business,<br />
but for Daniel Gonzalez, D15, the son <strong>of</strong> a dentist, going to dental<br />
school was far from a birthright. It meant not just hard work for<br />
him, but hard choices for everyone in his family.<br />
Gonzalez was born in Colombia, where his father, Guillermo, was a dentist,<br />
and his mother, Patricia, a social worker. When he was still a boy, his parents<br />
decided to immigrate to the United States. His mother, who was born in Boston<br />
and had studied there, moved first. Soon after, Daniel and his younger brother,<br />
Nicolas, joined her. But 11-year-old Danny<br />
was not happy about it.<br />
“I did not want to come,” he says. “I was<br />
leaving the comfort <strong>of</strong> my friends and family,<br />
even my culture, and going into something<br />
that I had no idea about. It was a completely<br />
alien world.”<br />
<strong>School</strong> was especially frustrating. He<br />
Daniel Gonzalez,<br />
D15, with his<br />
parents, Guillermo<br />
and Patricia.<br />
photo: alonso nichols<br />
spring <strong>2013</strong> tufts dental medicine 33
on campus<br />
knew he was good at science and math, but<br />
his undeveloped English skills hid what he<br />
was capable <strong>of</strong>. Being a social worker, his<br />
mother knew to tap into the support systems<br />
available. She signed him up for Big<br />
Brothers, the Boy Scouts, soccer leagues<br />
and a program called Summerbridge<br />
(now Breakthrough Cambridge), where<br />
high school and college student volunteers<br />
helped him improve his English and<br />
his study skills. His middle school grades<br />
improved so much that he was accepted to a<br />
private high school, Noble and Greenough.<br />
He still struggled with English, and he<br />
had an hour-and-a-half commute each<br />
morning, but in the end, he graduated<br />
with honors, winning the most-improved<br />
student award.<br />
“Danny is goal-oriented,” says his<br />
mother. Whether it was getting into a private<br />
school or becoming an Eagle Scout,<br />
“he wanted to really succeed in whatever<br />
he did.”<br />
While Gonzalez was in high school, his<br />
father joined his family in Cambridge and<br />
took a position as a dispensary assistant in<br />
the oral surgery clinic at <strong>Tufts</strong> <strong>School</strong> <strong>of</strong><br />
<strong>Dental</strong> <strong>Medicine</strong>. He had practiced dentistry<br />
for 25 years in Colombia, and hoped<br />
to go back to dental school for the degree he<br />
would need to practice in the United States.<br />
But that would mean loans and debt.<br />
He knew that his sons would be applying<br />
to college soon. After much thinking,<br />
Guillermo made a decision: he would retire<br />
from dental practice and help support his<br />
family so his sons could have a good start<br />
on their own careers.<br />
So with help from his family—not to<br />
mention several part-time jobs <strong>of</strong> his own—<br />
Danny Gonzalez attended the College <strong>of</strong><br />
the Holy Cross in Worcester, Mass.<br />
“I didn’t know exactly what I wanted<br />
to do,” he says. “With my dad when I<br />
was little, I was in his dental <strong>of</strong>fice many<br />
times. I knew it was a great pr<strong>of</strong>ession;<br />
you had a lot <strong>of</strong> autonomy. But medicine<br />
was also a little intriguing.” His<br />
grandfather had been a neurologist, and<br />
Gonzalez had gone with him when he visited<br />
patients in the Colombian countryside.<br />
“I was a little undecided, like most<br />
college students,” he says.<br />
The two years after graduation would<br />
help guide him. He took a job at the Dana<br />
Farber Cancer Institute in Boston, where<br />
he was involved in several cancer therapy<br />
research projects. He worked closely with<br />
a dentist who treated patients with head<br />
and neck cancer, and saw how vital dentistry<br />
was during treatment.<br />
“I was able to meet with patients, and<br />
they said one <strong>of</strong> their biggest complaints<br />
was losing their teeth while undergoing<br />
their therapy,” Gonzalez says, explaining<br />
that patients might lose the ability to produce<br />
saliva because <strong>of</strong> radiation or multiple<br />
chemotherapy drugs, and their teeth<br />
would begin to decalcify. “Not only is it an<br />
important medical component to be able<br />
to chew and eat food, but socially and psychologically,<br />
to be able to smile and display<br />
your teeth to other people was very important<br />
for the patients.”<br />
Gonzalez started to think seriously<br />
about dentistry. He talked to his dad (who<br />
tried to stay objective), but also other dentists.<br />
He shadowed faculty in the <strong>Tufts</strong><br />
dental clinics and did research under the<br />
guidance <strong>of</strong> Aidee Herman, associate clinical<br />
pr<strong>of</strong>essor <strong>of</strong> periodontology.<br />
By the time he was accepted into the<br />
<strong>Tufts</strong> <strong>Dental</strong> class <strong>of</strong> 2015, Gonzalez was<br />
already a familiar face at One Kneeland<br />
Street. He has since become president-elect<br />
<strong>of</strong> the <strong>Tufts</strong> student chapter <strong>of</strong> the national<br />
Hispanic <strong>Dental</strong> Association, participated<br />
on the school’s admissions committee and<br />
organized a school soccer team.<br />
Guillermo feels only pride at what his<br />
son has accomplished and doesn’t mind<br />
being a retired dentist. “I have no regret<br />
about my decision,” he says. He is now a<br />
case manager for Somerville-Cambridge<br />
Elder Services. “I love what I am doing<br />
right now. I love my elders.”<br />
Of course, should his son need help<br />
studying for a perio exam, he always<br />
makes himself available to, say, explain the<br />
boundaries <strong>of</strong> a free gingival margin and<br />
biological width. “I have another resource<br />
whenever I don’t understand something,”<br />
Gonzalez says <strong>of</strong> his father. “He’s been a<br />
great help.”<br />
Julie Flaherty, a senior health sciences writer<br />
in <strong>Tufts</strong>’ Office <strong>of</strong> Publications, can be<br />
reached at julie.flaherty@tufts.edu.<br />
2020 Vision<br />
Strategic planning initiative<br />
charts a course for the dental<br />
school by Helene Ragovin<br />
for the past year, tufts school <strong>of</strong> dental<br />
<strong>Medicine</strong> has been looking ahead, developing<br />
a strategic plan, known as 2020<br />
Vision!, which will chart a future direction<br />
for the school. A 14-member committee<br />
<strong>of</strong> faculty and staff from across<br />
the school—basic science, preclinical and<br />
clinical—along with a student from the<br />
class <strong>of</strong> 2014, has been gathering information<br />
and soliciting feedback from those<br />
who work and study at One Kneeland<br />
Street, as well as alumni and leaders in<br />
oral health care and policy.<br />
The <strong>Tufts</strong> <strong>Dental</strong> community has been<br />
eager to respond: More than 500 people<br />
have participated in the process in some<br />
way. From this feedback, the committee<br />
will develop a series <strong>of</strong> short- and longterm<br />
recommendations.<br />
Along with the school’s strategic<br />
plan, several working groups have been<br />
involved in a curriculum revision project,<br />
looking at how to integrate the basic<br />
and clinical sciences, how to use more<br />
technology for teaching and learning and<br />
how to get students involved in clinical<br />
care earlier in their training, says Nadeem<br />
Karimbux, associate dean for academic<br />
affairs. Although revision <strong>of</strong> the curriculum<br />
has already started in some areas, the<br />
new 2020 <strong>Tufts</strong> Oral Health Curriculum<br />
will be fully implemented in the 2014-15<br />
academic year.<br />
Those leading the strategic-planning<br />
process say inclusiveness has been paramount.<br />
“Whatever we do, we like to be<br />
transparent and to make sure that everybody<br />
understands what we are doing,”<br />
says Roya Zandparsa, clinical pr<strong>of</strong>essor<br />
<strong>of</strong> prosthodontics and operative dentistry<br />
and chair <strong>of</strong> the school’s Strategic<br />
Planning Steering Committee. “We want<br />
to make sure we work as a team, as part<br />
<strong>of</strong> the university, to reach to a higher<br />
level.” <strong>Tufts</strong> <strong>Dental</strong> <strong>Medicine</strong> talked with<br />
Zandparsa about the strategic plan.<br />
34 tufts dental medicine spring <strong>2013</strong>
Why is the school developing a<br />
strategic plan now<br />
Roya Zandparsa: Many things are changing<br />
at our school—we have a new dean and administration;<br />
technology is improving very<br />
fast; we have completed the expansion that<br />
added five floors to our building. There are<br />
new opportunities and challenges, and we<br />
want to be able to move to a higher level <strong>of</strong><br />
prominence as a leader in dental education,<br />
not only locally and nationally, but<br />
globally. So we have turned our attention<br />
to strategic planning. We want to<br />
be innovators in developing opportunities<br />
for our students to become outstanding<br />
leaders in oral health.<br />
What has taken place with the<br />
strategic-planning process over the<br />
past year<br />
You always want to establish a baseline,<br />
so we started gathering information<br />
and reviewing existing documents:<br />
the annual surveys <strong>of</strong> our alumni, the<br />
unit assessments, the senior student<br />
exit survey, patient satisfaction surveys,<br />
the dean’s annual reports. We<br />
were already in the process <strong>of</strong> revising<br />
the curriculum, so the curriculum<br />
revision committee was in place. We<br />
wanted to make sure we were aligned<br />
with that committee and that there<br />
were no surprises. Then we came up<br />
with issues and priorities as well as several<br />
distinct areas <strong>of</strong> focus.<br />
What are those priorities<br />
They are: Community and social responsibility.<br />
How can we ensure that the <strong>Tufts</strong><br />
<strong>Dental</strong> community devotes time and effort<br />
to address access-to-care issues Curriculum.<br />
How do we provide a comprehensive<br />
dental education for future generations<br />
People. How do we engage and support<br />
the <strong>Tufts</strong> <strong>Dental</strong> community to promote<br />
our mission Research. How can we foster<br />
collaborative, interdisciplinary research<br />
throughout the school and, by extension,<br />
throughout the university<br />
Capitalizing on the benefits <strong>of</strong> technology<br />
for teaching, learning, research and<br />
patient care was initially a priority, but technology<br />
was later incorporated into the four<br />
other strategic directives and identified as a<br />
key enabler for success in all those areas.<br />
What is the timeline for rolling out the<br />
strategic plan<br />
We want to have short-term, mid-term and<br />
long-terms goals and be able to implement<br />
them little by little. This is a living document—it<br />
will require constant revision. We<br />
will constantly look to it to see how we’re<br />
doing. It’s a process. The name is 2020<br />
Roya Zandparsa<br />
Vision!, but that doesn’t mean we’re going<br />
to wait until 2020 to begin implementing<br />
the recommendations.<br />
We anticipate the overall planning will<br />
be completed this spring, and then we will<br />
craft a document that reflects the consensus<br />
<strong>of</strong> the Strategic Planning Steering<br />
Committee and make that available to all<br />
stakeholders.<br />
How did you get people involved<br />
Our goal was to engage as many people as<br />
possible. We went through a variety <strong>of</strong> focus<br />
groups. We put everything online. We had<br />
a poster that was displayed throughout One<br />
Kneeland Street to reach people who do not<br />
have access to the Internet. We tried every<br />
way possible to approach people and try to<br />
get them involved, to engage them and let<br />
them know their opinion really matters. We<br />
wanted to be sure everybody had a chance<br />
to be heard. The focus groups were great–<br />
some people prefer face-to-face communication.<br />
We had two rounds, with eight groups<br />
<strong>of</strong> eight to 10 people each time <strong>of</strong> students,<br />
staff and faculty. We met separately with the<br />
Alumni Council to gain the perspective <strong>of</strong><br />
alumni who are not necessarily members <strong>of</strong><br />
the faculty. And we also had an anonymous<br />
survey for people who were more comfortable<br />
providing input that way.<br />
Who did you talk to beyond<br />
One Kneeland Street<br />
Our consultants, Karl Haden <strong>of</strong> Academy<br />
for Academic Leadership in Atlanta<br />
and Joshua Mintz <strong>of</strong> Cavanaugh, Hagan,<br />
Pierson & Mintz in Washington, D.C.,<br />
interviewed leaders in dental and health<br />
care and public health to gain perspective<br />
on what challenges and opportunities<br />
lay ahead for the pr<strong>of</strong>ession and<br />
dental education. We also interviewed<br />
members <strong>of</strong> the Chinatown community,<br />
in which our school and clinics are<br />
located, and representatives from the<br />
<strong>Tufts</strong> <strong>Dental</strong> Alumni Association.<br />
The university is also involved in a<br />
strategic-planning process. How do<br />
these two initiatives intersect<br />
We talked to <strong>Tufts</strong> President Anthony<br />
Monaco and Provost David Harris. We<br />
wanted to make sure we were aligned<br />
with their vision, and that our plan and the<br />
university plan were in sync. Dean Huw<br />
Thomas is part <strong>of</strong> the university strategic<br />
planning group, and he gives us updates on<br />
that process. We want to make sure we're<br />
all on the same page and whatever we do is<br />
under the <strong>Tufts</strong> umbrella.<br />
How can alumni get involved<br />
Everything is online, and we’re not going<br />
to stop asking for opinions. At any point, if<br />
you decide you want to get involved, send<br />
an email to me (roya.zandparsa@tufts.<br />
edu), Dean Thomas (huw.thomas@tufts.<br />
edu) or Executive Associate Dean Mark<br />
Gonthier (mark.gonthier@tufts.edu). Or<br />
go to our website, http://dental.tufts.edu/<br />
strategicplan.<br />
Helene Ragovin, the editor <strong>of</strong> this magazine,<br />
can be reached at helene.ragovin@tufts.edu.<br />
photo: kelvin ma<br />
spring <strong>2013</strong> tufts dental medicine 35
on campus<br />
Revolution Afoot<br />
21st-century challenges will transform dental schools by Jacqueline Mitchell<br />
ith major population<br />
shifts and a rapidly evolving<br />
health-care landscape,<br />
dental education is about<br />
to undergo significant changes, according to<br />
Richard Valachovic, executive director <strong>of</strong> the<br />
American <strong>Dental</strong> Education Association.<br />
The inaugural presenter in the Dean’s<br />
Distinguished Speaker Series, which brings<br />
outside experts to the <strong>School</strong> <strong>of</strong> <strong>Dental</strong><br />
<strong>Medicine</strong> to talk about issues in health sciences<br />
education and practice, Valachovic<br />
touched on the “drivers <strong>of</strong> change” that<br />
will affect dentistry and dental education<br />
in the next 10 years.<br />
Overall, the future looks bright for dentistry,<br />
he said. Public perception <strong>of</strong> the pr<strong>of</strong>ession<br />
continues to be positive, as people<br />
recognize the importance <strong>of</strong> oral health.<br />
“With the wars in Iraq and Afghanistan,<br />
up to 35 percent <strong>of</strong> the troops from some<br />
battalions didn’t have the dental status that<br />
allowed them to be deployed to the field,”<br />
Valachovic said during his talk in November.<br />
The fact that so many military personnel<br />
could not be deployed because <strong>of</strong> poor<br />
oral health underscores the need for more<br />
dental-care providers, said Valachovic,<br />
who serves on the dental school’s Board <strong>of</strong><br />
Advisors. In 2000, 28 million Americans<br />
lived in federally designated dental health<br />
pr<strong>of</strong>essional shortage areas, meaning<br />
there was less than one dentist for every<br />
5,000 patients. By 2008, that number had<br />
climbed to 48 million Americans.<br />
With two-thirds <strong>of</strong> the nation’s 186,000<br />
practicing dentists age 50 or older, the<br />
dentist-to-patient ratio in the United<br />
States—already on the decline since the<br />
1990s—is poised to dip precipitously.<br />
“I graduated in 1977. Half <strong>of</strong> my class is<br />
retired or working only part time now,”<br />
said Valachovic.<br />
Today about 12,000 applicants vie for<br />
approximately 5,000 spots in U.S. dental<br />
schools, making this the first time it’s<br />
been harder to get into dental school than<br />
into medical school, Valachovic said. “We<br />
are getting some <strong>of</strong> the best and brightest<br />
we’ve ever had,” he said, but 5,000 new dentists<br />
a year won’t be enough to address the<br />
impending nationwide shortage <strong>of</strong> providers.<br />
The solution, he said, is to rethink the<br />
existing model for dental education.<br />
“The standard predoctoral curriculum<br />
as we now know it, and that we’ve been so<br />
successful at for so many years, will prove<br />
inadequate,” he said. <strong>Dental</strong> education<br />
eventually will look more like medical education,<br />
he said, with an increasing emphasis<br />
on clinical training in community settings.<br />
In fact, educating dentists alongside<br />
physicians, nurses and other health-care<br />
“The standard predoctoral curriculum as<br />
we now know it, and that we’ve been so<br />
successful at for so many years,<br />
will prove inadequate.” —Richard Valachovic, adea<br />
providers–a concept known as interpr<strong>of</strong>essional<br />
education (IPE)–could prove a workable<br />
solution to solving access-to-care issues<br />
across the health pr<strong>of</strong>essions, Valachovic<br />
said. IPE has been endorsed by the World<br />
Health Organization as a means <strong>of</strong> creating<br />
a more flexible and efficient health-care<br />
workforce. Many U.S. medical schools—<br />
including Nova Southeastern <strong>University</strong>’s<br />
College <strong>of</strong> Osteopathic <strong>Medicine</strong>, which<br />
opened a dental program in 1997—have<br />
adopted some versions <strong>of</strong> IPE.<br />
Likewise, some new dental schools have<br />
been launched in existing academic health<br />
centers in a bid to expand the education<br />
they <strong>of</strong>fer to students and the services they<br />
<strong>of</strong>fer to patients. These new dental programs—tend<br />
to be located in economically<br />
stagnant regions where access-to-care<br />
issues are already acute.<br />
In addition to being able to share<br />
resources with other health and science<br />
educators on campus, these new schools<br />
will pioneer innovative ways to deliver dental<br />
education via the Internet, Valachovic<br />
said. “Does every school really need to have<br />
every department Or can we find ways to<br />
collaborate through massive open online<br />
courses,” known as MOOCs.<br />
No discussion <strong>of</strong> the future <strong>of</strong> dentistry<br />
would be complete without mention <strong>of</strong> the<br />
ongoing debate about a new kind <strong>of</strong> dental<br />
health provider, sometimes called a dental<br />
therapist.<br />
Some advocate the use <strong>of</strong> these mid-level<br />
providers as a means <strong>of</strong> broadening access<br />
to care—a model akin to the way physician<br />
assistants and nurse practitioners operate<br />
in medicine. (Minnesota became the first<br />
state to license dental therapists in 2009.)<br />
But others say the access-to-care problem<br />
can be solved more easily by expanding the<br />
scope <strong>of</strong> hygienists and dental assistants.<br />
Opponents also worry that there are yet no<br />
<strong>of</strong>ficial standards or accreditation processes<br />
for programs <strong>of</strong> dental therapy as there are<br />
for hygienists and assistants.<br />
The issue is likely to come to a head<br />
in the next few years, said Valachovic, as<br />
proponents in at least 15 other states are<br />
pushing their legislatures to license midlevel<br />
providers. In 2011, Oregon decided to<br />
allow the limited use <strong>of</strong> midlevel providers<br />
in a pilot program to test the viability<br />
<strong>of</strong> that care model, and legislators in<br />
Washington state are considering a measure<br />
to allow midlevel providers.<br />
“There’s a lot <strong>of</strong> strength <strong>of</strong> conviction on<br />
both sides without really a lot <strong>of</strong> data yet,”<br />
Valachovic said. “We’re going to be hearing<br />
about it a lot more.”<br />
36 tufts dental medicine spring <strong>2013</strong>
Jenny Citrin, D14, works with<br />
students at the Josiah Quincy<br />
Upper <strong>School</strong> to develop iSmile,<br />
an educational video game app.<br />
Education with Byte<br />
Jenny Citrin, D14, invents a computer game that helps kids teach<br />
kids about oral health by Julie Flaherty<br />
he weapons on his utility<br />
belt are a toothbrush and floss.<br />
Cookies and candy are the enemies.<br />
And should his strength<br />
start to ebb, fluoride makes him all but<br />
invincible. His name is Tom; he is a gradeschool<br />
superhero, and he is coming soon to<br />
a video game near you.<br />
Tom is the main character <strong>of</strong> iSmile, a<br />
kind <strong>of</strong> third-person-flosser app that educates<br />
children about proper dental care.<br />
Jenny Citrin, D14, a Schweitzer Fellow,<br />
conceived iSmile as an <strong>of</strong>fbeat way to head<br />
<strong>of</strong>f oral disease in the next generation. She<br />
is creating the game with a group <strong>of</strong> teenagers<br />
at the Josiah Quincy Upper <strong>School</strong><br />
in Boston’s Chinatown neighborhood. The<br />
students will eventually use iSmile, with<br />
its message <strong>of</strong> good oral health, to teach<br />
elementary school students. The idea is to<br />
hit young kids where they live: video games,<br />
mobile devices and looking up to cool highschoolers<br />
(“peer-to-peer learning,” as the<br />
education experts call it).<br />
“Education is the way we’re going to<br />
address preventative oral health, which is<br />
the most important aspect <strong>of</strong> oral health<br />
and dentistry as I see it,” Citrin says.<br />
Conventional dental education hasn’t made<br />
a big enough impact, she says, perhaps<br />
because it “isn’t that much fun.”<br />
The team meets Tuesday afternoons in<br />
a computer lab at the high school. While<br />
snacking on pretzel rods and cheese sticks,<br />
Citrin and a half dozen teens talk about<br />
Closeup <strong>of</strong> the game in development.<br />
how Tom will have to navigate the game’s<br />
food obstacles. “Nutrition is one <strong>of</strong> the very<br />
overlooked aspects <strong>of</strong> dental health,” Citrin<br />
says. Tom will have to pick the good foods<br />
and avoid the bad ones—dentally speaking,<br />
that is. And not just the obvious ones, such<br />
as opting for apples over gummy bears. As<br />
the player reaches higher levels, the choice<br />
becomes more nuanced: apple or…banana<br />
They have a storyboard, but there is<br />
still much to decide. Will the game be<br />
like Temple Run, or have more <strong>of</strong> a Mario<br />
Brothers vibe “I think we moved away from<br />
Pac Man,” Citrin reminds the team.<br />
After some voting, all agree that players<br />
can earn points by completing minigames<br />
that show how to brush and floss properly.<br />
The ending is still uncertain. If Tom does<br />
poorly, does he get a mouth full <strong>of</strong> cavities<br />
The team breaks up into groups to work<br />
on details before heading over to the dental<br />
school for a tour. Some <strong>of</strong> the students are<br />
interested in going into health fields; others<br />
just like video games or art.<br />
While things are going well, Citrin has<br />
to admit that getting high school students<br />
excited about oral health can be a hard<br />
sell, especially when she is competing with<br />
homework and college applications for their<br />
attention. Citrin didn’t grow up as a gamer<br />
herself (she plans to subcontract the coding<br />
to an outside programmer), and her primary<br />
teaching experience has been as a gymnastics<br />
instructor (she was a competitive gymnast<br />
for many years). Keeping things on<br />
track can be as difficult as connecting back<br />
handsprings on the balance beam.<br />
Still, her mentors at the Schweitzer<br />
Fellowship Program, which encourages<br />
graduate students to address the health<br />
needs <strong>of</strong> the underserved, warned her that<br />
these endeavors rarely go exactly as planned.<br />
“They tell you, ‘You are never going to finish<br />
a project the way you started it,’ ” she says.<br />
For now, she is enjoying hearing all the<br />
silly and sometimes-inspired suggestions<br />
that the students <strong>of</strong>fer. “They have so many<br />
creative ideas,” she says. “I don’t know where<br />
they come up with all <strong>of</strong> them.”<br />
photos: alonso nichols<br />
spring <strong>2013</strong> tufts dental medicine 37
on campus<br />
onekneeland<br />
In case you hadn’t heard...<br />
students share their match<br />
news with each other and with<br />
charles rankin, d79, dg86,<br />
interim chair <strong>of</strong> diagnosis and<br />
health promotion.<br />
congratulations<br />
all around<br />
tufts school <strong>of</strong> <strong>Dental</strong> medicine and its<br />
students have received several awards<br />
and marks <strong>of</strong> distinction recently:<br />
dIversIty the dental school is a<br />
recipient <strong>of</strong> the first higher education<br />
excellence in Diversity award from<br />
INSIGHT Into Diversity magazine, the<br />
largest diversity-focused publication<br />
in higher education. the school was<br />
featured along with other recipients in<br />
the magazine’s December 2012 issue.<br />
tufts was selected for such initiatives as<br />
its faculty development seminar series<br />
on diversity; efforts to increase minority<br />
student representation and retention;<br />
diverse student groups and outreach to<br />
promote oral health and access to care<br />
for underserved populations.<br />
make me a match<br />
the dental school hosted its first<br />
National Match Day celebration on January<br />
28 for members <strong>of</strong> the Class <strong>of</strong> <strong>2013</strong>.<br />
“Match Day represents the hopes and<br />
aspirations <strong>of</strong> thousands <strong>of</strong> students who<br />
wish to pursue residency or specialty training,”<br />
said Nadeem Karimbux, associate dean<br />
for academic affairs. “These students apply<br />
roxanna Khajavi, d13, hugs caitlin coleman, d13.<br />
to highly competitive programs across the<br />
country, and Match Day <strong>of</strong>ten times has<br />
the same effect as a lottery—you open your<br />
email and find out where you are going to<br />
spend the next one to six years.”<br />
At <strong>Tufts</strong>, approximately 50 percent <strong>of</strong> the<br />
graduating class applies to and is accepted<br />
into specialty residency training programs.<br />
The dental match occurs in two phases:<br />
Phase I results were released in November<br />
for students who applied to orthodontics<br />
or dental anesthesiology programs. Phase<br />
II results, for students who applied to programs<br />
in oral and maxill<strong>of</strong>acial surgery,<br />
pediatric dentistry, advanced education in<br />
general dentistry and general practice residencies,<br />
were announced on January 28. As<br />
<strong>of</strong> mid-March, more than 70 members <strong>of</strong> the<br />
class <strong>of</strong> <strong>2013</strong> had been accepted to specialty<br />
programs, general practice residencies and<br />
advanced education in general dentistry programs<br />
and residencies in the U.S. military.<br />
research For the second consecutive<br />
year, tufts was ranked number one by<br />
the american association for <strong>Dental</strong><br />
Research national student Research<br />
Group for having the most student<br />
abstracts accepted (60) for the annual<br />
session <strong>of</strong> the american, international<br />
and Canadian associations <strong>of</strong> <strong>Dental</strong><br />
Research, which took place in seattle<br />
in march. the school’s student<br />
research group will receive $300 for<br />
the achievement.<br />
debate Competing against students<br />
from the dental schools at harvard and<br />
Boston <strong>University</strong>, the team from tufts<br />
won the fourth annual american student<br />
<strong>Dental</strong> association District i debate, held<br />
at the dental school on February 23.<br />
tufts was represented by andrew tonelli,<br />
D14, Claire mcCarthy, D15, Christopher<br />
paolino, D16, and saad Butt, D15.<br />
student group the tufts student<br />
chapter <strong>of</strong> the american <strong>Dental</strong> education<br />
association (aDea) was recognized at<br />
aDea’s <strong>2013</strong> annual session, held in<br />
march in seattle, with the Distinguished<br />
Chapter award and outstanding<br />
activities award.<br />
38 tufts dental medicine spring <strong>2013</strong><br />
photos: kelvin ma
Food bank<br />
Frank Chow, assistant<br />
clinical pr<strong>of</strong>essor <strong>of</strong> prosthodontics<br />
and operative<br />
dentistry, and his wife,<br />
Eva (kneeling, front), are<br />
sharing their enthusiasm<br />
for volunteering at the<br />
Greater boston Food bank<br />
with others from <strong>Tufts</strong> dental<br />
<strong>School</strong>. on March 16, a<br />
group <strong>of</strong> 20 volunteers, which<br />
included students, faculty,<br />
family and friends, sorted<br />
more than 8,000 pounds <strong>of</strong><br />
food—the equivalent <strong>of</strong> 277<br />
meals per volunteer. The<br />
Chows hope to make this<br />
an annual event.<br />
celebrating persian new year<br />
back at fenway<br />
Former Red Sox pitcher Jim Lonborg,<br />
d83, who now practices dentistry<br />
instead <strong>of</strong> hurling fastballs, greeted<br />
fellow <strong>Tufts</strong> alumni and dental grads<br />
from other boston area schools at an<br />
alpha omega event at Fenway Park in<br />
december. “Gentleman Jim,” as he was<br />
known during his days on the mound,<br />
practices in Hanover, Mass.<br />
norouz, the persian new year, begins<br />
on the first day <strong>of</strong> spring. At the dental<br />
school, student groups have arranged<br />
Norouz celebrations since 1996.<br />
This year, the Persian Association<br />
<strong>of</strong> Student Dentists and Doctors <strong>of</strong><br />
<strong>Tufts</strong> <strong>University</strong> enjoyed a dinner at<br />
the Sackler Center on March 12, with<br />
110 in attendance, and performances<br />
by the Aftab dance group <strong>of</strong> Boston.<br />
“Most importantly, each year we set<br />
up a Haft Seen table on which symbolic<br />
objects are placed, such as apples,<br />
sib, symbolizing health,” said Serena<br />
Kankash, D13, vice president <strong>of</strong> the<br />
<strong>Tufts</strong> Persian group.<br />
Students enjoy the<br />
Persian new Year meal.<br />
Jim Lonborg,<br />
d83<br />
The aftab dance Group performs.<br />
photos: Fenway, Matthew Modoono; persian, eMily zilM<br />
spring <strong>2013</strong> tufts dental medicine 39
on campus<br />
1 2<br />
The Most Valuable Tool<br />
Good research is the foundation <strong>of</strong> good practice, aDa exec says by Julie Flaherty<br />
athleen o’loughlin, d81, the<br />
executive director and chief<br />
operating <strong>of</strong>ficer <strong>of</strong> the American<br />
<strong>Dental</strong> Association, tells a story<br />
about an observation that her husband,<br />
an HVAC mechanic, once made about one<br />
<strong>of</strong> her dental instruments. “I have one <strong>of</strong><br />
those,” he said. “It’s just bigger.”<br />
The tools may be similar, O’Loughlin<br />
said, but there is one important thing that<br />
keeps dentists from being perceived as glorified<br />
fix-it guys: evidence-based research.<br />
“That is what preserves us as a pr<strong>of</strong>ession,”<br />
she said. “Without it, we are nothing more<br />
than a trade.”<br />
O’Loughlin emphasized just how crucial<br />
research is to the future <strong>of</strong> dentistry<br />
when she gave the keynote address in<br />
March at Bates-Andrews Day, the annual<br />
showcase <strong>of</strong> research by <strong>Tufts</strong> dental<br />
students.<br />
Dentistry, she said, has come far from the<br />
days when dentists learned by apprenticeship.<br />
“You hung around for a couple years;<br />
you went out and practiced your own way;<br />
there was no scientific basis for the pr<strong>of</strong>ession,”<br />
she said. It has taken about 150 years<br />
for dentistry to achieve its current status as a<br />
medical pr<strong>of</strong>ession, she said. “So we cannot<br />
risk losing our reputation . . . by focusing on<br />
things that are not based in sound science<br />
and research. We just can’t risk it.”<br />
She encouraged students to follow in<br />
the footsteps <strong>of</strong> the creators <strong>of</strong> Novocain,<br />
nitrous oxide and modern composites. She<br />
pointed out that Rafael Bowen, the dentist<br />
who invented resin composites in the<br />
1960s, isn’t resting on his laurels; he is currently<br />
working on new restorative materials<br />
at the ADA Foundation’s Paffenbarger<br />
Research Center.<br />
Caries is a global public health issue,<br />
and more pr<strong>of</strong>essional resources need to be<br />
devoted to risk assessment and prevention,<br />
O’Loughlin said. Oral health research needs<br />
to refocus on disease management related to<br />
both oral and general health outcomes. To<br />
address current environmental concerns,<br />
O’Loughlin said, we need to find suitable<br />
restorative materials to phase down the use<br />
<strong>of</strong> materials with chemicals such as mercury<br />
and lead, for instance.<br />
“We need better, easier-to-use, more utility-driven<br />
restorative materials. If you are<br />
interested in this field <strong>of</strong> research,” she told<br />
the students in the audience, “get going.”<br />
Yet, O’Loughlin also pointed out that<br />
by focusing on research and taking a disease-management<br />
approach, including<br />
increasing awareness <strong>of</strong> the importance <strong>of</strong><br />
oral health to overall health and how to<br />
prevent dental diseases, dentists worldwide<br />
can help decrease the need for all<br />
restorative materials.<br />
Dentistry needs more and better studies<br />
vaLUabLe, continued on page 42<br />
40 tufts dental medicine spring <strong>2013</strong> photos: kelvin ma
Bates Day awarD winners<br />
3<br />
1 Claire McCarthy, d15,<br />
presents her research to tufts<br />
<strong>School</strong> <strong>of</strong> dental <strong>Medicine</strong><br />
dean Huw thomas at Batesandrews<br />
Research day.<br />
2 Jenna Hubacz, d15,<br />
discusses her research<br />
with Paul Leavis, associate<br />
pr<strong>of</strong>essor <strong>of</strong> physiology.<br />
3 the ada’s Kathleen<br />
o’Loughlin, d81, says the<br />
future <strong>of</strong> dentistry depends on<br />
a quality research enterprise.<br />
Best Postgraduate Poster<br />
Presentation<br />
(cash prize donated by Jess Kane, David Tesini<br />
and Nancy Jo, Soporowski): Eileen Saunders,<br />
“General Pediatricians’ Knowledge and<br />
Involvement in Oral Health Promotion in New<br />
England: A Survey”; faculty mentor: Cheen Loo<br />
Best scientific research<br />
Presentation By a senior,<br />
andrews society award<br />
(cash prize donated by Jess Kane, David Tesini<br />
and Nancy Jo Soporowski): Julianna Bair,<br />
“Shear Bond Strength <strong>of</strong> Resin Cements to<br />
Dentin and Enamel”; faculty mentors: Ronald<br />
Perry and Gerard Kugel<br />
ada/dentsPly student clinician<br />
award for Best overall<br />
PREdoCtoRaL taBLE CLiniC (travel to<br />
present research at <strong>2013</strong> ADA annual session):<br />
amanda Merikas, “Contact Angle and<br />
Shear Bond Strength Tests <strong>of</strong> Silane Primers”<br />
second-Place award for<br />
Predoctoral taBle clinic<br />
(cash prize donated by Jess Kane, David<br />
Tesini and Nancy Jo Soporowski, and present<br />
research at Greater New York <strong>Dental</strong> Meeting):<br />
Kyler McEwen, “Dentin Shear Bond Strength<br />
<strong>of</strong> RMGI Cements”; faculty mentors: Masly<br />
Harsono and Gerard Kugel<br />
third-Place award for<br />
Predoctoral taBle clinic<br />
(cash prize donated by Jess Kane, David<br />
Tesini and Nancy Jo Soporowski, and present<br />
research at Greater New York <strong>Dental</strong> Meeting):<br />
Saad Butt, “Functional Characterization <strong>of</strong> alk8<br />
in Zebrafish Mineralized Tissue Development”;<br />
faculty mentor: Pamela Yelick<br />
research committee award for<br />
Basic science research<br />
Shruti Pore, “E-Cadherin Suppression Alters<br />
Dab2-mediated Endocytosis in Squamous<br />
Cell Carcinoma Cells”; faculty mentor:<br />
addy alt-Holland<br />
massachusetts dental society<br />
and asda PuBlic health award<br />
(cash prize donated by the Massachusetts<br />
<strong>Dental</strong> Society): Erica Stutius, “Developmentally<br />
Disabled Adults Treated under<br />
General Anesthesia: Periodontitis and<br />
Correlates”; faculty mentor: John Morgan<br />
omicron KaPPa uPsilon (oKu)<br />
hilde tillman award<br />
(cash prize donated by OKU): Jaskaren<br />
Randhawa, “Analyzing the Trends and<br />
Associated Management Outcomes <strong>of</strong> Oral<br />
Lesions and Medication Regimens among<br />
the HIV-positive Patient Population at <strong>Tufts</strong><br />
<strong>University</strong> <strong>School</strong> <strong>of</strong> <strong>Dental</strong> <strong>Medicine</strong>”; faculty<br />
mentors: Kanchan Ganda and diana Esshaki<br />
Procter & gamBle traveling<br />
fellowshiP award<br />
(award donated by Procter & Gamble):<br />
Chase Larsen, “Fracture Toughness <strong>of</strong><br />
Provisional <strong>Dental</strong> Materials”; faculty mentors:<br />
Ronald Perry and Masly Harsono<br />
dr. chad anderson family award<br />
for innovative methodology and<br />
research design<br />
(cash prize donated by Chad Anderson):<br />
Lindsay Fox, “Marginal/Internal Fit <strong>of</strong> e.Max<br />
Impulse versus e.Max CAD All-ceramic<br />
Crowns”; faculty mentors: Gerard Kugel and<br />
Masly Harsono<br />
multicultural award for the<br />
advancement <strong>of</strong> dental research<br />
(travel award donated by Kistama Naidu):<br />
Errol Ramos, “Effect <strong>of</strong> Loupes on Ocular Blue<br />
Light Hazard: Indirect Viewing”; faculty mentor:<br />
Ronald Perry<br />
oral health disParities award<br />
natalie McClain, “Oral Health and Body<br />
Mass Index <strong>of</strong> Intellectually/Developmentally<br />
Disabled Adults”; faculty mentor: John Morgan<br />
Bates student research grouP<br />
Peer-reviewed award<br />
nick Freda, “Comparison <strong>of</strong> Polymerization<br />
Stress using RMGI Bond and Resin Adhesive”;<br />
faculty mentors: Ronald Perry and<br />
Gerard Kugel<br />
adea student grouP educational<br />
research award<br />
dave Cho, “The Relationship between<br />
Performance on Perceptual Ability Test Section<br />
<strong>of</strong> DAT and Clinical Success in <strong>Dental</strong> <strong>School</strong>”;<br />
faculty mentor: Yun Saksena<br />
spring <strong>2013</strong> tufts dental medicine 41
on campus<br />
vaLUabLe, continued from page 40<br />
on best practices, she said. Too <strong>of</strong>ten, answers<br />
to such questions as “Should you premedicate<br />
patients who have had joint replacements”<br />
are hard to come by, because existing studies<br />
have not produced clear-cut results.<br />
“Until you have a significant pool <strong>of</strong><br />
papers … that are high-quality research<br />
papers with good design with good controls<br />
. . . sometimes, frustratingly, we don’t<br />
have the answers,” she said.<br />
Unfortunately, good research is<br />
hindered by many obstacles, including<br />
lack <strong>of</strong> funding.<br />
The federal budget sequestration cuts<br />
that went into effect in March meant<br />
that the National Institute <strong>of</strong> <strong>Dental</strong> and<br />
Crani<strong>of</strong>acial Research, which supports<br />
more than 1,000 research projects, lost $21<br />
million <strong>of</strong>f its books overnight.<br />
“Speak up to your policymakers,” urged<br />
O’Loughlin, “because they undervalue<br />
oral health in general, and they certainly<br />
don’t understand the value <strong>of</strong> research in<br />
the dental pr<strong>of</strong>ession.”<br />
Practicing dentists, themselves, sometimes<br />
need a push toward appreciating<br />
evidence-based research. To make knowledge<br />
more accessible, the ADA’s Center<br />
for Evidence-Based Dentistry conducts<br />
systematic reviews <strong>of</strong> the scientific literature<br />
to help dentists integrate up-to-date<br />
evidence into patient care. “So that you<br />
don’t have to read 200 papers and figure<br />
that out,” O’Loughlin said, “we will do<br />
that for you.”<br />
Rajvir Jutla, D14, presents his research<br />
to <strong>Tufts</strong> President anthony Monaco at the<br />
bates-andrews Research Day<br />
4<br />
5<br />
4 John Lee, D14,<br />
presents his project<br />
to Sung M. Chi, DG14,<br />
from the postgraduate<br />
prosthodontics program.<br />
5 aundrea vereen, D11,<br />
a student in the postgraduate<br />
prosthodontics<br />
program, and Michael<br />
Thompson, pr<strong>of</strong>essor<br />
<strong>of</strong> diagnosis and health<br />
promotion.<br />
42 tufts dental medicine spring <strong>2013</strong><br />
photos: kelvin ma
university news<br />
the wider world <strong>of</strong> tufts<br />
New Tick-borne<br />
Disease Found<br />
<strong>Tufts</strong> researcher Sam<br />
Telford collects ticks for<br />
study on the grounds <strong>of</strong><br />
the Cummings <strong>School</strong> in<br />
North Grafton, Mass.<br />
What looks like Lyme could be a different illness transmitted<br />
by the same bug by Lindsey Konkel<br />
Under the microscope, sam telford surveyed the tiny, spiral<br />
bacteria floating in spinal fluid taken from an 80-year-old woman.<br />
They looked very similar to the spirochete bacteria that can cause<br />
Lyme disease. But in fact, he had discovered yet another public<br />
health threat—a brand new disease that people can get from the same ticks that<br />
transmit the Lyme bacteria.<br />
“We’ve known that this bacteria existed in the Northeast in deer ticks, but<br />
there was little data linking it to human disease” until now, says Telford, an<br />
expert on tick-borne diseases and a pr<strong>of</strong>essor in the Department <strong>of</strong> Infectious<br />
Diseases and Global Health at the Cummings <strong>School</strong> <strong>of</strong> Veterinary <strong>Medicine</strong> at<br />
<strong>Tufts</strong>. “We just needed the right patient to confirm the presence <strong>of</strong> the disease.”<br />
That patient was the elderly woman, who lived on a farm in New Jersey.<br />
Over four months, she had become increasingly confused. Her gait grew<br />
wobbly, and she didn’t have much <strong>of</strong> an appetite. Her immune system was<br />
compromised from a previous bout with cancer, so her doctors drew spinal<br />
fluid in the hopes <strong>of</strong> finding out what was going on.<br />
When technicians at a commercial diagnostic laboratory saw the mysterious<br />
spiral bacteria, they sent the sample for further testing to Telford,<br />
whose laboratory serves as a reference center for unusual zoonotic infections,<br />
those that pass between animals and humans.<br />
Telford and Heidi Goethert, J93, a microbiologist at the Cummings<br />
<strong>School</strong>, sequenced the spirochete DNA,<br />
and identified it as Borrelia miyamotoi,<br />
which was first found in ticks in Japan<br />
in 1995 and is closely related to the bacteria<br />
that causes Lyme disease. Previous<br />
human cases <strong>of</strong> B. miyamotoi infections<br />
were found in Russia in 2011.<br />
The <strong>Tufts</strong> scientists reported the first<br />
U.S. case <strong>of</strong> human B. miyamotoi infection<br />
in the New England Journal <strong>of</strong> <strong>Medicine</strong><br />
in January. (The woman was treated with<br />
antibiotics and has since recovered.)<br />
The B. miyamotoi bacteria may be an<br />
underrecognized source <strong>of</strong> human disease,<br />
especially in regions such as the northeastern<br />
United States, where Lyme disease is<br />
prevalent, say Telford and his coauthors.<br />
There’s controversy in the scientific and<br />
medical communities about whether a<br />
person can test negative for Lyme and still<br />
have Lyme, says Telford. This latest research<br />
raises the question <strong>of</strong> whether patients with<br />
atypical Lyme disease—those who have<br />
symptoms but whose blood doesn’t test positive<br />
for Lyme—may actually be infected<br />
with B. miyamotoi, he says. Both are treated<br />
with the same course <strong>of</strong> antibiotics.<br />
While an estimated 12 to 18 percent <strong>of</strong><br />
coastal New Englanders have been infected<br />
with the Lyme bacteria, called Borrelia burgdorferi,<br />
only between 1 and 3 percent <strong>of</strong> people<br />
have likely been infected with its lesserknown<br />
cousin, B. miyamotoi, researchers<br />
at Yale reported in a correspondence that<br />
accompanied the <strong>Tufts</strong> study in NEJM.<br />
This new disease, which has yet to<br />
be named, is the fifth known human<br />
infection to come from deer ticks in<br />
the Northeast, after Lyme, babesiosis,<br />
ehrlichiosis and deer tick virus.<br />
Ticks are notorious transmitters <strong>of</strong><br />
infectious disease around the globe. Their<br />
indiscriminate dining habits (they don’t<br />
seem to care what animals they feed on)<br />
and the relatively large amount <strong>of</strong> blood<br />
they consume (200 times their own body<br />
weight) make ticks great at picking up<br />
pathogens and spreading them.<br />
“Lyme disease alone is enough <strong>of</strong> an<br />
argument to take action to reduce risks, let<br />
alone four other infections,” says Telford.<br />
Lindsey Konkel is a freelance writer based in<br />
Worcester, Mass.<br />
spring <strong>2013</strong> tufts dental medicine 43
advancement<br />
giving. growth. gratitude.<br />
Justin Altshuler, D46,<br />
on his boat in Florida.<br />
All Hands on Deck<br />
To encourage young alumni to donate, Justin Altshuler, D46, issues second fundraising challenge<br />
by Heather Stephenson<br />
The call came at 6 a.m. fire had broken out in the boston<br />
building where Justin Altshuler, D46, operated his bustling<br />
dental practice. When Altshuler and his wife arrived at the<br />
scene, they found students from the apartments upstairs huddled<br />
in blankets provided by the Salvation Army. Snow covered the ground,<br />
and flames leapt from the upper windows.<br />
Once the smoke cleared, at least some <strong>of</strong> the <strong>of</strong>fice was salvageable. The<br />
records, fortunately, were in firepro<strong>of</strong> containers. But the appointment book<br />
was ashes. “Who was coming in tomorrow” Altshuler recalls wondering.<br />
“How could we call them”<br />
He and his wife, Bunny, who ran the <strong>of</strong>fice, got down to reclaiming—and<br />
ultimately redefining—their business. They quickly reconfigured the practice<br />
from a staff <strong>of</strong> 18 with five chairs for patients to just the two <strong>of</strong> them, a<br />
hygienist and two chairs.<br />
Now an 89-year-old widower who lives<br />
in Tampa, Fla., Altshuler says the downsizing<br />
triggered an epiphany. “We went home<br />
the first calendar year with more net pr<strong>of</strong>it<br />
with the small situation, and I didn’t have<br />
to worry about the management <strong>of</strong> the<br />
enterprise,” he says. “Small was better.”<br />
That kind <strong>of</strong> business insight, optimism<br />
and roll-up-your-sleeves effort has served<br />
Altshuler well. Born in Dorchester, Mass.,<br />
he completed his undergraduate courses at<br />
what is now the <strong>University</strong> <strong>of</strong> Massachusetts<br />
in two years because <strong>of</strong> World War II and his<br />
<strong>Tufts</strong> dental degree in three. He married and<br />
44 tufts dental medicine spring <strong>2013</strong><br />
photo: brian tietz
served in the Air Force in Puerto Rico and<br />
Trinidad for two years before returning to<br />
Boston to practice dentistry with his father<br />
in Kenmore Square.<br />
Eventually, he joined the faculty at<br />
the Goldman <strong>School</strong> <strong>of</strong> <strong>Dental</strong> <strong>Medicine</strong><br />
at Boston <strong>University</strong> as a clinical pr<strong>of</strong>essor.<br />
Henry Goldman, the former dean for<br />
whom the school is named, invited him to<br />
teach students about business practice in<br />
the dental <strong>of</strong>fice, but “without mentioning<br />
money,” he says.<br />
Money—earning it, managing it<br />
and giving it away—is a key theme for<br />
Altshuler. One <strong>of</strong> his two daughters, a sonin-law<br />
and his two grandchildren work in<br />
fundraising. “We were always brought up<br />
to be charitable,” he says.<br />
He made a significant donation to <strong>Tufts</strong><br />
<strong>University</strong> <strong>School</strong> <strong>of</strong> <strong>Dental</strong> <strong>Medicine</strong><br />
last year in honor <strong>of</strong> his classmates.<br />
Understanding the need to boost leadership-level<br />
gifts—that is, donations <strong>of</strong> more<br />
than $1,000—he issued this challenge: If<br />
300 alumni, parents or friends made a gift<br />
<strong>of</strong> $1,000 or more, he would donate $50,000.<br />
The response was tremendous and the<br />
challenge a success: Nearly 400 alumni,<br />
parents and friends gave a record amount,<br />
more than $773,000, to the <strong>Tufts</strong> <strong>Dental</strong><br />
Fund. More than half <strong>of</strong> those donors<br />
increased their gifts to $1,000 or more to<br />
meet the challenge.<br />
Now Altshuler has issued a new challenge,<br />
this one for young alumni, designed<br />
to increase participation at any level <strong>of</strong><br />
giving. With the GOLD Challenge (for<br />
graduates <strong>of</strong> the last decade), Altshuler<br />
will match dollar-for-dollar, up to $50,000,<br />
gifts that alumni from the classes <strong>of</strong> 2002 to<br />
2012 make to the <strong>Tufts</strong> <strong>Dental</strong> Fund before<br />
June 30, <strong>2013</strong>. This time, his money will go<br />
to scholarships to help deserving students.<br />
“The first challenge worked out,”<br />
Altshuler says. “I wanted to try something<br />
creative this time to assist even more young<br />
people in giving to <strong>Tufts</strong>.”<br />
For more inFormation about participating in the<br />
altshuler golD challenge, contact maria gove<br />
tringale, senior Director oF <strong>Dental</strong> Development<br />
anD alumni relations, at 617.636.2783<br />
or maria.tringale@tuFts.eDu or visit bit.ly/<br />
altshulerchallenge.<br />
The giving Tree<br />
Minna Kim, D03, doesn’t need to visit campus to stay connected. Two<br />
other dentists in the Marlborough, Mass., practice where she works are<br />
also alumnae: classmate Ina Daci, D03, and Margarita Panajoti, DI94.<br />
Her daughter’s orthodontist, James “Jess” Kane, D74, DG76, G78, DG79,<br />
D04P, DG06P, is an active volunteer<br />
and advocate for <strong>Tufts</strong> <strong>University</strong><br />
<strong>School</strong> <strong>of</strong> <strong>Dental</strong> <strong>Medicine</strong>.<br />
These connections weren’t the<br />
only factor in Kim’s decision to join<br />
the practice, or her choice <strong>of</strong> an<br />
orthodontist for her child. But knowing<br />
that a dentist was educated<br />
at <strong>Tufts</strong> gives her confidence in<br />
that person’s skills, she says. “The<br />
quality is just top-notch. It’s highcaliber<br />
dentistry.”<br />
Grateful for her own <strong>Tufts</strong> dental education, Kim was one <strong>of</strong> hundreds<br />
<strong>of</strong> alumni who participated in the first Justin Altshuler, D46, fundraising<br />
challenge to encourage donations at the leadership-giving level, making<br />
her donation just before Christmas 2012. Although she had never contributed<br />
at the $1,000 level before, the challenge inspired her.<br />
“It may sound cliché, but <strong>Tufts</strong> gave me the opportunity to pursue<br />
a career that I’m passionate about,” she says. “I enjoy going to work<br />
every day. I feel like every day I do something positive. It’s a good feeling,<br />
having the skills and knowledge to do that.”<br />
Soon after making her gift to <strong>Tufts</strong>, Kim decided to run the Boston<br />
Marathon to raise money for a nonpr<strong>of</strong>it group that helps students<br />
navigate the college financial aid process. “I got a great education,<br />
so I want to give that back to students,” she says.<br />
As a 2003 graduate, Kim qualifies for Altshuler’s new GOLD Challenge,<br />
for graduates <strong>of</strong> the last decade, and says she will give to the <strong>Tufts</strong> <strong>Dental</strong><br />
Fund again this year, encouraged once more by his <strong>of</strong>fer <strong>of</strong> a $50,000<br />
matching gift. Altshuler’s challenges have inspired her to imagine increasing<br />
her philanthropy, she says: “I just hope someday I can honor <strong>Tufts</strong> with<br />
a challenge like this.”<br />
—heather stephenson<br />
photo: alonso nichols<br />
spring <strong>2013</strong> tufts dental medicine 45
alumni news<br />
staying connected<br />
Changes on the horizon<br />
your dental alumni association board has been<br />
extremely busy. We started the year by creating<br />
a strategic plan to help guide us through the next<br />
five years and have begun implementing changes to<br />
existing programs, planning new ones and achieving<br />
new records.<br />
At our annual <strong>Tufts</strong> Wide Open Golf and Tennis<br />
Tournament last September, we had our highest<br />
attendance in more than a decade and we raised<br />
$28,000 for the Student Loan Fund, a record for the<br />
event. This is greatly needed and appreciated by our students.<br />
We have decided on a change <strong>of</strong> location for the annual reunion weekend.<br />
Starting in 2014, we will hold the event at the Four Seasons Boston, within<br />
walking distance <strong>of</strong> the dental school. It requires a great deal <strong>of</strong> work to move a<br />
complex event, and Susan Ahearn, senior associate director <strong>of</strong> alumni relations,<br />
did a wonderful job handling the process.<br />
Another new component <strong>of</strong> reunion weekend in 2014 will be the inaugural<br />
<strong>Tufts</strong> <strong>University</strong> <strong>Dental</strong> Alumni Association Educational Symposium, a full day<br />
<strong>of</strong> continuing education held on Friday <strong>of</strong> reunion weekend. The symposium will<br />
be open to reunioners as well as nonreunion-year alumni who want to attend.<br />
Our budget and our ability to create<br />
programming is a direct result <strong>of</strong> our duespaying<br />
members, and we thank them. If you<br />
are not a dues-paying member, please join<br />
us and help us shape the <strong>Dental</strong> Alumni<br />
Association experience.<br />
I had the opportunity to meet with<br />
many <strong>of</strong> you during our receptions in San<br />
Francisco, New York and at Yankee <strong>Dental</strong><br />
Congress. Thank you for all you shared with<br />
me during these visits. It has been a great<br />
honor to serve as your president.<br />
john j. millette, d91, a15p<br />
president, tufts university<br />
dental alumni association<br />
jmilldmd@gmail.com<br />
j<br />
j<br />
The Perks <strong>of</strong><br />
MeMbershiP<br />
It is time to renew your membership<br />
in the <strong>Tufts</strong> <strong>University</strong><br />
<strong>Dental</strong> Alumni Association.<br />
With so many organizations<br />
seeking your membership,<br />
why should you join this one<br />
This is your organization,<br />
and it represents your school.<br />
We speak with pride when we<br />
say we are graduates <strong>of</strong> <strong>Tufts</strong><br />
<strong>University</strong> <strong>School</strong> <strong>of</strong> <strong>Dental</strong><br />
<strong>Medicine</strong>. We are proud <strong>of</strong> its<br />
reputation as a world leader<br />
in research, education and<br />
patient care. A <strong>Tufts</strong> diploma<br />
is a mark <strong>of</strong> excellence.<br />
Did You Know<br />
Dues support the <strong>Tufts</strong> <strong>Dental</strong> Alumni Association,<br />
which has raised more than $325,000 for student loan funds. Dues<br />
subsidize Homecoming & Reunion Weekend. Dues help<br />
produce the award-winning <strong>Tufts</strong> <strong>Dental</strong> <strong>Medicine</strong> magazine. Dues<br />
sponsor the Student/Alumni Networking Event every<br />
March, as well as other student/alumni programming. Dues support<br />
regional receptions and activities in New York, Boston, California and<br />
Florida. Dues payers receive a $75 credit toward a <strong>Tufts</strong><br />
j<br />
Continuing Education course.<br />
Annual nual Dues for July 1, 2012, through<br />
June 30, <strong>2013</strong>, are $125.<br />
To pAy onlIne: http://dental.tufts.edu/dues.<br />
or, pleASe SenD checkS pAyAble To:<br />
<strong>Tufts</strong> <strong>University</strong> <strong>Dental</strong> Alumni Association:<br />
<strong>Tufts</strong> <strong>Dental</strong> Alumni Relations<br />
136 Harrison Avenue<br />
Boston, MA 02111<br />
j<br />
j<br />
j<br />
j<br />
j<br />
46 tufts dental medicine spring <strong>2013</strong><br />
pHoTo: kelvin MA
calendar<br />
Alumni<br />
Together, we begin...<br />
de-loVely. This work by the Massachusetts abstract painter Amy Maas hangs outside the<br />
14th-floor conference room at one kneeland Street. Maas works in acrylic media to create<br />
textured paintings that combine feelings <strong>of</strong> chaos and calm.<br />
MAy 19<br />
<strong>Tufts</strong> <strong>University</strong>’s<br />
157th Commencement<br />
Academic Quad<br />
Medford/Somerville Campus<br />
9 a.m.<br />
Commencement.tufts.edu<br />
MAy 25<br />
Alumni reception in<br />
conjunction with the annual<br />
session <strong>of</strong> the American<br />
Academy <strong>of</strong> pediatric<br />
Dentistry<br />
Walt Disney World<br />
Swan & Dolphin Hotel<br />
Orlando, Florida<br />
JUne 5<br />
Alumni reunion and<br />
continuing education program<br />
in conjunction with the<br />
Quintessence Symposium<br />
on periodontics and<br />
Restorative Dentistry<br />
<strong>Tufts</strong> <strong>University</strong> <strong>School</strong> <strong>of</strong><br />
<strong>Dental</strong> <strong>Medicine</strong><br />
Boston, Massachusetts<br />
SepTeMber 23<br />
Wide open Golf and<br />
Tennis Tournament<br />
Wellesley Country Club<br />
Wellesley, Massachusetts<br />
11 a.m. shotgun start; tennis<br />
tourney, 2-4 p.m., followed<br />
by reception and awards<br />
dinner<br />
SepTeMber 28–<br />
ocTober 1<br />
Alumni reception in<br />
conjunction with the annual<br />
session <strong>of</strong> the American<br />
Academy <strong>of</strong> periodontology<br />
Philadelphia,<br />
Pennsylvania<br />
ocTober 7–12<br />
Alumni reception in<br />
conjunction with the annual<br />
session <strong>of</strong> the American<br />
Association <strong>of</strong> oral and<br />
Maxill<strong>of</strong>acial Surgeons<br />
Orlando, Florida<br />
ocTober 9 –12<br />
Alumni reception in<br />
conjunction with the<br />
annual session <strong>of</strong> the<br />
American College <strong>of</strong><br />
prosthodontists<br />
Las Vegas, Nevada<br />
ocTober 31–<br />
noVeMber 3<br />
Alumni reception in<br />
conjunction with the annual<br />
session <strong>of</strong> the American<br />
<strong>Dental</strong> Association<br />
New Orleans, Louisiana<br />
noVeMber 29–<br />
DeceMber 4<br />
Alumni reception in<br />
conjunction with the Greater<br />
new York <strong>Dental</strong> Meeting<br />
New York City<br />
For more information about<br />
alumni events in your area, contact<br />
the <strong>of</strong>fice <strong>of</strong> <strong>Dental</strong> Alumni<br />
relations at 617.636.6773;<br />
email dental-alumni@tufts.edu or<br />
visit go.tufts.edu/dentalalums.<br />
During a time <strong>of</strong> transition<br />
and expanding horizons for<br />
the university, <strong>Tufts</strong> Alumni is<br />
pleased to invite you to meet<br />
with <strong>Tufts</strong> President Anthony P.<br />
Monaco to hear about his plan<br />
for developing a road map for<br />
where <strong>Tufts</strong> aspires to be in the<br />
next 10 years.<br />
During the first year <strong>of</strong> his<br />
tenure, <strong>Tufts</strong> Alumni hosted<br />
15 receptions to introduce the<br />
university’s 13th president to<br />
alumni and friends around<br />
the world. This year, President<br />
Monaco will be visiting a number<br />
<strong>of</strong> European cities as well as<br />
cities in Arizona, Colorado,<br />
Connecticut, Maine, New Jersey,<br />
Pennsylvania and Rhode Island.<br />
All members <strong>of</strong> the <strong>Tufts</strong><br />
community are invited to attend<br />
any <strong>of</strong> these special events to<br />
meet President Monaco and hear<br />
his thoughts on <strong>Tufts</strong> today and<br />
his vision for the future.<br />
As the president’s itinerary<br />
is developed, you can find<br />
event dates and locations at<br />
tuftsalumni.org/president.<br />
pHoTo: AMY MAAS pAinTinG CURATeD BY JUleS plACe GAlleRY, BoSTon, MA<br />
spring <strong>2013</strong> tufts dental medicine 47
alumni news<br />
Above: Derek Wolkowicz, D97, DG00, and<br />
bob harelick, e69, D73, A05p, D10p. below:<br />
Mira Zinger, D92; Virginia Shahinian, D77,<br />
DG79, D12p; and Sandra cove, D92.<br />
yankee dental dandy<br />
Senior class gift will support work <strong>of</strong> <strong>Tufts</strong> dental students at free clinic in boston<br />
ean huw f. thomas, john millette, d91, a15,<br />
president <strong>of</strong> the <strong>Tufts</strong> <strong>University</strong> <strong>Dental</strong> Alumni<br />
Association, and staff from the Office <strong>of</strong> <strong>Dental</strong><br />
Development and Alumni Relations welcomed<br />
more than 1,000 alumni, family and friends to the Westin<br />
Boston Waterfront hotel on February 1 for a reception that<br />
took place in conjunction with Yankee <strong>Dental</strong> Congress<br />
<strong>2013</strong>. Many alumni visited the <strong>Tufts</strong> Alumni Lounge,<br />
located on the exhibit floor, during New England’s largest<br />
dental meeting.<br />
That same day, the school was host to its annual reception for<br />
the senior class. Class President Kevin Burke and Vice President<br />
Ellen H<strong>of</strong>fman announced that graduating seniors will direct<br />
their class gift to support dental students who provide services<br />
at the Bridge Over Troubled Waters dental clinic in Boston.<br />
In keeping with the spirit <strong>of</strong> active citizenship that is a hallmark<br />
<strong>of</strong> a <strong>Tufts</strong> education, more than 50 members <strong>of</strong> the class<br />
<strong>of</strong> <strong>2013</strong> and others from the dental school <strong>of</strong>fer free services<br />
to youth ages 14 to 24 through the Project Bridge program.<br />
Jess Kane, D74, DG76, G78, DG79, D04P, DG06P, and<br />
Mary Jane Hanlon, D97, cochairs <strong>of</strong> the <strong>Dental</strong> M Club executive<br />
committee, and Abi Manter, D10, reminded the fourthyear<br />
students about the importance <strong>of</strong> staying engaged with<br />
<strong>Tufts</strong>, volunteering as a reunion cochair, joining the <strong>Dental</strong><br />
Alumni Association or volunteering as faculty.<br />
Save the date for Yankee <strong>Dental</strong> Congress 2014, which is<br />
scheduled for January 29 to February 2, 2014, at the Boston<br />
Convention and Exhibition Center.<br />
48 tufts dental medicine spring <strong>2013</strong><br />
pHoToS: MATTHeW MoDoono
Members <strong>of</strong> the class <strong>of</strong> <strong>2013</strong> spend<br />
some time with Jess kane, fourth<br />
from left, cochair <strong>of</strong> the M club. From<br />
left: yen Tran, christopher rohe, Matt<br />
elston, kane, brian beck, Arpan Desai,<br />
Victor Mai and christine lee.<br />
register now!<br />
<strong>Tufts</strong> <strong>Dental</strong><br />
Career<br />
Link<br />
Above, From left: natalia h<strong>of</strong>fmann, D02,<br />
DG04; Abdullaibrahim Abdulwaheed, e97,<br />
D02; and Stanislav Moline, D02. below,<br />
Senior class Vice president ellen h<strong>of</strong>fman<br />
and president kevin burke address their<br />
classmates at the reception.<br />
• Search job openings and<br />
practices for sale or rent.<br />
(Searches can only be made by<br />
members <strong>of</strong> the <strong>Tufts</strong> <strong>Dental</strong><br />
community. Postings are available<br />
to nonalumni and multiple<br />
members <strong>of</strong> an <strong>of</strong>fice.)<br />
• Use the Alumni Advisors<br />
Network, an opt-in directory<br />
that connects <strong>Tufts</strong> students<br />
and alumni for advising,<br />
networking, referrals or<br />
just keeping in touch.<br />
• Create or enhance<br />
résumés with templates<br />
from Resume Builder.<br />
From left: caitlin coleman, Georgia Dellas, rita estephan,<br />
Damion cooper and Julie Williams, all D13.<br />
dental.tufts.edu/careerlink<br />
spring <strong>2013</strong> tufts dental medicine 49
alumni news<br />
out&about<br />
Golden Gate GatherinG<br />
More than 100 alumni attended a <strong>Tufts</strong> reception on October 19, held in<br />
San Francisco in conjunction with the annual session <strong>of</strong> the American <strong>Dental</strong><br />
Association. Alumni were able to visit with classmates and friends and spend<br />
time with Dean Huw F. Thomas.<br />
From left: Richard Harold, D80; Hugh Phillis, D80,<br />
DG82, D13P; Joanne Falzone, D80; Robert Chideckel,<br />
D80; Tom Green, D80; Desiree Palmer, D80;<br />
Bruce Verrill, D80; and Pamela DiTomasso, D80.<br />
From left: Mark Gonthier, executive associate dean;<br />
Jin-Por Tsai, D13P; Cheng-Ho Tsai, DI87, D13P;<br />
Michael Lee, D96; and Dean Huw Thomas.<br />
dinner<br />
with the deans<br />
Dean Huw F. Thomas and Executive Associate<br />
Dean Mark Gonthier invited alumni, parents and<br />
friends <strong>of</strong> the dental school from the Los Angeles<br />
area to attend a dinner at Spago in Beverly Hills on<br />
November 8. The event, “Conversations with the<br />
Deans,” gave Thomas and Gonthier an opportunity<br />
to share their vision for the school’s future.<br />
surGeons<br />
in san dieGo<br />
More than 30 alumni and<br />
friends who were in San Diego<br />
for the annual session <strong>of</strong> the<br />
American Association <strong>of</strong> Oral<br />
and Maxill<strong>of</strong>acial Surgeons<br />
mingled at a reception at the<br />
Hilton San Diego Bayfront<br />
on September 11. Maria<br />
Papageorge, D82, DG86,<br />
DG89, A12P, pr<strong>of</strong>essor and<br />
chair <strong>of</strong> oral and maxill<strong>of</strong>acial<br />
surgery, welcomed the group<br />
and updated them about<br />
news from the department.<br />
From left: Pushka Mehra, Richard<br />
D’Innocenzo, Laurie Manthos, D87, DG91,<br />
Kalpakam Shastri, DG05, Michael Hunter<br />
and Maria Papageorge, pr<strong>of</strong>essor and chair<br />
<strong>of</strong> oral and maxill<strong>of</strong>acial surgery.<br />
From left: Jaubin Nguyen, D99; Myhanh Tran; Mark Gonthier;<br />
Emad Bassali, D97; and Clark Martin, D79, DG83, D15P.<br />
Scott Wolpin, D89; Astrid Soegaard,<br />
D89; and Ron Zeidler, D89.<br />
50 tufts dental medicine spring <strong>2013</strong>
Periodontists<br />
in l.a.<br />
Alumni and friends gathered at the JW Marriott at<br />
lA live in los Angeles on october 1 for a reception<br />
held in conjunction with the annual meeting <strong>of</strong><br />
the American Academy <strong>of</strong> periodontology. James<br />
Hanley, D75A, DG79, associate dean for clinical<br />
affairs and interim chair <strong>of</strong> periodontology welcomed<br />
the group and provided an update on the<br />
search for the next department chair.<br />
new york state <strong>of</strong> Mind<br />
The Greater new York <strong>Dental</strong> Alumni Chapter held its fall meeting in<br />
conjunction with the Greater new York <strong>Dental</strong> Meeting on november 27<br />
at the Marriott Marquis. Dean Huw F. Thomas and Mark Gonthier, executive<br />
associate dean, hosted a discussion on the changing face <strong>of</strong> dental<br />
education. Alumni shared their thoughts on curriculum, technology in<br />
dentistry and interpr<strong>of</strong>essional education.<br />
hiroshi kimura, D93, DG95, and<br />
Duke yau-Fwu huang, DG82.<br />
Above, from left: evan<br />
Schwarz, D03; Steve<br />
rubin, D75; rob berg,<br />
D03; Julia Sivitz, D05,<br />
DG08; and Jordan<br />
lissauer, D08.<br />
MeetinG in BaltiMore<br />
Hiroshi Hirayama, DG90, Di93, DG94, pr<strong>of</strong>essor <strong>of</strong><br />
prosthodontics and operative dentistry, hosted alumni<br />
at a reception at the Baltimore Marriott Waterfront on<br />
november 1. More than 50 alumni, who were in town<br />
for the annual meeting <strong>of</strong> the American College <strong>of</strong><br />
prosthodontists, gathered poolside to reconnect with<br />
colleagues and classmates.<br />
left, from left: Dean<br />
huw F. Thomas, Debbie<br />
lee, D94, and Steven<br />
Tunick, D73.<br />
Above: betina yuen and<br />
Aundrea Vereen, D11, DG16.<br />
From left: M<strong>of</strong>tah<br />
el-Ghadi, DG08;<br />
holly Shepherd,<br />
DG13; and hamilton<br />
le, D05, DG08.<br />
From left: e.J. bartolazo, D92; Mauro perdomo, D12; Marjorie baptiste,<br />
D08, DG11; nirmol chandhoke, D12; and omar hassani, D12.<br />
spring <strong>2013</strong> tufts dental medicine 51
alumni news<br />
class notes<br />
Stephen M. Bank<br />
D61is working as a<br />
part-time librarian in Cary, N.C.<br />
Edwin N. Galkin made New<br />
Jersey Magazine’s “Top Dentists”<br />
list, chosen by his peers for the<br />
second consecutive year.<br />
D63<br />
Jack L.<br />
Appelbaum is<br />
the national meeting chair for<br />
the American Academy <strong>of</strong> Oral<br />
<strong>Medicine</strong> and an investigator for<br />
the Medicare Fraud Division for<br />
the state <strong>of</strong> Nevada.<br />
After 47 years <strong>of</strong><br />
D65running a solo<br />
practice that served the D.C.<br />
suburbs in Maryland, Allan C.<br />
Johnson is retiring to Bethany<br />
Beach, Del., with his wife <strong>of</strong> 41<br />
years, Jan Johnson. He says he<br />
will be seeking a new puppy and<br />
beach and golf time.<br />
Stephen V. McLaughlin, DG78,<br />
DG03P, D11P, still practices<br />
four days a week. He has 10<br />
children, three <strong>of</strong> whom are<br />
dentists (Ian, D11, Caitlin,<br />
NYU <strong>Dental</strong>, and Brendan,<br />
DG03, NYU <strong>Dental</strong>.). He has 49<br />
grandchildren and is expecting<br />
two more. His daughter Cara<br />
is a graduate <strong>of</strong> Johns Hopkins<br />
Medical <strong>School</strong>.<br />
Angelo G.<br />
D66 Boncore, see D85.<br />
Daniel G. Davidson<br />
D72 has served as<br />
president <strong>of</strong> the California <strong>Dental</strong><br />
Association. This year he is chair<br />
<strong>of</strong> Cal DPAC, the state dental<br />
PAC <strong>of</strong> California. He continues<br />
to practice general dentistry in<br />
San Francisco and lives in Marin<br />
County with his wife, Leslie.<br />
Steven J. Tunick,<br />
D73 an oral surgeon<br />
who practices in New York<br />
City, was tapped by New York<br />
State Health Commissioner<br />
Nirav Shah to serve on the<br />
new I-STOP (Internet System<br />
for Tracking Over-Prescribing)<br />
Advisory Committee. The I-STOP<br />
Committee is expected to play<br />
a major role in developing educational<br />
programs for healthcare<br />
providers on helping their<br />
patients avoid prescription drug<br />
abuse through the new I-STOP<br />
controlled-substance prescription<br />
registry. Committee efforts<br />
will be aided by new electronic<br />
prescribing standards for New<br />
York State. Tunick is a clinical<br />
assistant pr<strong>of</strong>essor <strong>of</strong> oral and<br />
maxill<strong>of</strong>acial surgery at Weill<br />
Cornell Medical College, assistant<br />
attending oral surgeon at<br />
New York Presbyterian Hospital<br />
and clinical assistant dentist<br />
at Memorial Sloan-Kettering<br />
Cancer Center. He is a past<br />
president <strong>of</strong> the New York State<br />
Society <strong>of</strong> Oral and Maxill<strong>of</strong>acial<br />
Surgeons and currently serves<br />
on the organization’s board <strong>of</strong><br />
directors. He is a member <strong>of</strong><br />
the New York County <strong>Dental</strong><br />
Society board <strong>of</strong> directors and<br />
chairs the group’s Pr<strong>of</strong>essional<br />
Liability Claims Committee.<br />
D75a<br />
Paul J.<br />
Desjardins<br />
retired in 2011 and now heads<br />
Desjardins Associates, a drug<br />
and medical device consulting<br />
company. He also chairs the<br />
<strong>School</strong> <strong>of</strong> <strong>Dental</strong> <strong>Medicine</strong>’s<br />
Board <strong>of</strong> Advisors. He can be<br />
reached at paul.j.desjardins@<br />
gmail.com.<br />
D79<br />
Alan W. James<br />
and his wife,<br />
Joanne, became first-time<br />
grandparents when their daughter,<br />
Kelsey, gave birth to a baby<br />
girl, Hope Maya, on March 6,<br />
2012.<br />
William A. Kropa, Kevin F.<br />
Toomey, D80, and Katharine<br />
A. Burton, D10, have opened<br />
the Wellfleet <strong>Dental</strong> Group in<br />
Wellfleet, Mass.<br />
Jeffrey R. Prinsell was the<br />
invited chair and lecturer at a<br />
surgery symposium in Rome at<br />
the World Congress on Sleep<br />
Apnea. He gave presentations<br />
on maxillomandibular advancement<br />
and other extrapharyngeal<br />
surgery for the treatment<br />
<strong>of</strong> obstructive sleep apnea.<br />
Prinsell is the founding president<br />
<strong>of</strong> the American Board <strong>of</strong><br />
<strong>Dental</strong> Sleep <strong>Medicine</strong>, past<br />
president and Distinguished<br />
Service Award recipient <strong>of</strong><br />
the American Academy <strong>of</strong><br />
<strong>Dental</strong> Sleep <strong>Medicine</strong> and<br />
past chair <strong>of</strong> the Obstructive<br />
Sleep Apnea Section <strong>of</strong> the<br />
American Association <strong>of</strong> Oral<br />
and Maxill<strong>of</strong>acial Surgeons<br />
(AAOMS). He served on the<br />
American Academy <strong>of</strong> Sleep<br />
<strong>Medicine</strong> Standards <strong>of</strong> Practice<br />
Committee Task Force to<br />
update practice parameters<br />
for obstructuve sleep apnea<br />
surgery. He authored a chapter<br />
in the textbook Current Therapy<br />
in OMS (Elsevier 2011). Prinsell<br />
is a diplomate <strong>of</strong> the AAOMS,<br />
treasurer <strong>of</strong> the Georgia Society<br />
<strong>of</strong> OMS; a visiting lecturer at<br />
Emory <strong>University</strong> and Vanderbilt<br />
<strong>University</strong> and a surgical consultant<br />
at several Atlanta area<br />
sleep centers. He maintains a<br />
private practice in Marietta, Ga.,<br />
where he resides with his wife,<br />
Kim, and sons Jeffrey and Eric.<br />
Kevin F. Toomey,<br />
D80 see D79.<br />
After a 30-year<br />
D81career in the U.S.<br />
Army, most recently serving at<br />
Fort Jackson, S.C., Michael F.<br />
Cuenin retired from the U.S.<br />
Army <strong>Dental</strong> Corps in 2011 at<br />
the rank <strong>of</strong> colonel. A board-certified<br />
periodontist, he joined the<br />
Carolina Center for Restorative<br />
Dentistry (www.ccrdonline.com)<br />
in Mount Pleasant, S.C.<br />
Joseph Kenneally has been<br />
elected vice president <strong>of</strong> the<br />
International College <strong>of</strong> Dentists<br />
for <strong>2013</strong>, and will serve as<br />
president in 2015. Kenneally, <strong>of</strong><br />
Biddeford, Maine, has received<br />
numerous leadership awards<br />
from the American <strong>Dental</strong><br />
Association, the Maine <strong>Dental</strong><br />
Association, Yankee <strong>Dental</strong><br />
Congress and the <strong>University</strong> <strong>of</strong><br />
New England. His ICD activities<br />
have been numerous at the<br />
New England District, the USA<br />
section and the international<br />
level. He chaired the Information<br />
Technology Committee for many<br />
years and helped guide the ICD’s<br />
electronic communications and<br />
web media efforts.<br />
Paul Shamirian, D16P, writes<br />
that his son, Paul R. Shamirian,<br />
began his dental education at<br />
<strong>Tufts</strong> in September 2012.<br />
Nancy H. Starr<br />
D83 writes that her<br />
oldest son, Zachary, is in his<br />
second year <strong>of</strong> dental school<br />
Follow <strong>Tufts</strong> <strong>Dental</strong> alumni<br />
facebook.com/tuftsdentalalumni<br />
@tuftsdental<br />
52 tufts dental medicine spring <strong>2013</strong>
Dino Man<br />
Stanley Alexander, D75A, was just 4 when his parents first<br />
took him to a place known for its drama and majesty, the<br />
American Museum <strong>of</strong> Natural History in New York City. On the<br />
museum’s fourth floor, he stood amazed as he gazed at the<br />
Tyrannosaurus skeleton. That instant the young Alexander<br />
fell in love with dinosaurs—a passion that continues to this<br />
day. In fact, he jokes, were it not for creature comforts, he<br />
might have become a field paleontologist.<br />
Alexander’s own children have met the museum dinosaurs,<br />
including the skeleton <strong>of</strong> a long-necked Barosaurus rearing up<br />
to protect its young from an Allosaurus, a predator with gnashing<br />
teeth and sharp claws, both holding court in the grand<br />
entrance.<br />
As pr<strong>of</strong>essor and chair <strong>of</strong> pediatric dentistry at <strong>Tufts</strong> <strong>School</strong><br />
<strong>of</strong> <strong>Dental</strong> <strong>Medicine</strong>, Alexander has an <strong>of</strong>fice that is a dinosaur<br />
fan’s treasure trove. Children on their way to be treated in the<br />
pediatric dental clinic <strong>of</strong>ten wander in and play with one <strong>of</strong> his<br />
fossils or dinosaur toys. Some he has collected himself; others<br />
are gifts from patients, colleagues, family and friends.<br />
The saber-tooth cat jaw on his desk is especially fearsome,<br />
with its 11-inch pair <strong>of</strong> canines and rows <strong>of</strong> tiny, sharp teeth.<br />
“They attacked mammals,” he notes, matter-<strong>of</strong>-factly, “and<br />
ripped them apart.”<br />
On the floor is a plaster footprint <strong>of</strong> a Dilophosaurus made<br />
at Dinosaur State Park in Rocky Hill, Conn., which has 2,000<br />
dinosaur tracks. Alexander lugged 50 pounds <strong>of</strong> material into<br />
the park to make the cast. There are also dinosaur cartoons,<br />
a Tyrannosaurus rex made out <strong>of</strong> leaded glass, a tie pin in<br />
the shape <strong>of</strong> an Apatosaurus and fuzzy dice shaped like<br />
a Triceratops. Even his business card has a picture <strong>of</strong> an<br />
Allosaurus dashing to a dental appointment.<br />
When Alexander taught orthodontics at Long Island’s Stony<br />
Brook <strong>University</strong>, where he was a pr<strong>of</strong>essor for 28 years, he had<br />
his students participate in a scavenger hunt at the American<br />
Children on their way to be treated in the pediatric dental<br />
clinic <strong>of</strong>ten wander in and play with one <strong>of</strong> Stanley Alexander’s<br />
fossils or dinosaur toys.<br />
Museum <strong>of</strong> Natural History. After all, he says, the skulls, jaws<br />
and teeth they had to search for are related to dentistry and<br />
orthodontics. He has yet to assign his Massachusetts students<br />
to a similar scavenger hunt, as the nearest place with fossils,<br />
Harvard’s Museum <strong>of</strong> Comparative Zoology, doesn’t quite live<br />
up to his beloved Manhattan institution.<br />
He’s been teaching at <strong>Tufts</strong> for six years now, and sometimes<br />
wonders what would have happened had he taken a different<br />
path. During his own dental education at <strong>Tufts</strong>, he nearly<br />
left to pursue a doctorate in paleontology, a field perhaps less<br />
practical than the one he chose. What changed his mind It<br />
wasn’t just the lack <strong>of</strong> a comfortable bed and a hot shower.<br />
“My parents talked me out <strong>of</strong> it,” he says.<br />
—marjorie howard<br />
at the <strong>University</strong> <strong>of</strong> Maryland.<br />
He plans to join his mother in<br />
practice in Massachusetts when<br />
he graduates.<br />
Fern E. Selesnick-<br />
D85 Frisch, took over<br />
the dental <strong>of</strong>fice <strong>of</strong> Angelo G.<br />
Boncore, D66, in January 2010,<br />
and renamed it Marblehead<br />
<strong>Dental</strong>.<br />
David J. Ward<br />
D89 received his associate<br />
fellowship in the American<br />
Academy <strong>of</strong> Implant Dentistry<br />
in 2011.<br />
DG89 Lyon<br />
Hamburg<br />
has completed his 20th year<br />
as the staff endodontist at<br />
Children’s Hospital <strong>of</strong> Eastern<br />
Ontario. He also recently served<br />
with the <strong>Dental</strong> Volunteers<br />
for Israel in Jerusalem, which<br />
provides free dental services to<br />
impoverished Jewish, Christian<br />
and Muslim children.<br />
Steven A. Brown<br />
D91is serving as president<br />
<strong>of</strong> the Rhode Island <strong>Dental</strong><br />
Association for 2012–13.<br />
Michelle M. Dorsey was<br />
installed as president <strong>of</strong> the<br />
Brevard County <strong>Dental</strong> Society<br />
in Florida in September 2012.<br />
Nishan A. Odabashian was<br />
named president <strong>of</strong> the<br />
California State Association<br />
<strong>of</strong> Endodontists at its biannual<br />
meeting on Oct. 26, 2012.<br />
Odabashian and his wife, Lilit,<br />
PHOTO: ALONSO NICHOLS spring <strong>2013</strong> tufts dental medicine 53
alumni news<br />
have three children, Galia, 7;<br />
Serge, 5; and Noah, 2. He practices<br />
restorative endodontics in<br />
Glendale, Calif.<br />
Peiman Mahdavi, see D98.<br />
Chris B.<br />
D94 Theodorou and<br />
his wife announce the birth<br />
<strong>of</strong> their second daughter,<br />
Panagiota Basil Pandora, on<br />
October 9, 2012.<br />
Di94<br />
Ejaz Ali, DI94,<br />
A11P, D15P<br />
and Femina Ali, DI97, A11P,<br />
D15P, received a record amount<br />
<strong>of</strong> donated Halloween candy<br />
in response to the Wellesley<br />
<strong>Dental</strong> Group’s fifth annual candy<br />
drive to donate treats, accompanied<br />
by handwritten notes,<br />
to troops serving overseas in<br />
Iraq and Afghanistan. More than<br />
20 schools and organizations<br />
donated.<br />
D95<br />
Robert E. Lane<br />
and his wife welcomed<br />
twins Jason Blake Lane<br />
and Samantha Emily Lane on<br />
August 20, 2012.<br />
Finn T. Esrason<br />
D96 sold his practice<br />
in Randolph, Mass., and is moving<br />
to Hawaii to be near his sons<br />
and grandchildren.<br />
Femina Ali, see<br />
Di97DI94.<br />
D98<br />
John A. Pavlo,<br />
A94, DG00,<br />
has been practicing in his<br />
hometown <strong>of</strong> Peabody,<br />
Mass., with a satellite <strong>of</strong>fice<br />
in Newburyport since 2000.<br />
Married to Vickie, they have two<br />
sons, Thanos and Yianno. Pavlo<br />
is excited to take the reins from<br />
fellow <strong>Tufts</strong> alumnus Peiman<br />
Mahdavi, D91, DG94, as<br />
president <strong>of</strong> the Massachusetts<br />
Association <strong>of</strong> Orthodontists.<br />
Gina R. Marcus-<br />
D03 Melnick and<br />
her husband, Ilan Melnick,<br />
welcomed their second child,<br />
Jordan Myles, on May 26,<br />
2012. She has been appointed<br />
director <strong>of</strong> the board <strong>of</strong> the<br />
Sandy B. Muller Breast Cancer<br />
Foundation.<br />
Charley Cheney<br />
D04 joined the<br />
advisory board <strong>of</strong> The New<br />
Dentist journal. Shortly after<br />
graduating from <strong>Tufts</strong>, he was<br />
deployed to Baghdad for a year<br />
as a U.S. Army dentist. Since<br />
then, he has completed a fouryear<br />
active-duty tour. He notes<br />
that his tour in Iraq was an<br />
excellent opportunity to obtain<br />
experience.<br />
Whitney C.<br />
D09 Mitchell has<br />
been working as an associate<br />
with Morgan, Morgan & Morgan<br />
D.D.S. in Jacksonville, N.C.<br />
since October 2012. She was<br />
expecting a second son in<br />
January. He will join older brother<br />
Wyatt Carter Mitchell.<br />
Jane Saltman Os<strong>of</strong>sky and<br />
her husband, Max Os<strong>of</strong>sky,<br />
welcomed a girl, Eliza Os<strong>of</strong>sky,<br />
on April 24, 2012.<br />
Katharine A.<br />
D10 Burton, see D79.<br />
WE WANT TO HEAR FROM yOu. Send your Class Note information<br />
to Susan Ahearn, <strong>Tufts</strong> <strong>Dental</strong> Alumni Relations, 1 Kneeland St.,<br />
Floor 7, Boston, MA 02111 you can also email dental-alumni@tufts.<br />
edu or fax 617.636.4052<br />
Travel To exTraordinary places wiTh excepTional people<br />
Adventures Above And beyond<br />
TufTs<br />
Travel-learn<br />
visit: www.tuftstravellearn.org<br />
Visit our<br />
website to see<br />
the exciting<br />
lineup <strong>of</strong> <strong>2013</strong><br />
destinations!<br />
From Peru to Provence, from<br />
Myanmar to the Mediterranean,<br />
our lineup features classic and<br />
traditional to undiscovered and<br />
emerging destinations, showcasing<br />
our world’s natural beauty<br />
and cultural diversity.<br />
Join us!<br />
Contact usha sellers, ed.d.,<br />
director, at usha.sellers@tufts.edu<br />
or 617-627-5323 for our catalog<br />
or specific brochure, or visit our<br />
website for itineraries.<br />
54 tufts dental medicine spring <strong>2013</strong>
obituaries<br />
Norman Diamond, Longtime Faculty Member<br />
Norman Diamond, D57, DG64, who was<br />
on the faculty <strong>of</strong> <strong>Tufts</strong> <strong>School</strong> <strong>of</strong> <strong>Dental</strong><br />
<strong>Medicine</strong> for nearly half a century, died on<br />
February 27 at the age <strong>of</strong> 80.<br />
Diamond joined the Department <strong>of</strong><br />
Orthodontics in 1966 and retired as an<br />
associate clinical pr<strong>of</strong>essor in 2012. He<br />
Norman Diamond<br />
served in the U.S. Navy <strong>Dental</strong> Corps<br />
from 1957 to 1959. A board-certified orthodontist, he held a<br />
number <strong>of</strong> leadership roles at <strong>Tufts</strong> and in dental societies.<br />
He was a former president <strong>of</strong> the <strong>Tufts</strong> <strong>Dental</strong> Alumni<br />
Association and the <strong>Tufts</strong> Association <strong>of</strong> Orthodontists and<br />
held <strong>of</strong>fices in the Massachusetts <strong>Dental</strong> Society and the<br />
Metropolitan District <strong>Dental</strong> Society, among others.<br />
He is survived by his wife, Judith, three children, five grandchildren<br />
and a brother. Donations in his memory may be made<br />
to the Department <strong>of</strong> Orthodontics, <strong>Tufts</strong> <strong>University</strong> <strong>School</strong> <strong>of</strong><br />
<strong>Dental</strong> <strong>Medicine</strong>, 1 Kneeland St. (DHS-11), Boston, MA 02111<br />
or the Michael J. Fox Foundation for Parkinson’s Research, Grand<br />
Central Station, P.O. Box 4777, New York, N.Y. 10163-4777.<br />
IN MEMORIAM<br />
G. Robert Carvelli, D43B<br />
October 12, 2012<br />
Waltham, Massachusetts<br />
Arnold H. Serow, D43B<br />
January 12, <strong>2013</strong><br />
Hamden, Connecticut<br />
Frank X. Manganaro, D44<br />
December 3, 2012<br />
Woburn, Massachusetts<br />
William J. Pendergast,<br />
D44, DG81P<br />
August 17, 2012<br />
Marion, Massachusetts<br />
Robert L. Kantor, D46<br />
December 20, 2012<br />
Longmeadow, Massachusetts<br />
Arthur J. Seiler, D47<br />
September 14, 2012<br />
Barnegat, New Jersey<br />
George V. Picard, D49<br />
December 12, 2012<br />
Cumberland, Rhode Island<br />
Frederick A. Hickey, D52<br />
November 9, 2012<br />
Lowell, Massachusetts<br />
John S. Miller, D52<br />
August 12, 2012<br />
Lowville, New York<br />
John R. Gould, D53<br />
December 24, 2012<br />
Holden, Massachusetts<br />
Walter J. Leckowicz, D53,<br />
D91P, D92P<br />
October 28, 2012<br />
Newington, Connecticut<br />
Harold R. Ratchford, D53<br />
November 7, 2012<br />
Chicopee, Massachusetts<br />
James Will, D53<br />
November 28, 2012<br />
Hingham, Massachusetts<br />
Robert J. Detamore, DG55<br />
September 20, 2012<br />
Carmel, Indiana<br />
Paul R. DeLisle, D56<br />
September 9, 2012<br />
Leominster, Massachusetts<br />
Lewis Skeirik, D56, A76P,<br />
D79P, J84P<br />
January 9, <strong>2013</strong><br />
Georgetown, Massachusetts<br />
Henry J. Heim, DG56<br />
September 12, 2012<br />
Bethesda, Maryland<br />
Frederick M. Mansour, D58,<br />
DG61, A75P, M90P<br />
September 11, 2012<br />
Lancaster, Massachusetts<br />
Ronald E. Myers, D58<br />
November 14, 2012<br />
Otis, Massachusetts<br />
Morton J. Weyler, DG59<br />
January 5, <strong>2013</strong><br />
Woodbridge, Connecticut<br />
Winthrop W. Harrington,<br />
D60, J89P<br />
October 8, 2012<br />
Lincoln, Massachusetts<br />
Rene J. Leclerc, D60<br />
November 5, 2012<br />
West <strong>Spring</strong>field, Massachusetts<br />
Roderick M. Goyette, D61<br />
December 28, 2012<br />
Barre, Vermont<br />
Kiva Skolnick, D62<br />
August 4, 2012<br />
Beverly, Massachusetts<br />
Nicholas D. Procino, D63<br />
November 9, 2012<br />
Hollywood, Florida<br />
Arthur R. Sergi Jr., D63, DG66<br />
November 16, 2012<br />
Duxbury, MA<br />
Thomas F. Winkler III, A62, D66,<br />
D10P, DG12P<br />
October 20, 2012<br />
Lexington, Massachusetts<br />
Jeffrey I. Eisman, D68<br />
January 7, <strong>2013</strong><br />
Amherst, Massachusetts<br />
Roger A. yurgelun, D68<br />
November 11, 2012<br />
Marshfield, Massachusetts<br />
Daniel G<strong>of</strong>fred Jr., D70<br />
September 16, 2012<br />
Wolcott, Connecticut<br />
Dwane E. Brown, D72<br />
October 8, 2012<br />
Framingham, Massachusetts<br />
Michael J. John, D74<br />
October 18, 2012<br />
Carlisle, Massachusetts<br />
Thomas F. Dorsey Jr., D77<br />
September 19, 2012<br />
North Weymouth, Massachusetts<br />
Jitka M. Janicek, DI91,<br />
DG92, DG08P<br />
December 8, 2012<br />
Sandwich, Massachusetts<br />
spring <strong>2013</strong> tufts dental medicine 55
Courses fill quiCkly!<br />
register early!<br />
For registration information and<br />
course details, please contact us:<br />
Online: dental.tufts.edu/ce<br />
Email: <strong>Dental</strong>ce@tufts.edu<br />
Phone: 617.636.6629<br />
Fax: 617.636.0800<br />
DiVisioN <strong>of</strong> CoNtiNuiNg eDuCatioN<br />
tufts uNiVersity<br />
sCHool <strong>of</strong> DeNtal MeDiCiNe<br />
oNe kNeelaND street<br />
BostoN, Ma 02111<br />
continuing education<br />
june 5<br />
How to Take Your Direct Posterior<br />
Restorations to the Next Level:<br />
The Stress-reduced Protocol<br />
Simone Deliperi, D.D.S.;<br />
David N. Bardwell, D.M.D., M.S.<br />
june 7<br />
Eighth annual Head and Neck Cancer<br />
Symposium: The Mouth and Beyond<br />
Michael A. Kahn, D.D.S.; Scott Benjamin,<br />
D.D.S.; J. Michael Hall, D.D.S.;<br />
Nora Laver, M.D.; Adele Moreland, M.D.;<br />
Richard O. Wein, M.D.; Sook-Bin Woo, D.M.D.<br />
june 8<br />
“When Can We Start”<br />
The Magic <strong>of</strong> Case Acceptance<br />
Stan Michalski III, D.D.S.<br />
september 27–28<br />
Symposium on Oral Appliances in<br />
<strong>Dental</strong> Sleep <strong>Medicine</strong><br />
Noshir R. Mehta, B.D.S.; D.M.D., M.D.S.,<br />
M.S.; Leopoldo P. Correa, B.D.S., M.S.,<br />
Noah Siegel, M.D.<br />
oc tober 2<br />
Esthetics & Gingival Concerns for<br />
Anterior Implant Restorations<br />
Arnold Weisgold, D.D.S., F.A.C.D.;<br />
Paul A. Levi Jr., D.M.D.;<br />
Eduardo Marcuschamer, D.D.S.<br />
oc tober 4<br />
Maxill<strong>of</strong>acial Imaging Frontiers<br />
and Applied Imaging<br />
David C. Hatcher, D.D.S., M.Sc., M.R.C.D.<br />
november 1<br />
Ultrasonic Instruments in Fixed<br />
Prosthodontics: Their Use for<br />
Anterior Tooth Preparation and<br />
Nontraumatic S<strong>of</strong>t-tissue Retraction<br />
Vincent Bennani, D.D.S.<br />
november 2<br />
Headache Consortium<br />
<strong>of</strong> New England<br />
<strong>Tufts</strong> <strong>University</strong> <strong>School</strong> <strong>of</strong> <strong>Dental</strong><br />
<strong>Medicine</strong> is an ADA CERPrecognized<br />
provider. Approval<br />
dates: 11/11–12/15. ADA CERP<br />
does not approve or endorse<br />
individual courses or instructors,<br />
nor does it imply acceptance<br />
<strong>of</strong> credit hours by boards <strong>of</strong><br />
dentistry. Concerns or complaints<br />
about a CE provider may be<br />
directed to the provider or to<br />
ADA CERP or ada.org/goto/cerp.
SPORTS FOR SCHOLARSHIP<br />
WIDE OPEN<br />
<strong>Dental</strong> Alumni<br />
Student Loan Fund<br />
Can’t participate this year Please consider<br />
a $100 donation to help future students <strong>of</strong><br />
<strong>Tufts</strong> <strong>Dental</strong> and be listed as a tournament<br />
sponsor in <strong>Tufts</strong> <strong>Dental</strong> <strong>Medicine</strong> magazine.<br />
Please complete the registration form and<br />
enclose your check, made payable to<br />
<strong>Tufts</strong> <strong>University</strong> <strong>Dental</strong> Alumni Association,<br />
and mail to:<br />
Office <strong>of</strong> Alumni Relations<br />
<strong>Tufts</strong> <strong>University</strong><br />
<strong>School</strong> <strong>of</strong> <strong>Dental</strong> <strong>Medicine</strong><br />
One Kneeland Street, 7th Floor<br />
Boston, MA 02111<br />
For more information:<br />
Phone: 617.636.6773<br />
Email: dental-alumni@tufts.edu<br />
http://dental.tufts.edu/alumni
SPORTS FOR SCHOLARSHIP<br />
OPEN<br />
Join the <strong>Tufts</strong> <strong>University</strong><br />
<strong>Dental</strong> Alumni Association for the<br />
31st Annual Wide Open<br />
Golf & Tennis Tournament<br />
Monday, September 23, <strong>2013</strong><br />
Wellesley Country Club<br />
300 Wellesley Avenue<br />
Wellesley, Massachusetts<br />
<strong>Tufts</strong> <strong>Dental</strong> alumni, faculty, family<br />
and friends are invited to participate!<br />
All proceeds benefit<br />
the <strong>Dental</strong> Alumni Student<br />
Loan Fund<br />
Golf and Tennis Registration<br />
9:30 a.m. to 2 p.m.<br />
Golf Tournament<br />
11 a.m. shotgun start<br />
Lunch included<br />
Tennis Tournament<br />
2 to 4 p.m.<br />
Reception<br />
4 p.m.<br />
Awards Dinner<br />
5 p.m.<br />
Registration Fees<br />
Golf Tournament<br />
$375/player<br />
$1,400/foursome if signed up together<br />
Tennis Tournament<br />
$200/player<br />
Reception and Awards Dinner<br />
$75 for guests and noncompetitors
<strong>2013</strong> Wide Open Tournament<br />
Registration Form<br />
Name__________________________________________________<br />
Graduation year or affiliation with <strong>Tufts</strong> <strong>Dental</strong>____________<br />
Guest(s) name(s)_______________________________________<br />
Address________________________________________________<br />
_______________________________________________________<br />
Daytime phone_________________________________________<br />
Email__________________________________________________<br />
My handicap is___________.<br />
Cost includes lunch, tournament, reception and<br />
awards dinner.<br />
Golf Tournament<br />
$375/player<br />
$1,400/foursome if signed up together<br />
My foursome will include:<br />
2. ____________________________________________________<br />
3. ____________________________________________________<br />
4. ____________________________________________________<br />
❒ Please check here if you would like to be placed<br />
in a foursome.<br />
Tennis Tournament<br />
$200/player<br />
Reception & Awards Dinner Only<br />
$75 for guests and non-competitors<br />
Payment:<br />
_____ golfers @ $ 375 each = $____________<br />
_____ tennis @ $ 200 each = $____________<br />
_____ dinner only @ $ 75 each = $____________<br />
_____ I am unable to attend the <strong>2013</strong> WIDE OPEN,<br />
but I’d be proud to be listed as a sponsor for my<br />
$100 donation to the Student Loan Fund.<br />
❒ My check for $__________ is enclosed.<br />
❒ Please charge $__________ to my<br />
❒ MasterCard ❒ VISA ❒ Discover<br />
Card #_____________________________________ Exp._______<br />
Billing Address:<br />
Street __________________________________________________<br />
City ______________________ State ______ Zip _____________<br />
TOTAL ENCLOSED<br />
$__________<br />
Please mail this form and your check, payable to <strong>Tufts</strong><br />
<strong>University</strong> <strong>Dental</strong> Alumni Association, to Office <strong>of</strong> Alumni<br />
Relations, <strong>Tufts</strong> <strong>University</strong> <strong>School</strong> <strong>of</strong> <strong>Dental</strong> <strong>Medicine</strong>,<br />
One Kneeland Street, 7th Floor, Boston, MA 02111.<br />
Registration confirmation and directions will be mailed<br />
to you prior to the tournament.
<strong>School</strong> <strong>of</strong> <strong>Dental</strong> <strong>Medicine</strong><br />
136 Harrison Avenue<br />
Boston, ma 02111<br />
www.tufts.edu/dental<br />
NoNpr<strong>of</strong>it org.<br />
U.s. postage<br />
paid<br />
BostoN, ma<br />
permit No. 1161<br />
o pioneers!<br />
Like the other female students at <strong>Tufts</strong>’ dental<br />
and medical schools in 1917, Erna Neumann,<br />
front row, left, didn’t hew to a conventional path.<br />
Getting her D.M.D. took pluck and courage.<br />
For more on her story, turn to page 24.<br />
TuFTs uNIvErsITy OFFIcE OF PuBlIcATIONs 8444 05/13