dental care—but also being able toafford it.Brian Roy (’13) participated in rotationsat three public health clinics during hisfourth year <strong>of</strong> dental school, anddescribes treating an 11 year-old girlwho presented with significant decay onher maxillary left first molar, which hadbecome symptomatic to the point <strong>of</strong>disturbing the girl’s sleep.<strong>UDM</strong> Dental student Michael Liu (‘14), and Dr. Heidi Hudson <strong>of</strong> Covenant Community Care,review their patient’s scansChanging attitudes (and lives)For many dental students, especiallythose who come from relativelycomfortable, middle-class backgrounds,caring for patients who are <strong>of</strong>tenstruggling with multiple, complexissues—including extreme poverty,homelessness, legal problems, and evenaddiction—can initially be somewhatdistressing. However, initialawkwardness frequently turns tounderstanding, and even empathy, asstudents begin to see their patients notjust as “cases” to be solved, but asindividuals—each with his or her ownlife story, including their own uniqueopportunities and challenges.In many cases, these interactions forcestudents to challenge their own attitudesand assumptions about the “poor” andthe “underserved.”Lisa Sontag (’13) describes a patient shetreated while participating in a CBDEprogram rotation at the Cherry Streetclinic in Grand Rapids. Whenever theman arrived, he was always wellgroomed,and very well dressed, so shejust assumed he was a middle-classpr<strong>of</strong>essional. But, after making smalltalk with the man, she eventuallydiscovered he had been unemployed—and desperately searching for work—forseveral years.While participating in a rotation in<strong>Detroit</strong>, Sontag says she alsoencountered a man who showed up foran appointment over an hour late—bundled up, head-to-toe in a snowsuit.“He cheerfully responded to ourquestioning glances by saying ‘It’s coldoutside! I had to walk!’… as it turns outthe man had walked three miles inbone-chilling cold in order to make hisappointment,” says Sontag. “Thecommon assumption is that people whoattend community dental clinics don’ttake responsibility for their health, orfeel they are ‘entitled’ to care. However,my program experiences showed this<strong>of</strong>ten is not the case.”For other students, participating in theCBDE program illuminates thetremendous challenges many patientsface with regard to not only accessing“The tooth was restorable, but itrequired endodontic treatment,” saysRoy. “The patient was enrolled inMedicaid, which covers endodontictreatment for children—but there are noproviders in the Grand Rapids area thataccept Medicaid payment for rootcanals. I suggested to her father that wecould perform a root canal, and that itwould cost around $800…but he toldme that he simply could not afford it,and asked me to extract the tooth. Thatcase made me really sad, and I felt veryguilty extracting a restorable molar onsuch a young patient,” he says.New experiences leadto new career pathsFor some students, having suchexperiences leads not only to greaterawareness and better understanding,but also a greater willingness toconsider practicing in underserved areas,after graduation.Kyle Blau (’13) says that as he began hisfourth year <strong>of</strong> dental school and beganto consider his post-graduationemployment options, his primary focuswas on finding a job that would allowhim to follow his passion <strong>of</strong> practicingdentistry while still being able to “paythe bills.” However, following a CBDErotation in Kalamazoo, and two in<strong>Detroit</strong>, he began to think differently.“After finding out that almost all publichealth dentistry jobs <strong>of</strong>fer some form <strong>of</strong>loan repayment assistance, it becamemore obvious to me that this might besomething worth looking into,” says22 LEADING EDGE SUMMER 2013
Blau. Eventually, I had opportunitiesto work with doctors at multipleclinics who all told me how much theyenjoyed their work, and howrewarding it was to be able to providedental services to underservedpopulations. Many <strong>of</strong> them alsoexpressed how important they felt itwas to be able to continue to providethese services to many people whoneed them so badly…and I started tobecome more and more convinced.“Based on these experiences, I’vedecided that public health dentistry isdefinitely the route I want to take afterdental school,” says Blau.From modest beginnings…many promising futures<strong>UDM</strong> Dental student John Yurkovich (‘14) spends a few minutes chattingwith a nervous patient at Gateway ClinicFrom its modest beginnings only fiveyears ago, the CBDE has come toprovide hundreds <strong>of</strong> <strong>UDM</strong> Dentalstudents with extraordinaryopportunities to help—and to betterunderstand the complex challengesthat many patients, and communities,face with regard to being able toaccess (and afford) regular, preventivedental care. In so doing, the programhas also allowed many students tobetter appreciate, and perhaps evenconsider career opportunities inpublic health dentistry.In the process, the CBDE program hasbecome an integral part <strong>of</strong> both the<strong>UDM</strong> Dental curriculum, as well the<strong>School</strong>’s ongoing commitment toproviding expanded services to thecommunity — including providingdental sealants in school-basedprograms, oral cancer screenings athealth fairs, and prevention programstargeting certain populations in groupcare settings, such as nursing homes.As such, the CBDE program is yetanother outstanding example <strong>of</strong><strong>UDM</strong>’s mission to promote Jesuitand <strong>Mercy</strong> education.Here’s HowYou Can HelpNo matter where youlive or practice, thereare many ways you canhelp to to closethe “dental divide,”by providing direct,or indirect, assistanceto individuals who needregular, preventivedental care:Work in a “safety-net” clinic,such as a Federally QualifiedHealth Center (FQHC) or acommunity clinic located ina Dental Health Pr<strong>of</strong>essionShortage Area (D-HPSA).Help to sponsor, start, orparticipate in a school-basedsealant program.Agree to take more Medicaidpatients in your practice. (Ifevery practicing dentist agreedto see only a relatively smallnumber <strong>of</strong> these patients, theoverall access rate wouldimprove dramatically.)Make a donation to <strong>UDM</strong> Dentalto support programs such asthe school mouth guardprogram, school-based dentalsealant programs, and othercommunity programs.To donate, contact:Bradd R. Melville(313) 494-6927bradd.melville@udmercy.eduFor more information aboutCommunity Programs, contact:Dr. Divesh Byrappagari(313) 494-6898divesh.byrappagari@udmercy.edu