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   from the issue of February 10, 2005

     
 
Dental College providing health care to rural areas

UNMCs College of Dentistry is developing creative ways to address the growing problems of access to oral health care and the shortage of dentists practicing in rural areas.

"Thanks to a lot of hard-working faculty, staff, and students, we were able to reach some goals that we've been dreaming about for years," said John Reinhardt, D.D.S., dean of the UNMC College of Dentistry, located on UNL's east campus.

In one year the college:

Established an electronic link between a hospital in Alliance and the college to offer practicing dentists 400 miles away the support and expertise of dental faculty.

Partnered with the Nebraska State Dental Association to form a consortium with Wyoming, Kansas and South Dakota to address oral health access problems of underserved populations in rural areas.

Launched a distance continuing education course for rural dentists to save them time and money.

At the same time, the college continued to offer free dental care to 973 underserved children across the state, educate more than 200 dental and dental hygiene students and rose to the rank of 20th in research support from the National Institutes of Health out of the 55 dental colleges around the country.

"This past year we have grown closer to fulfilling our vision of becoming a premier institution in the United States for educating dental health care professionals,"Reinhardt said.

With the formation of the Great Plains Oral Health Consortium, the UNMC College of Dentistry is able to address access to care issues in Nebraska and partner states Wyoming, South Dakota and Kansas by supporting recruiting efforts in those states, providing guaranteed spots at the college for their students who qualify and encouraging those same students to consider a rural practice through externships to small towns.

"Being in a rural state where there is a shortage of dentists, it is important that we find ways to lure the best and brightest students to consider a career in dentistry," said Tim Pieper, D.D.S., president of the Wyoming Dental Association. "Then hopefully those students will return to our state to practice."

Pieper was one of several people from Nebraska and surrounding states that Reinhardt approached with the idea of forming a consortium at an American Dental Association meeting in 2001.

Reinhardt suggested that Nebraska and the other three states jointly apply for "Target Access" grants ear-marked by the federal government.

In partnership with the Nebraska Dental Association, the College of Dentistry and dental associations in Wyoming, Kansas and South Dakota applied for and won a one-year Target Access Great Plains Oral Health grant.

Spearheaded by the UNMC College of Dentistry, three of the four states received funding totaling more than $800,000, with Wyoming receiving $360,000, Nebraska $250,000 and South Dakota $200,000.

"We will use the money to train practicing dentists across the state of Wyoming to go into high schools, community colleges and undergraduate institutions to recruit students," Pieper said.

As the lead institution, the College of Dentistry is using the funding to provide recruiting materials and guidance, including a recruitment DVD customized for each state, literature and 3,000 recruiting posters that will be sent to each dentist in the partner states.

Curt Kuster, D.D.S., director of admissions and a professor in the department of growth and development at the UNMC College of Dentistry, is coordinator of all Target Access activities.

Part of his duties will include visiting rural colleges in all of the states as well as the University of Wyoming to meet with students and advisors.

The UNMC College of Dentistry also will facilitate a pre-dental class at the University of Wyoming, via satellite link.

"Perhaps, one of the neatest things that the College of Dentistry is doing," said Pieper, "is they are organizing a survey of practicing dentists in all four states to establish a baseline of where dentistry stands in each state and then come back with another survey in five years to see how we've done."

All four states have the same goal, Reinhardt said.

"We hope to raise awareness so the best rural students from each state will put dentistry at the top of their list for a potential career and consider practicing in a rural community," he said.

In the meantime there is still access to care and shortage issues to address, said David Brown, UNMC professor of oral biology.

To meet those needs the College of Dentistry has continued to host a Children's Dental Day in Lincoln, busing in youths from a dozen surrounding counties, as well as providing dental services for a program in Hastings, Brown said.

But last year faculty, staff and students from the college decided to take up a request from the residents of Alliance, and bring Dental Day to them.

On June 3, 73 faculty, staff and students made the 800-mile round-trip from Lincoln to Alliance, bringing with them 11 portable operatories and all of the instruments and supplies needed to provide comprehensive restorative care, cleanings and fluoride treatments.

The value of care provided during the two-day event reached $55,000.

"We plan to return to Alliance the first weekend of June," Brown said. "This time we are going to try to pull patients from the whole Panhandle and not just Box Butte County.

Children's Dental Day enables low-income, uninsured and underinsured families the opportunity to receive care, he said, while at the same time it gives our students the opportunity to not only practice their dental and cultural competency skills but reinforce the college's message that dental education is a gift that one should share with the less fortunate.

The College of Dentistry first began offering Children's Dental Day in 2001. Since then, the college has provided care for more than 700 youths at a value of $375,000.

"We target children because we have an opportunity to teach them what good oral health is and why it is important to look after their teeth as adults," Brown said.

"A side-benefit of Dental Day VI was the chance to showcase to the dental and dental hygiene students the reward of practicing in a rural area," said Donald "Cork" Taylor Jr., D.D.S., whose practice is in Alliance. "We are constantly searching for innovative ways to ease the shortage of dental practitioners in rural locations."

It was during the Alliance Dental Day event that the College of Dentistry established the first telehealth link between the local hospital and the college in Lincoln, using sophisticated cameras and high-speed internet transmission.

Children who presented more difficult cases were sent to the hospital where dental faculty could converse via audio and video internet means with specialists at the college.

The ongoing link has provided local residents more flexibility in accessing care from their local dentists who might otherwise have to send their patients miles away for specialized care.

Brown said another reason for establishing the link is to show dental students how to use teledentistry and make it a part of their practice, especially if they are in a rural area.

"We are looking at establishing another telehealth site somewhere in the area of Grand Island or Kearney," he said.

While the satellite links help improve access to care and give practicing dentists an immediate link to specialists at the college, it also can provide an opportunity for those dentists to fulfill their continuing education requirements closer to home, said Brian Lange, D.D.S., professor and chairperson, dental practice management and director of continuing education at the UNMC College of Dentistry.

On Nov. 11 the college did just that with the introduction of its first interactive continuing education course conducted via internet to dentists in Gering.

Using the technology already available through the College of Dentistry's dental hygiene program in which students in Gering take courses with peers in Lincoln, the college offered a three credit-hour oral pathology course on lichenoid lesions, burning mouth syndrome and white lesions.

Gering Dentist George Schlothauer, D.D.S., said the program was a "wonderful opportunity for us to get continuing education credits without having to drive across the state."

Sam Jacoby, a D.D.S. from Bridgeport, Neb., agrees.

"We are required to have 30 hours of continuing education credits every two years to keep our license," Jacoby said. "Sometimes in our part of the world that is hard to do without having to travel 400 miles to Lincoln or 250 miles to Denver."

Lange said the program was very well received and the college is planning to offer more courses in the future.

For dentists practicing in rural Nebraska that is welcome news.



GO TO: ISSUE OF FEBRUARY 10

NEWS HEADLINES FOR FEBRUARY 10

Communications key to nurturing grad students, new faculty
Dental College providing health care to rural areas
A Piece of University History
NU Press reorganization addresses future

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