May 02, 2008

Case Western Reserve University Dental Students learn through experience at Free Clinic

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Worries about paying the dentist increases the agony of a toothache or prevents people from seeking care, but sufferers find relief at The Free Medical Clinic of Greater Cleveland.  At the patients’ sides are students from Case Western Reserve University School of Dental Medicine, who are on the front lines of combating one of the country’s major health problems—poor oral health.

For many students, who hail from middle-class backgrounds, easing the pain for the country’s working-class poor, who lack access to dental and health insurance or are unemployed, is an eye-opening experience to health disparities in the United States, Benjamin Schechter, Case Western Reserve’s director of patient services at the dental school.

Established in 1970, the Free Clinic is one of the oldest free clinic in the country and is staffed by 57 employees and a corps of 250 volunteers. The Free Clinic provides free health care services to those who lack  appropriate alternatives and advocates for public policies to make health care accessible to all people.  It is the training site for some 25 programs in medicine, mental health, social work, nursing, pharmacy and dentistry—many of these programs providing a “real life” education for Case Western Reserve’s students.

When The Free Clinic was rebuilt in 2002 at its Euclid Avenue site in University Circle, the building included a Dental Clinic with five chairs, x-ray room, administrative office and an equipment sterilization center.  The facilities’ design provides a private office atmosphere.  The Dental Clinic plans were heavily influenced by John Ball, a dental school alum and president of the Free Clinic’s board of trustees.

Schechter says he knows the value of The Free Clinic experience, because he volunteered there in its early days when the clinic operated from a house on Cornell Road.  That experience changed his life.  After graduation in 1974 from the dental school, he devoted approximately 30 percent of his private practice appointments for people on Medicaid.

In 2006, Schechter helped update the protocols for a formal affiliation agreement with The Free Clinic that extends the clinical experience for third- and fourth-year students to include this community clinic. Each week three students rotate from the university’s dental clinic to train and provide services at The Free Clinic. They are supervised by dentist Louis Ebersold and 14 volunteer dentists, all visiting faculty members of the dental school.

"The Free Clinic experience supports two educational missions of the dental school-community service and educational training," said Schechter. The Free Clinic experience is one of 600 partnerships the university has with community organizations throughout the region.

"This collaboration allows us to leverage our limited resources and to provide quality care to hundreds of uninsured patients each year," stated Danny Williams, executive director of The Free Clinic and also a 2004 graduate of the Mandel Center for Nonprofit Organizations.

In addition to the rotation, students are encouraged to volunteer "the second shift" where appointments are designated for emergency extractions. Last year, the clinic did 1,750 extractions of the 8,462 dental services offered, according to Ebersold. "Pain brings people here," he said.

The Free Clinic and the discounted services of Case Western Reserve's dental clinic at Cornell Road and Emergency Drive provide dental health safety nets for the area's people.

During the day, two fourth-year and one third-year students see at least three patients each. The daytime hours are spent doing restorations, fillings, root canals and cleanings.

While the average Free Clinic dental patient is between the ages of 28-35, they see adult patients ranging in age from 18 to older than 90.

More volunteer dentists are needed. Because of the shortage of volunteers, some patients will have to wait as long as five weeks for a first-time appointment. In addition, The Free Clinic is in the planning stages of offering dental and other services on the weekends, which will require more volunteer help.

"The long wait attests to the fact that these people do not have insurance and cannot go somewhere else to see a dentist," said Ebersold.

He added that for low income patients the no-show rate for appointments is high as people find difficulties in keeping appointments due to lack of transportation, childcare or even communications like the use of a telephone.

It takes a special kind of dentist to understand the challenges these patients face and work around them, Schechter says. "Our students learn what those challenges are and hopefully will see the need to help now and later after they graduate," he added.

Posted by: Paula Baughn, May 2, 2008 11:05 AM | News Topics: Collaborations/Partnerships, Collaborations/Partnerships, Community Outreach, Faculty, School of Dental Medicine, Teaching, University Circle

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