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Taking a bite out of tooth decay

MORGANTOWN - Brandi Howard, a senior at West Virginia University's School of Dentistry, likes to take her time when she's drilling a tooth, pulling a molar or fitting a crown. So before she started on a six-week practicum at a rural dental practice in Webster County, she called the office to warn them about her speed with patients.

"I'm slow," she recalled telling the person who answered the telephone.

The receptionist wasn't sure what to make of Howard's statement.

"She apparently thought I was mentally slow," Howard said. "When I got down there, I had to make sure they knew I wasn't slow. I learned a lot."

By the end of the semester, Howard not only proved she wasn't mentally slow, she improved her speed and skills.

Howard was one of two dozen WVU dental students who fanned out across rural parts of the state last fall to work in dental practices.

The program, which is part of the West Virginia Rural Health Education Partnerships, aims to keep WVU graduates in the state and expose them to underserved West Virginia communities.

The program's dental component started in 1992 with four dentists.

Now, more than 30 dental practices have teamed up with WVU's School of Dentistry.

Dental students must be in their final year of study. Most get a steady schedule of patients - children and adults - five days a week over at least six weeks during the practicum.

They sharpen their skills, develop patient treatment plans and learn the business side of dentistry - billing, Medicaid reimbursement, private insurance, patient scheduling and employee payroll.

"It helps build their confidence," said Richard Meckstroth, who directs the Department of Dental Practice and Rural Health at WVU's School of Dentistry. "They say, 'Hey, I can do this.' They realize they're up to the challenge."

Students also must take part in community outreach programs, visiting schools, 4-H fairs, day-care centers and nursing homes to talk about the importance of oral health.

Some students return to a dental practice near their hometown during the practicum.

"It was absolutely the best experience of my life," said Jamie Wheeler, who worked with two dentists in Gassaway. "I loved every day, every minute."

Wheeler and her classmates returned to Morgantown one afternoon earlier this month to talk about their experiences.

Most raved about their practicum, but there also were complaints.

Some students didn't see as many patients as they'd hoped. Others struggled with equipment that was different than what they learned on at WVU.

Most students worked with low-income patients. One dentist office gave patients a 40 percent discount if they had work done by a WVU student.

Kolin Weaver worked in a community health clinic that charged patients only $10 per visit. That fee paid for everything.

"I got to help people who more than likely couldn't get help because they couldn't afford it and would otherwise not be receiving treatment," Weaver said. "I was seeing patients nonstop."

Poor oral health remains a neglected epidemic in West Virginia, especially among low-income children and adults.

West Virginia leads the nation in the percentage of senior adults with total tooth loss, according to the Centers for Disease Control. West Virginia also has one of the lowest percentages of people who visit a dentist at least once a year.

The state also has high rates of tooth decay among children.

WVU students saw the problem firsthand.

"We did mostly extractions," said Maria Bonasso, who worked at a clinic in Shinnston.

During his practicum, Mark Knott developed a PowerPoint presentation that explains how to conduct oral screenings. The report, available on CD, will be provided to all WVU health-science students to help them determine patients' oral-health needs and make proper referrals.

Knott volunteered in an office in Preston County.

"It has improved my efficiency and enabled me to provide better care," he said.

Dan Brody, a veteran Wayne County dentist with Valley Health Systems, said the rural program allows him to give back to the dental school and helps him keep abreast of the latest dentistry practices.

"The [students] see folks who aren't going to have access to care any other way," said Brody, who has mentored WVU dental students for 12 years. "They see the need."

More than half of WVU dental school students plan to return to rural practices next semester before they graduate in May, even though another practicum is not required.

"I want them to do as much dentistry as they can possibly do," Meckstroth said. "They're developing their skills. They're developing their speed. You can't do too much dentistry."

To contact staff writer Eric Eyre, use e-mail or call 348-4869. Eyre's work on dentistry is being supported by a fellowship from the Kaiser Family Foundation.


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