A REASON TO SMILE

This May, future dentists will toss their mortarboard hats into the air as the first cohort of students to graduate from the University of Utah’s School of Dentistry. The U’s first new school in more than 50 years has built an impressive reputation in its four short years; the inaugural class had the second-highest GPA for incoming dental students in the United States, all 20 students have passed their dental board exams and scored in the top 15 percent nationally, and all will practice dentistry either in private practice or with additional training.

The decades-long dream of a dental school became a reality with a gift from the Noorda family that funded the Noorda Oral Health Sciences Building. The school aims to do more than educate future dentists; its mission is to spur innovation through research, integrate oral care into overall health care and to meet the needs of community members who lack access to dental care. The community service aspect of the mission is especially important.

“The Noorda family was very much interested in the theme of caring for underserved populations, and we totally bought into that,” says Glen Hanson, associate dean and former interim dean of the School of Dentistry, and supporter of the dental school from the beginning. “We’ve used that as a foundation for who we are, and where we want to go.”

Dental dreams become reality

PHOTO CREDIT: School of Dentistry

The inaugural class of the University of Utah School of Dentistry breaks ground on the Noorda Oral Health Sciences Building in August, 2013.

The inaugural class started in the summer of 2013, but the dream for a dentistry school began more than three decades ago when G. Lynn Powell developed the Regional Dental Education Program in the School of Medicine in 1980. The program provided the first year of training for ten Utah students, who completed dental school at Creighton University in Omaha, Nebraska. Powell, assistant dean of the program and the first dean of the School of Dentistry, lobbied to turn the program into a full dental school for years, but the opportunity never presented itself, says Hanson, who also serves as director of the University of Utah’s Addiction Center. A complete health care university needs the big four: medicine, pharmacy, nursing and dentistry, Hanson explains. The U was lacking the oral care component.

In 2009, Tye and Ray Noorda gave $30 million to fund the School of Dentistry and build the Noorda Oral Health Sciences Building. The Noordas charged the school to do more than educate dental students, challenging them to meet the needs of the underserved Utah community without access to oral care.

Hanson spent 30 years researching the neurology of drug abuse, and served as a director of the National Institute on Drug Abuse for the National Institutes of Health between 2000 and 2003. He aligned his expertise with the school’s vision to create a program unlike anything that previously existed.

“You’re going to be targeting underserved populations, you’re going to want to be doing research, and I brought the drug abuse piece with me,” he says. “How do you put all these things together?”

The school received a grant from the Health Resources and Services Administration for $1.5 million to fund a three-year partnership between the School of Dentistry and local drug treatment agencies to provide oral care to those suffering from substance abuse disorder. Individuals addicted to drugs typically neglect taking care of their mouths, and the drugs themselves can ravage the mouth by drying up salivary glands.

“The dental world has typically ignored them. Not deliberately, but they’re just very easy to let fall through the cracks. The system doesn’t really support dental activity in these folks,” says Hanson. “This is about creating a program that’s sustainable, and that has an outcome that will be long-term.”

Participants in the program can get dental care as long as they’re in treatment for drug abuse, providing an extra incentive to stay in rehabilitation programs.

“The literature says that the longer you can keep them engaged in their treatment, the greater their likelihood of success, and the less likely they are to relapse,” says Hanson. The program keeps track of their patients and preliminary results show that the program is successful. “Our initial data show that we approximately double the length of time the patients stay engaged in their treatment.”

The substance abuse program is just one of many outreach programs built into the School of Dentistry curriculum. The Give Kids A Smile program busses in elementary school kids in need of oral care to the school’s pediatric dentistry clinic, and this year, the state legislature approved the school to provide care for Medicaid adults with disabilities. Working with Medicaid patients gives the school a chance to improve integrative care with the rest of the University of Utah’s health services. Oral health has implications in many diseases; people with diabetes have high incidence of serious dental problems, cancer treatment ravages the mouth, to name just a few.

“Lots of people view oral health care separately from other health care. There’s no reason to keep them separate,” says Alex Steele, executive assistant to the dean of the School of Dentistry, Rory Hume. “One of our biggest goals is to integrate oral health care into overall health care. It’s so important to us that we incorporated this into the mission of the School of Dentistry.”

From the classroom to clinic

Providing care to an underserved population not only benefits those without access to oral care, but also gives the students an opportunity to practice dentistry on patients as early as their second year, says Gary Lowder, director of student admissions. This aspect has been a major selling point during Lowder’s recruiting trips.

“The school’s philosophy is, once the students get the didactic information in the lecture, we want to get them into the clinic to apply it as soon as possible,” says Lowder. “The patient group we see have tremendous neglect, and we’ve given them the opportunity for that care. We were benefited by that, and so were our patients.”

The teaching philosophy, and that the school is the only dental school affiliated with a major university in the Intermountain West, made the first-year applications very competitive. In 2013, they received over 700 applications vying for only 20 spots. As a result, the class had the highest GPA of all dental schools in the United States, besides Harvard. The students continued to exceed all expectations, Lowder boasts. The entire class has passed the written part of the dentistry board exams and scored in the top 15 percent nationally. They take the practical portion in May.

“For a brand-new school, that speaks well for the students, the curriculum, the faculty, the staff for that record. That’s very impressive, even beyond our biases. Those numbers are real,” says Lowder, laughing. “Our biases are real, too.”

The School of Dentistry has evolved over the past four years, and the students played a big role in shaping some of those changes, says Lowder. All major committees have student representatives to offer perspectives on making their education better. For example, students pointed out topics repeated by two classes, which helped administrators make adjustments to reduce redundancy.

“We know these are young adults with ambition, intelligence, motivation, whose goal is to improve what they’re experiencing and what they’re paying for,” says Lowder. “The inaugural class has endured a lot in helping to formulate the program and to influence the changes. They’ve had tremendous input and are exceptionally bright, dedicated students.”

The guinea pigs

PHOTO CREDIT: Dave Titensor, University of Utah

Amber Clark is a member of the inaugural class of the University of Utah School of Dentistry. Next year, Clark heads to New York for a general practice residency, and will pursue a pediatric dental residency afterward.

Amber Clark, a member of the graduating class, loved the faculty and staff’s willingness to hear their input. She and her classmates shaped more than just the curriculum, however; they also shaped student life by founding organizations and social events that set a participatory tone for the school. Clark co-founded the Utah chapter of the American Student Dental Association, which won the national association’s Golden Crown Award for Rookie Chapter of the Year in 2016.

“That’s a huge benefit of coming to a new school. There’s nothing laid in stone just yet, so we can implement new programs and bring forth new ideas,” she says. “There are ups and downs in the whole process, and we have definitely been the guinea pigs for all four years. But it has been a really good experience and it’s something that I would definitely do again.”

There were some growing pains, admits Clark; she and her classmates spent their first year and a half in small labs and classrooms in the Health Sciences Education Building while the state-of-the-art Noorda building was under construction. Still, the benefits of a small class size that gave her the opportunity to bond with faculty and classmates far outweighed any annoyances.  

“It’s like a School of Dentistry family,” Clark says. “All of our clinical and didactic faculty really care, and they all have open door policies, so you can chat with them whenever you want. They want to see you succeed. That’s huge, and that makes going through dental school a whole lot better.”

Next year, Clark heads to New York for a general practice residency, and will pursue a pediatric dental residency afterward.

In the clinic

A.J. Smith, assistant dean of clinical affairs and patient care, ran a private dental practice in the Salt Lake Valley before joining the School of Dentistry a year ago. The small class size allows him to get to know the students and build trust. He, along with all the faculty and staff, have open door policies that encourage the students to seek out the help they need.

“The great thing about having students pop their heads into my office is that it means we have a great rapport. I think it’s important for me as clinic dean to have the students comfortable to come talk to me about anything,” he says.

This year, the school will admit 50 students to the program, but still aim to keep ratio to six students for every faculty member. This allows the students to perform complicated procedures that most schools wouldn’t have the capacity to do, says Smith. The emphasis on underserved populations provides a steady stream of patients who have a big need for oral care. Patients come in to see the students for myriad dental issues. The students develop a treatment plan, get it approved by the faculty clinicians at every step, and complete the procedures. Faculty members are available to monitor the students doing treatments that would be too difficult for more crowded schools.

“I think it’s almost unheard of to have students in their third year of dental school doing a full mouth rehabilitation. You see students treating a tooth here, a tooth there — they’re looking at the full mouth, but treating one problem at a time. We’ve had exceptional students who have been able to participate in exceptional experiences,” Smith says.

Saying goodbye

For Julie Oyler, director of administration, saying goodbye is bittersweet. She’s been a part of the School of Dentistry dream since the regional dental program began in the 80s.

“I have mixed emotions. I’m sad that they’re leaving, but so excited to see them move on and start their careers,” she says. “They’re great, young people. It’s like being a proud parent.”

The students have made exceptional differences in the lives of community members, she continues. Recently, a graduating student told Oyler about a 90-year-old woman she fit with dentures at a nursing home. One of the school’s outreach programs sends students to provide care for elderly folks who are unable to move around easily. The women’s daughter told the student that the dentures have changed her mother’s life. Before, the mother was unable to eat, and had no desire to leave the nursing home.

“After the dentures, the 90-year-old woman called up her daughter and said, ‘I’m feeling so great, I’m eating. Can you come take me to Chuck-A-Rama?” says Oyler, laughing. “The students have been able to change lives for the better and I think that’s what we’re all about as a school.”