When Gregg Stewart, D.M.D., was a dental student at the University of Florida College of Dentistry in the early 1980s, one of his favorite experiences was spending two weeks on an external rotation at the Lafayette County Health Department.
“In dental school, most of our patients were selected to align with dental students’ learning needs. The community dentistry rotation gave me experience caring for patients with a variety of challenges and oral health needs, and I was able to use the foundations I’d learned and apply them to achieve a good outcome,” Stewart said.
Stewart also saw less than optimal outcomes created by a lack of access to care and oral health education, “During my rotation I delivered a complete denture set to a 21-year-old patient who neglected his oral health for far too long.”
After graduating in 1984 from UFCD, he worked in private practice in central Florida but the impact of the patients, and the need he saw during his rotation, stayed with him. In 1991, Stewart began working two days a week at the nearby Community Health Centers, or CHC, a federally qualified health center that is based in Winter Garden and, today, has 15 centers throughout central Florida.
After a few years of service, Stewart realized the growing need for oral health in the community he was caring for at CHC and saw his path forward when he was asked to come aboard full time; Stewart left private practice and has never looked back.
In 1996, Stewart was immediately interested when he learned that UFCD was creating a network of community dental centers in Florida that would host predoctoral students for external rotations during their junior and senior years.
CHC became the first dental center to join the UF Statewide Network for Community Oral Health, and almost 25 years later continues to host a rotating group of dental students at two of their dental centers, while also assisting with housing requirements.
“CHC is a wonderful partner for the network and the relationship we’ve enjoyed brings a great deal of value to our students’ education,” said Micaela Gibbs, D.D.S., interim chair of the UF Department of Community Dentistry and Behavioral Science.
Hannah Eder, a senior dental student who spent two weeks at CHC in July 2020, says the experience made her more confident in her own skills and capabilities, and helped her realize how well UFCD prepared her for completing complex treatment. In addition to handling patient scheduling and working with four-handed dentistry, Eder completed an entire treatment plan for a patient during her two-week rotation.
Eder also worked with pediatric patients and expressed what an incredible experience it was for her, “I will most remember the experience of using a breathing technique to calm a seven-year-old child before an extraction. At the CHC, I was able to really put the behavioral management techniques I learned in school into practice with the guidance of the CHC faculty.”
Stewart says that CHC’s partnership with UFCD is a win-win-win for the center. First and foremost, dental care provided by the students expands the number of patient visits that CHC completes by 30 to 35 percent, which aligns with CHC’s goal of increasing access to oral health care for some of the most vulnerable populations in Florida. Also, CHC’s dental assistants enjoy working with the students and learning from them, even as the assistants guide the students in the world of four-handed dentistry.
“In school, dental students learn the latest in technology and treatment, and so they’re sharing things with our courtesy faculty and staff. It helps keep us up to date, it’s interesting hearing their fresh perspective and allows us to challenge some of the ways we do things. We just enjoy having them around,” Stewart said.
A third benefit is that the partnership allows for a “peek” into a different world for many students, a world many haven’t seen before because of the demographics of the patients CHC cares for and, for dentists like Stewart who are always working to expand the number of colleagues who choose to work in underserved areas, there is the hope that it will attract more new dentists into a career in community health care.
It was a peek that, for Eder, has made her consider community health care as a potential career path, “Another positive from the experience was seeing the extent to which CHCs benefit the community. CHC provides a lower-cost but high-quality dental service to the community. The CHC faculty are so caring, kind and helpful. I really appreciated the experience for both my professional growth as a dentist and my personal growth in empathy and patience. The CHC rotation has made me consider community health care as a potential path for my future. It has further deepened my responsibility and fondness for community care.”
Four Catholic nuns founded CHC at the Apopka Farmworker Clinic in 1972 to provide underserved people in the community access to the healthcare they couldn’t afford. Initially the center provided only general medical care; dental and maternity care services were added in 1979. Today, there are 15 Community Health Center locations throughout Central Florida that provide a range of health services including pediatrics, family medicine, dental for children and adults, internal medicine, obstetrics and gynecology, optometry, behavioral health, and laboratory and pharmacy services.
CHC serves an average of 70,000 patients a year; a little less than half of them under the age of 18. Last year they completed 55,000 dental visits for more than 20,000 patients.
From March to May 2020, CHC was able to keep its doors open during the early months of Florida’s COVID-19 shutdown, when dental care was only allowed for emergency needs, and many private dental practices had challenges securing personal protective equipment and materials needed to manage care appropriately. Stewart said that, because CHC is a larger organization, they had ready access to supplies and served as a dental home during that time for the community, “We kept about 1,000 people out of local emergency rooms by being able to handle oral health emergencies.”
CHC is just one of 13 community health centers that host UF dental students as part of the UF Statewide Network for Community Oral Health. Through the network, at centers spanning the state from coast to coast, dental students play a role in providing oral health services for some of Florida’s most vulnerable populations from all 67 counties in Florida.
The partnerships created almost 25 years ago have made a significant impact on oral health for Floridians, and have fostered an understanding for predoctoral students of the need for access to care for so many vulnerable adults and children in the state.