Year of Gratitude: Embracing Our Values

Life Transformed graphicEach year, Dr. David Nelson sends a message to the UF Health Community with highlights and updates from the previous year. His 2024 theme was “Year of Gratitude” and his message includes highlights from each of the six health colleges showcasing stories of gratitude, reflecting our collective achievements and embodying the values we all embrace and live each and every day at UF Health.

The UF College of Dentistry’s story is below and if you’d like to enjoy Nelson’s full message, visit this site.

Child in sensory room
Sensory room in the Special Needs Oral Health Promotion Center at the NCEF Pediatric Dental Center in Naples.

UF College of Dentistry

Access to oral health care for persons with special needs is one of the most pressing concerns across the nation. It’s created by multiple hurdles but especially an acute shortage of qualified providers. For over a decade, the University of Florida College of Dentistry has focused on innovative dental solutions for these vulnerable groups and, during 2023, added significant services in four UF-owned and affiliated dental centers to care for adults and children with special needs.

Not long after beginning to provide oral health care at the Marion County Department of Health in late 2023, Bryan Smallwood, D.M.D., a 2022 UF College of Dentistry graduate and now an assistant professor at the college, had a small but meaningful breakthrough with a patient in his 40s. The patient, who has developmental disabilities and autism spectrum disorder, experienced a lifetime of high anxiety during dental care. The referring dentist thought the patient would require care under general anesthesia due to his history of dental fear and anxiety.

Funding from a new CareQuest grant to the college to provide oral health for persons with special needs allowed Smallwood to take time with the patient and actively listen to him and the patient’s mother to fully understand their needs and concerns. “Just spending time with him, which most dentists can’t do in a normal practice environment, I realized that he wanted to know how things worked and to understand what was happening,” Smallwood said.

Smallwood gave the patient a mirror so he could watch during his exam and feel reassured. That simple act made a world of difference. For the first time in the patient’s life, his treatment anxiety lessened and Smallwood was able to restore the patient’s teeth in the dental office that same day, using only local anesthesia and without sedation.

“Developmentally disabled individuals, in particular, face steep challenges in accessing oral health care, regardless of their socioeconomic status, and suffer disproportionately from oral health issues, such as malnutrition, speech problems and potentially serious oral infections,” said A. Isabel Garcia, D.D.S., M.P.H., dean of the UF College of Dentistry.

The Marion County of Department of Health, or MCDOH, recently joined the UF Statewide Network for Community Oral Health, comprising five UF-owned dental centers and 11 affiliated sites, where dental students and residents care for patients during external rotations. The program at MCDOH is the newest resource in the college’s growing list of options for patients with special needs in Florida, made possible by the support from numerous philanthropic organizations.

The college’s work in this area goes back to decades of specialized dental care provided at Tacachale, a community for adults with disabilities in Gainesville. Efforts expanded in 2010 when the Special Day Foundation began to fund specialized oral health care for adults with special needs in the college’s St. Petersburg Dental Center. In 2020, Special Day expanded support to two additional UF centers — UF Health Hialeah Dental Center and the NCEF Pediatric Dental Center in Naples. And, with support from the Naples Children and Education Foundation, Special Day Foundation, the Richard M. Schulze Family Foundation, the B. Thomas Golisano Foundation and Henry Schein Cares last year, the NCEF Pediatric Dental Center in Naples added another resource with the opening of a sensory-adapted room designed to create a unique and comforting space for children with autism and sensory disorders. There, UF College of Dentistry dentists and pediatric dental residents work to create a positive relationship with patients, helping the children transition to dental care in a regular setting.

According to the Special Day Foundation, over half a million Florida adults and children are estimated to have developmental disabilities and limited funding available to afford dental care. “These three UF centers are also homes to dental residency programs, so the value is, in essence, two-fold. In addition to giving vulnerable individuals a pathway to optimal oral health, our residents gain the skills needed to care for and increase access to special needs patients in Florida for years to come,” Garcia said.

Together, these programs extend the college’s ability to close the gap in oral health disparities across the state and make a difference in the lives, and health, of patients every day. Importantly, they are creating a new generation of dentists and specialists well-equipped to deal with some of Florida’s most needy and neglected patients.