How do some of the neediest people in San Antonio and South Texas get professional dental care? For thousands, the answer involves the Health Science Center.
Dental School personnel and students handled 66,000 visits by needy patients and provided care valued at $8 million last year. The work ranged from fixing children's cavities to providing dental care to the homeless.
Students and faculty work side by side in clinics, homeless shelters and schools. Many visits involve the Health Science Center's 38- foot specially equipped mobile vans that double as dental offices. The work stretches from San Antonio's inner city to the rural communities of South Texas where many residents have never been to a dentist.
In the inner city, Vidal G. Balderas, DDS, is one of the many tireless individuals involved in the work. Dr. Balderas, assistant clinical professor of community dentistry, provides federally funded care for children of migrant workers. "I restore smiles," said Dr. Balderas, who picked crops himself as a teenager growing up in San Antonio.
Dr. Balderas uses the dental van to visit schools in the San Antonio Independent School District once a week. He's been doing it since 1987, and has treated hundreds of migrant children. Dr. Balderas has recorded 1,500 visits.
Migrant children have a high risk of dental problems because they lack continuity of care. His school-based primary dental care treatment program is a success.
Dr. Balderas and his dental students are able to perform needed dental work before the child moves, and he also reports seeing more of his young patients returning a year later with further dental work in place.
"I am encouraged. Seven years into the program now, I'm seeing patients I've treated return and I can see they have had tooth restorations done since I saw them. The work may not be done by me, but it is being done in another place," Dr. Balderas said.
Dr. Balderas has turned his attention to elementary school-age children in an attempt to prevent dental problems that might affect the children's permanent teeth.
"It no longer shocks me to look into a little one's mouth, some as young as 5 years old, and see stubs where there should be baby teeth. There are things we can do to help make sure the permanent teeth come in correctly in that case. I do it for another reason, too. I want to help create self-esteem for these children as they grow up. They are very conscious of how they look and how their teeth look," he said.
Ramon J. Baez, DDS, associate professor of general practice, is another faculty member working for the poor. Dr. Baez is a clinical researcher who is helping produce the most comprehensive study of oral health ever done in Texas' impoverished Rio Grande Valley. But he also treats patients -- thousands of them.
"People are reluctant to participate in research projects and never hear anything more after the study is completed," Dr. Baez said. "That is one reason I provide care. These people feel they are being cared for and getting something immediate in return."
Dr. Baez, who heads the Dental School's World Health Organization Collaborating Center in Oral Health, has examined 3,000 patients since his study began in 1990. He said 45 percent of them needed urgent care. In addition, two out of every 10 patients had infections or were in pain. He has provided emergency dental care to about 2,000 patients.
Dr. Baez's work is underwritten by the South Texas Health Research Center and the National Institute of Dental Research through the Regional Research Center for Minority Oral Health. He provides an added dimension to his research by taking blood samples of his patients. The samples are helping researchers identify the prevalence of hepatitis and whether children have developed significant defenses in their system against common infectious diseases.
In 1988, Dr. Baez was part of a team that examined residents of San Elizario, a town of 3,000 near El Paso where many residents had no running water. The group found an unusually high rate of exposure to hepatitis A, which is caused by fecal contamination of water. Among adults ages 30-34, more than 90 percent of the population had experienced hepatitis A sometime in their lives. The findings helped residents in their campaign for a water and sewer system.
Martha X. Baez, associate professor of community dentistry at the Health Science Center and a dental hygienist, is a co-investigator for the border project, but she also works to promote dental health among San Antonio schoolchildren.
Mrs. Baez, who is married to Dr. Baez, heads a highly successful program that provides tooth sealants and fluoride mouth rinses to students in the Edgewood Independent School District, one of the poorest districts in Texas.
Anne P. Dodds, DDS, a postdoctoral fellow in periodontics, and Kathy M. Geurink, clinical assistant professor of dental hygiene education, also take dental care to the city's poor. Using the university van, they and their students have treated an estimated 1,500 adults and children in the past 10 years. They work at St. Philip of Jesus Community Health Center two days a week during the spring semester.
Another border program involves an all-volunteer effort supervised by Health Science Center faculty and run by the Christian Medical and Dental Society. About 6,000 people have received free dental care thanks to the efforts of volunteers such as Bud Luecke, DDS, assistant professor of orthodontics and a faculty adviser to the program. He takes third- and fourth-year dental students in the van to the middle Rio Grande Valley. They visit cities such as Eagle Pass, Rio Bravo, Laredo and Del Rio.
The students set up shop at a church on a Friday morning and leave Saturday night, three to four weekends a year. The Dental School provides the mobile dental facility. The medical-dental society pays for the fuel and supplies. Volunteers such as Dr. Luecke and the students provide the labor. Churches in the area supply the support work.
"It's a win-win situation," Dr. Luecke said. "It doesn't cost the state anything aside from our using its van. It's a good learning experience because the students get to see disease manifestations they sometimes otherwise wouldn't see. And, of course, the patients need the care."
Dental School faculty and students are involved in a number of community service projects, which include:
The university's dental projects help thousands of people who otherwise would not see a dentist, but they also help the university prepare tomorrow's dentists. "In many ways, the students we teach get more out of this service than the people we are serving," said John P. Brown, PhD, professor and chairman of the community dentistry department. "We need to teach public health dentistry in practice as well as in the classroom, and that's what we do."
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