Finding affordable oral care is always a difficult challenge, but when you do not have dental insurance and you are living with the challenges of a mental health disorder, it can be next to impossible. Consider what happened to this patient, a 50-year old man with a history of major depression as well as alcohol, cannabis, and opiate abuse. He sought treatment at a local hospital emergency department for significant dental pain. He was prescribed antibiotics, which did not resolve the issue. The insufficient care led to a second visit to the emergency department, an accidental overdose and ambulance ride, several more rounds of antibiotics, and weeks of pain―none of which permanently resolved the original complaint. If the man had been treated by a dentist to begin with, it would have taken less than an hour to treat his pain and resolve the underlying issues.
Although UNC School of Dentistry students Nick Baker and Sarah Brobeck couldn’t help this patient, stories like his―which are not uncommon―provided incredible motivation for them to apply for and receive a North Carolina Albert Schweitzer Fellowship, supported by the Blue Cross and Blue Shield of North Carolina Foundation, to launch a dental clinic at UNC’s Healthcare WakeBrook campus, a behavioral health center in Raleigh.
As Schweitzer Fellows, Brobeck and Baker recently held their first dental clinic in October, where they treated four patients, several of whom were in severe pain with nowhere else to access care. “It was incredibly rewarding,” says Baker. “We can’t wait for future clinics.”
Reaching the point of actually being able to treat patients at the new clinic was even more challenging than first envisioned. Baker says he thought they’d have the clinic set up in about two months; ultimately it took about seven. Baker and Brobeck had to meet with WakeBrook and dental school leadership, borrow and acquire equipment; solicit donations, navigate legal requirements, design and organize their clinic space, and complete other administrative tasks that ultimately consumed much more of their time than expected.
“As dental students we are very familiar with clinical dentistry,” says Baker. “But often we’re incredibly naïve to the financial, liability, and legal issues that must be addressed when providing patient care, since many of these things are handled by the wonderful staff at the dental school. I have learned an incredible amount about the financial, legal, and ethical issues that must be considered when starting a clinic and am extremely thankful for the experience.”
Baker, along with Brobeck, is also grateful for the unwavering support they received from the staffs at WakeBrook and the dental school, and especially from their mentors Dr. Allen Samuelson, a clinical associate professor at the School of Dentistry, and Dr. Beat Steiner, the associate medical director at WakeBrook and the assistant dean for Clinical Education at UNC School of Medicine. Their mentors applied for and received a large federal grant for WakeBrook services and their clinic will receive almost $40,000 in funding.
“The support we’ve received during this project has been so inspiring,” says Brobeck. “This process has taught me that even though it may be a difficult road to begin a service project or initiative, there will always be others to help and support if I look for them. Being a Schweitzer Fellow reminds me of how many good people there are in the world.”
Concerned about the unmet dental needs of many WakeBrook patients, it was Steiner who reached out to Baker and Brobeck, in their capacity as leaders of Dental SHAC, a free community clinic run by UNC School of Dentistry student volunteers, to help them. “We met with Dr. Steiner several times to discuss our options for helping these patients, and the idea for a free, portable dental clinic based on site at WakeBrook was born,” says Baker.
With the start-up work out of the way, Broback and Baker feel the clinic is well-positioned to serve WakeBrook patients on a long-term basis. In addition to direct care, the Fellows have also launched bi-weekly oral health education sessions with patients to help empower them to take charge of their health.
“With unified support from all participating organizations, substantial amounts of financial aid through grants and donations, and a steady stream of younger student volunteers who desire to be more involved, we are very excited about the future of our project,” says Baker. “Fourth year dental students often have difficulty finding hands-on volunteering opportunities, and our WakeBrook dental clinic provides them with the perfect chance to gain direct care experience with a population they otherwise would rarely meet.”
The Fellows are intentionally starting small treating up to six patients at monthly clinics, but hope to transition to twice a month events treating up to eight patients each in early 2016.
“I hope that our project can help to alleviate the discomfort and pain associated with dental disease in the patients at WakeBrook,” adds Brobeck. “I hope that we can not only treat their existing needs, but also provide them with the information and skills they need to prevent future dental problems.”
“My eyes have been opened to the dental needs of people affected by mental illness and addiction,” Brobeck also says. “These populations are so often overlooked. As a provider, I want to include all types of people in my scope of practice.”