The University of Texas Health Science Center at San Antonio Dental School
San Antonio, Texas
Interviewees:
William Dodge, DDS; Birgit Junfin Glass, DDS, MS; Ken Kalkwarf, DDS, MS; Elaine Neenan, DDS, MS, MPH; Bjorn Steffensen, DDS, PhD; and Denee Thomas, PhD
Question No. 1
Inside Dentistry (ID): Exciting and innovative new research initiatives are taking place at dental schools nationwide. What is the most significant area of research at your school?
University of Texas Health Science Center at San Antonio Dental School Administrative Team (AT): In line with the importance of interdisciplinary research involving teams of investigators from a broad scope of disciplines, the University of Texas Health Science Center at San An?tonio (UTHSCSA) Dental School focuses on major thematic research areas. We currently have an extraordinary team of re?searchers investigating the basis of dental and trigeminal pain. These scientists use a broad range of approaches (from molecular biology and anatomic investigations to animal and human studies) to explore and develop novel methods for the control of oral and facial pain. A second team of scientists is exploring mechanisms of tissue regeneration in experiments assessing tissue breakdown during periodontal diseases and oral cancer, the biology of bone formation and regeneration, and optimal healing around dental implants. These studies use advanced stem cell biology, gene knockout models, and protein engineering. Our scientists typically hold primary appointments in dental school departments and are joint-appointed to other UTHSCSA basic science departments. This appointment model allows for creative interactions and interdisciplinary collaborations that promote translational applications of the new discoveries. In one such example, novel dental materials are being developed in a collaboration involving researchers at the UTHSCSA Dental School, the Uni?versity of Texas at San Antonio, and the Southwest Research Foundation.
Question No. 2
ID: What endeavors have been most successful for you in terms of securing funding for this type of research or other types of translational research?
AT: UTHSCSA Dental School scientists have a long-standing and successful record of generating grant support from agencies including the National Institutes of Health (NIH), our major source of funding, as well as industrial partners. The extensive interdisciplinary collaborations within the dental school’s thematic areas and with other Health Science Center scientists provide strong support for the grant applicants who benefit from collaborators’ unique expertise and novel technologies.
The UTHSCSA Dental School has positioned itself among the leading national sites for oral health?related research training ranging from initial dental student experiences to DDS/PhD programs. NIH Center Grants and individual fellowships have supported these research-training efforts continuously since the mid-1980s. Mentors from both the dental school and other UTHSCSA departments provide training in these programs.
Our translational researchers maintain a dynamic working relationship with industry sponsors seeking to validate and optimize products before market launch. These diverse funding sources and a cadre of talented researchers ensure that the dental school maintains a strong national funding position and has a national and international impact on oral health science and delivery of dental care.
Question No. 3
ID: The demographics of dental schools overall—in terms of faculty composition and the student population—are changing. What changes have you seen at your school in particular?
AT: We have noted more applicants who are interested in dentistry as a second career choice, more applicants from Asian and Arabic backgrounds, more older applicants, more female applicants, and more applicants with families. Because of our school’s location in south Texas, we have always matriculated classes with a significant number of Hispanic students.
Changes in the faculty composition for full-time faculty and administrators have been most dramatic in terms of gender. There were only two female faculty members in the first few years of the UTHSCSA Dental School (in the 1970s) and even fewer in administrative positions. Currently there are many women at all levels: 46 full-time female faculty members; three associate deans; two department chairs; and one director. Three of our administrators are Hispanic. An encouraging trend we hope will continue is that in the last group of new faculty, the majority were women, from minority groups, and were what we would consider "younger."
Question No. 4
ID: How has your school responded to these changes, and what have the reactions been from students, faculty, and administrators?
AT: The UTHSCSA Dental School has responded to changing demographics in the student population in multiple ways. Our faculty and students receive continuing training in diversity issues and cultural sensitivity, as well as in learning is-?sues and characteristics of different generational groups. Our school has always had a family feeling, with a great deal of mentoring and interaction between faculty, staff, and students. This collegial attitude has made the adaptation to changing demographics and other characteristics quite seamless.
There is a nationwide decline in interest for dental faculty positions. Our school is proactively encouraging our graduates to consider academic careers. An elective teaching program allows students to learn about an academic career and participate in teaching activities. A combined DDS/PhD program graduates clinical scientists. Two students have completed this program and both are currently in advanced education programs. Six more individuals are currently enrolled.
Question No. 5
ID: There are many challenges and opportunities in oral healthcare. What do you see as the most urgent need, and how does your school differentiate itself in efforts to re?spond to those challenges and opportunities?
AT: Many Americans enjoy excellent oral health by virtue of their access to well-trained general dentists and dental specialists. The challenge facing dentistry, and society in general, however, is how to address the current situation that links access to oral health to personal income. We know that the majority of oral disease is found in a relatively small (20%) cohort of the US population. Individuals in this group tend to be at the lower end of the economic spectrum, have no dental insurance, and once the necessities of everyday existence have been met, have no money remaining to af?ford basic dental care.
Despite advocacy by two surgeon generals, the current political will to address unmet dental need is lacking. Millions of Americans are in need of disease elimination, relief from pain, and systematic preventive services to maintain health—they are in need of a dental home. Many dentists provide for those in need through their involvement in charitable and faith-based organizations. There is also a network of community health center dental clinics throughout the nation whose mission is to provide for the less fortunate and dental schools are also reaching out to underserved communities. Nonetheless, the magnitude of the need compels the public and the private sector as well as the academic community to expand access to dental care.
The UTHSCSA Dental School has integrated and expanded extramural training programs in its clinical curriculum that provide ongoing service to underserved patients in inner-city neighborhoods and schools in San Antonio as well as urban and rural communities along the Texas?Mexico border. These programs provide patients with consistent access to dental care and expose students to the scale of unmet need and an appreciation for the factors that contribute to it. It is our belief that after participating for 4 years in public health promotion and school-based prevention programs, and providing comprehensive dental care in our affiliated outreach training sites, our graduates will better understand the issues that serve as barriers to dental treatment and, once in practice, will advocate for their remedy.
Question No. 6
ID: Is there anything else you would like readers to know about your school, or that you would like to comment on in general?
AT: The UTHSCSA Dental School feels strongly that we—and other US dental schools—must continue to create better ways to assure that each of our graduates is not only competent in the delivering the technical aspects of oral healthcare but is also capable of being a "lifelong learner providing evidence-based care to meet the needs of society." This is the vision of the American Dental Education Associ?ation’s Commis?sion on Change and Inno?vation in Dental Education (CCI). The CCI stresses the need for a student to better develop the skills of critical thinking, problem solving, and self-directed learning to practice successfully as a dentist in our rapidly changing world.
The UTHSCSA Dental School is aggressively implementing methods to decrease the amount of curricular time spent in discipline-based lectures where faculty members tell students what is important. This time will be replaced with active-learning exercises where students learn how to access the most current and reliable information, assimilate that information, and apply it to oral health problems presented by patients. In addition, assessment mechanisms that measure short-term memorization or the ability to perform isolated technical procedures are being replaced by methods capable of assessing competency in the complex task of delivering oral healthcare.
Scientific information, including that which defines the relationship between oral and systemic disease, is coming out of re?search laboratories across the world at an exponential rate. Technological advances continue to allow practitioners to deliver dental care in a more efficient and effective manner. Tomorrow’s practitioner must truly be lifelong learner. Dental education must take the responsibility to create graduates with the ability to manage their ongoing educational program.
William Dodge, DDS | Birgit Junfin Glass, DDS, MS Associate Dean | Ken Kalkwarf, DDS, MS | Elaine Neenan, DDS, MS, MPH | Bjorn Steffensen, DDS, PhD | Denee Thomas, PhD |
