Getting to the root of the problem

Getting to the root of the problem

Dr. Dwight McLeod teaches his students to give back.

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The St. Louis Dental Center is dedicated to teaching and serving others like its leader Dr. Dwight McLeod. The center provides access to oral health care for St. Louis and Missouri residents and also serves as a clinical facility. This month marks Dr. McLeod’s two-year anniversary as dean of A.T. Still University-Missouri School of Dentistry and Oral Health (ATSU-MOSDOH).

“I worked at Southern Illinois University School of Dental Medicine for more than 20 years,” McLeod said. “But, as with anything else in life, we can’t always be in one place forever. This opportunity was in line with my philosophy as an individual because it relates to giving back to underserved communities.”

ATSU is a leading graduate health sciences university with six professional schools, including two medical schools and two dental schools, located in Kirksville, Missouri and Mesa, Arizona. The St. Louis Dental Center is an extension of the Missouri School of Dentistry and Oral Health located near the Lafayette Square neighborhood.

Students spend their first two years studying basic sciences and principles on the Kirksville campus. During their last two years of training, students spend time at the St. Louis Dental Center, community health centers and other safety net clinics both in St. Louis and throughout the Midwest. “I spend 80 percent of my time at the St. Louis Dental Center and usually go to Kirksville once a week,” McLeod said.

Did you have a passion for dentistry early on?

I was always passionate about becoming a medical professional, either as a physician or a dentist. I graduated from undergraduate school in three years. During what would have been my fourth year, I worked at a hospital in Florida to determine whether I wanted to be a physician. After working for a year, I decided to pursue dentistry. I knew I didn’t want to be a general dentist and developed a love for periodontics, so I decided to specialize in that field.

What exactly is the St. Louis Dental Center?

The St. Louis Dental Center is an innovative collaboration between ATSU-MOSDOH and Affinia Healthcare, formerly Grace Hill Health Centers, Inc. Both have a shared mission in terms of their ability to serve the community and provide access to care for underserved populations. It’s a 79,000-square-foot state-of-the-art dental education facility and a comprehensive oral health clinic providing affordable oral health care services for patients of all ages.

ATSU owns the building and equipment, and we are responsible for the teaching and educating that goes on in the clinic for third- and fourth-year students. Affinia Healthcare provides the patient base, including the medical and dental records, and manages clinic operations. We are able to provide comprehensive services, including dentures, implants, crowns, bridges, root canals and advanced oral procedures — this allows us to provide a broad access of care to the patient at a more affordable cost.

The St. Louis Dental Center is also one of the only dental urgent care centers in the region. The Centene Charitable Foundation Urgent Dental Care Center is a walk-in clinic where patients can receive urgent dental care treatment Monday through Friday, with no appointment necessary. Our goal is to become fully integrated within the community we serve.

Is the St. Louis Dental Center a nonprofit?

ATSU is a private, nonprofit institution, as is ATSU-MOSDOH. The St. Louis Dental Center and Affinia Healthcare are also nonprofit. The St. Louis Dental Center is a federally qualified health center. We have a large public service commitment and a great social responsibility to be able to serve the community we are operating in.

Our model is unique — we are the only dental school in the United States where predoctoral education is taught within the confines of a community health center. It’s a very innovative and unique concept.

What factors do you think play a role in limiting oral health care access in the St. Louis area?

St. Louis has a large underserved population. There are many people in this city who work full time, but are not offered medical, vision and dental care. Or, they are offered medical, but not vision and dental. Some community members are only making minimum wage. Patients cannot afford dental care in a private practice, nor can they afford dental insurance on their own — it’s very expensive. Most dental insurance has a maximum annual benefit, anywhere from $1,000 to $1,500 per year. By the time a patient has a cleaning, a crown or a few fillings, the cost quickly exceeds the annual insurance benefits provided by many companies.

Unfortunately, most insurance companies have not changed dental benefits since the 1950s — there has been no cost-of-living adjustment. In my view, the benefit offerings need to be significantly increased, so patients can receive the oral health care they need, just as they do in medicine.

Other factors are education and oral health literacy. When patients do not think they need care because they don’t have pain, they will wait until the situation becomes too advanced. Prevention is always less costly than intervention; to rehabilitate the entire mouth is more expensive.

What are some other ways you partner with the community?

We have begun to develop strong relationships with other higher education institutions and major health care providers that share a mission with ours. We are also working with hospitals that only provide palliative care to dental patients who rush to the emergency room. Those hospitals are now referring patients to our walk-in clinic, where we are collaborating to make sure the patient benefits from the treatment — we want the root of the problem to be addressed at our center. Once registered as an urgent care patient, they can become a regular dental patient who can subsequently receive comprehensive care.

What is Dentures for Veterans?

It is a community service volunteer project completely independent of the curriculum. When I became dean in 2016, I worked to collaborate on this project with Dr. Herbert Silva, a retired Marine and dentist who is now involved in academia. Dr. Silva has a network of veterans around the St. Louis area, and together with additional staff and dental students, we are making sure this is a sustainable program.

The president of the university made a donation to start the program that provides care at no cost to veterans in St. Louis and Kirksville. As we expand our program, we would like to offer underserved veterans who have their natural teeth with good dental care, oral health stability and a maintenance program.

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