ECU dental school hosts symposium highlighting special care dentistry

ECU dental school hosts symposium highlighting special care dentistry

The East Carolina University School of Dental Medicine hosted its second annual Special Care Symposium on Nov. 2, gathering members of the dental professional community to discuss best practices for providing oral health care to patients with special needs.

Close to 60 participants - including practicing dentists, dental faculty, students, residents, staff, other providers and leaders in the profession - attended from as far west as Lincolnton and from Southport in Brunswick County to the southeast.

The event was an opportunity for the members of the dental community to gather and discuss topics to improve and innovate care for patients in need of special accommodations

due to physical, medical, developmental or cognitive conditions, including those with mobility issues, aging and elderly patients, mentally disabled individuals, medically complex patients, those with mental illness, and children with behavioral or emotional conditions.

"We need to be very comfortable graduating dentists who feel very comfortable caring for patients with special health care needs," said Dr. Greg Chadwick, dean of the ECU School of Dental Medicine, in his welcome to the group.

Keynote speaker Dr. Randy F. Huffines, who is recognized as one of the country's leading experts on aging and oral health, presented two sessions, "Chemotherapeutic Management of Caries" and "Root Caries: Proven Techniques for Frustrating Situations." Huffines used his expertise, experience and research - as well as humor - to engage the participants in ways to approach tooth decay management in aging adults.

"What works in one patient may not work in another," he said about preventive measures and products to prevent or slow tooth decay during the first session,

Huffines described and showed images of the tooth surface and explained how and why some surfaces are harder to restore than others.

"Concave surfaces are much harder to clean and much harder to restore," he said.

Huffines said that even the pulp - the center of a tooth that contains nerves, blood vessels and connective tissue - recedes with age.

"As we age, that pulp decreases in size, not just from traumatic occlusion (bad bite) or caries, but just by itself," he said. "The pulp got smaller with age even in impacted teeth that were never in the oral cavity… There are less early warning signs in older patients because their teeth are less sensitive."

Huffines said because of that, dentists should be checking older patients' mouths more frequently than they may check those of younger patients.

Participants were able to ask questions and share their knowledge and experiences throughout both sessions as well.

Dr. Paresh Naran, a dentist from Cary, attended the symposium and took note of products and treatment methods for caries in older adults.

"I think it is imperative that students and new dentists - even older dentists - know how to care for special-needs patients, because it is quite challenging managing caries," Naran said. "The presenter was very good at highlighting some things that can be done for this group, especially when it comes to etiology."

Special care as a top priority

The symposium also included a panel discussion, "ECU SoDM Special Care Initiatives Across NC," which included six members of the dental school community who are engaged in special needs care, research and initiatives. The panel was led by Dr. Mark Moss, division director of public health dentistry.

Dr. Michael Webb, chair of the Department of Pediatric Dentistry, Orthodontics and Dentofacial Orthopedics, highlighted opportunities for students and residents to care for pediatric and special care patients, including at the local Howell Center, for children who are on ventilators. Webb also helps train students and residents to care for patients in rural areas.

"The other way we are training general dentists to take care of special care patients is part of the (Dr. Jasper L.) Lewis Collaborative in Pediatric Dentistry, which is a yearlong program for general dentists that goes various topics in pediatric dentistry."

Dr. Ford Grant, faculty director of the school's community service learning center in Ahoskie, helps train students and residents to care for patients across the spectrum of special needs. He said special needs care education also includes "treating students, after they get acclimated, more like a resident in their fourth year. We have students who are seeing two to three times as many patients as you would in any other dental school in the country, and we're happy that we have that combination of education and community involvement in service. It's just been a unique experience for ECU."

Dr. David MacPherson, director of the Advanced Education in General Dentistry (AEGD) program, said the 21 residents accepted each year gain experience across the state among a diverse patient base.

"The spectrum of patients that we see within our residency spans families, young, geriatric patients and patients with special health care needs," he said. "To us, this is just our day-to-day life. We care for these patients within the normal clinic setting in our community service learning centers and here in Ross Hall."

Lydia Hartung, a fourth-year ECU dental student, shared her experiences leading and participating in activities, organizations and research geared toward patients with special needs. She was the founder and first president of the school's chapter of the Special Care Dentistry Association, has served children and families at the Howell Center through education, and has served at the national level in special-care-focused organizations.

"I've had a lot of opportunities at East Carolina to be able to integrate some special care concepts and work into my experience as a student," Hartung said. "We have really great support from our faculty, our deans, our advisors, to be able to see our special care patients and be educated and feel comfortable doing so."

Second-year AEGD special care resident Cayleigh Herman has focused on medically complex patients, including those who are hospitalized. She knew she wanted to go into special care and get more training at ECU.

"I met Dr. (Sukyung) Moon one day in the OR and I asked her, 'Hey, can I be a special care resident?' They were able to create this residency program for me, and I'm really thankful," Herman said.

Moon, clinical assistant professor in special care dentistry, provides patient care and student education on caring for patients with special needs in the school's Special Care Suite in Ross Hall, which is equipped to accommodate wheelchair, bariatric and gurney-bound patients.

"After their rotation, the students feel much more confident and want to be much more involved in special care dentistry," Moon said. "They will serve those populations much more comfortably after they graduate."

There is a wide range of other special care initiatives within the school, including a $3.1 million grant in 2020 from the Health Resources and Services Administration, one of the largest in the dental school's history, that focuses on training residents in special care.

The N.C. General Assembly awarded the school $1 million to move forward with a special care facility that will provide more space for patient care and education.

The symposium was another step toward continuing the dialogue across the state to provide all patients in rural areas of North Carolina access to quality dental care.

"The information was invaluable, and so was the opportunity to network and connect with other professionals who recognize the importance of special care dentistry," said Daniel Stevens, the dental school's director of faculty development and continuing education. "Patients will have a more cohesive network of care because the ECU School of Dental Medicine hosted this event."

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