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Major Estate Gift Supports the Many Growing Needs of the School's Integrated Special Care Clinic
The School of Dentistry occasionally receives major gifts from donors who don’t wish to be identified publicly. Such was the case when the school recently received a $1 million estate gift to be used for special needs patients who cannot afford dental care.
The gift is a significant contribution to the dental school’s initiative in recent years to enhance both the treatment of patients with special needs and the education of dental students in this area of patient care.
Toward those ends, school leaders included an Integrated Special Care Clinic (ISCC) when they designed the major Blue Renew renovation of the school that was completed in 2022. The second-floor clinic, supported with an inaugural $2 million gift from Delta Dental, has a unique design and accommodations to support the wide range of treatment options necessary for special needs patients.
The clinic serves patients with many physical and mental limitations and conditions. Those include cerebral palsy, autism spectrum disorder, Down syndrome, dementia, traumatic brain injury, progressive neurologic disorders, and disabilities that limit mobility, vision or hearing. Patients can present a variety of treatment challenges depending on their ability to communicate, interact with the dentist or sit in the dental chair for the duration of a 30-minute appointment. Patients may need a stimulation-free environment such as a private treatment room to ease their anxiety of going to the dentist. They may fear the sound of a dental drill or have a sensitivity to bright lights, both of which can be eased with thoughtful treatment and accommodations built into the physical space.
Patients who use a wheelchair need a larger room and cubicle in which to maneuver, compared to common private practice spaces. For patients who may not be able to transfer to a dental chair, the ISCC has a mechanical device that allows the patient to remain seated in the wheelchair while it is tilted back, allowing the dentist better access during the exam and treatment.
These are the sorts of challenges that Dr. Bryan Tervo, director of the ISCC, sees every day as he and students treat patients in the clinic. The school’s seemingly alreadyfull curriculum schedule was revised to add one week of ISCC rotation for both third and fourth-year students.
Tervo said students report that even the relatively short experience has given them important new insights into the need to be able to treat all patients, no matter their personal health needs. That understanding is as important to treating special needs patients as is the innovative physical space. By students gaining this experience now, Tervo said, they are likely to be more willing to treat special needs patients in their future private practice or other settings in which they choose to work.
Treating special needs patients is often a challenge for general practice dentists unaccustomed to their needs. As a result, dentists often refer those patients to clinics like the ISCC or hospital dentistry programs.
“That’s a frequently heard comment from parents and caregivers,” Tervo said. “They will tell us that they’ve called a number of places and they say they can’t accommodate the disability or the wheelchair or whatever their special needs. And so they try multiple offices and invariably they end up here.”
“I tell students we may not be able to treat them, either, but we’re going to try. We’re going to show effort, give it an attempt. I think it surprises the students how frequently they succeed. And they find that if you do give a little bit of effort and think outside the box, and try different ways, you can be successful. And I am very happy to see them think that way. That’s exactly what I’m going for.”
The demand at the ISCC is growing. Tervo’s latest annual report to school administrators last spring recorded 280 referrals and 170 exams. Appointments for cleanings are growing, about 300 per year, as patients became familiar with the new clinic and return more regularly. In general, scheduled visits quadrupled over the last year.
Tervo said many of the patients come from far western Michigan and other distant communities, which makes pre-appointment intake screening especially important. The clinic asks families and caregivers to fill out basic information in writing in advance, then students follow-up by phone to make sure the clinic understands and is prepared for the patient’s specific needs. In return, the family is informed of what treatment to expect during the appointment.
“People drive so far to get here, maybe a four-hour round trip or longer,” Tervo said. “I don’t want to waste their time, especially when they need special transportation like an ambulance or a van for a wheelchair. I want to make sure everyone is on the same page – that we are prepared as we can be, that they know what is going to happen, so it really helps minimize disappointments and other problems.”
The idea is to make the ISCC, its faculty and students a steady, welcoming and problem-solving presence for its patients. That improves oral and overall health and encourages repeat visits for a patient population that is often reluctant to go to the dentist because of previously unsuccessful or sometimes traumatic experiences. “I believe that a lot of dental anxiety and fear can be overcome by developing trust with the patient,” Tervo said.
