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The difference a smile makes

Positive changes in a community are sometimes hard to see, but for residents of Lafayette Square and neighboring communities in downtown St. Louis, Missouri, dental students from ATSU-MOSDOH are making a visible difference, one patient at a time. Through the St. Louis Dental Education and Oral Health Center, students are improving the appearances and attitudes of patients with unique and complex oral health cases. In turn, these patients are providing students with the experience of caring for a vulnerable population that has historically lacked access to oral healthcare services.

Fourth-year dental students have seen many memorable patients since the center opened in July 2015. One of Kristen Alexander’s favorite patients is a boxer. When he first came to the center, most of his teeth were knocked out. The dental team determined he needed an immediate denture, so they removed his teeth and placed the denture in the same day.

“He was grumpy and never smiled,” says Alexander. “When I gave him his denture, he became teary-eyed and short with me because he didn’t want to show how emotional he was.”

The patient returned to the center one week later. When Alexander asked him if he had received compliments on his teeth, he couldn’t stop smiling.

“People ask me what medication I’m on because all I do is smile,” says the patient. “No one has seen me smile in years.”

Alexander also cares for a patient with a genetic disorder that discolors her teeth, leaving them almost completely dark brown. As a child, the patient had crowns. When the crowns fell off, she was unable to afford further care and avoided social settings. Now through the center, she has a financially feasible plan to get new crowns.

“I’m making crowns for her two front teeth right now, and we’ll deliver those soon,” Alexander says. “I think that will make a big difference in her mental health and daily life.”

Maricon Copeland, another fourth-year student, understands the pain and depression patients go through. She had braces growing up, and even though the process was tough, her new smile remodeled her attitude and confidence. That experience led her to dentistry.

As a student dentist, she sees patients leaving the center feeling healthier and happier every day. She recently made her first denture for a patient. Although the denture still has to be processed and delivered, she was excited to see how the patient’s face looked younger and fuller.

“He just tried the denture, and he looks so happy,” says Copeland. “Those moments are so rewarding.”

Valerie Paulo’s first denture case was also memorable. She saw her patient every week for several weeks while making the denture, and they formed a close relationship. The elderly woman patient gave her advice and words of wisdom. She even brought Paulo little gifts.

“For my last appointment with her, she gave me a bracelet from her jewelry box,” says Paulo. “So I wrote her name on a tag, attached it to the bracelet, and told her I would always keep it to remember my first case.”

Other patients have kept students on their toes. For example, Jake Hamby, an engineer-turned-dental student, sees a patient with epilepsy. The patient has an implant and carries a magnetic device with her at all times. She instructed Hamby on what to do in the event she has a seizure.

“She’s actually had a few minor seizures while visiting the center, and I had to rub the magnet over her implant,” says Hamby. “It resets the firing order of the neurons.”

As students continue to see a wide variety of patients and cases, they are learning how to care for a population that hasn’t regularly seen a dentist. In fact, many patients have never visited a dentist. Consequently, students are educating patients on oral healthcare and the importance of consistent brushing and flossing.

One patient in his late 50s came to the center with black tartar and calculus buildup. He had never been to the dentist and thought his teeth were rotten. No one ever taught him the importance of going to the dentist, brushing his teeth, or flossing.

“After I cleaned his teeth, he couldn’t quit looking at himself in the mirror,” says Alexander. “He had every tooth, but when he went home, everyone thought he had gotten dentures.”

Each patient experience is a reminder of the importance of good oral health. As students rotate through the center, community members continue to express how thankful they are to have access to the center’s services.

“My experience with the student dentist was wonderful,” says Donna Wilkinson, who saw Supriya Koirala for a comprehensive exam. “She was professional and thorough, and I plan to go back.”

Cindy Fears, a chronic teeth grinder, split one of her molars at 4:00 p.m. on a Friday and had to use the center’s urgent care services.

“I was relieved to get into urgent care,” Fears says. “I recommend this center to all people under all circumstances.”

Another patient who has been thankful for the center’s services is Ovaloretta Harris. A former backup dancer and choreographer, Harris has worked with MC Hammer, TLC, Janet Jackson, Bobby Brown, and many others. She teaches dance to kids in the community and has become well-known among the dental students.

“I always smiled and was happy, but now I really can’t stop smiling,” says Harris. “Everybody can see how much more confident and happy I am.”

When she started coming to the center in late summer 2015, she was excited and wanted to fix everything in one day. Of course, her student dentist, Kalleb Greene, explained the process would take time. Before long, she was taking selfies with everyone in the center.

“It was an awesome and enlightening experience,” says Harris, who recommends the center to others in the community. “Students take the time to explain the process to patients.”

In addition to Harris’ case, Greene has been fortunate to see several cases from beginning to end. One case was especially educational as he worked with a prosthodontist on a full mouth rehab that included buildups on 28 teeth and 14 crowns. He notes this case was extensive and is something typically not seen in private practice because the treatment plan would cost $50,000-$60,000. But at the center, pricing is much more affordable.

“The patient is 6’7” and always looked mad,” says Greene. “He was very intimidating, but after his first few appointments, he came in with a huge smile on his face.”

Greene was surprised by the sense of camaraderie between students and patients. Like many students, he enjoys the different patient interactions while becoming versatile in his skills.

“I’ve been around dentistry my entire life, and I’ve seen how much of an impact you can have on someone’s life by changing their smile,” says Greene. “That’s what made me go into dentistry.”

It’s clear the students are forming real connections with the surrounding community. They have taken an interest in the lives of their patients, and as a result, patients have reciprocated by keeping in touch with their student dentists and bringing homemade treats and special trinkets in appreciation.

“It’s nice to get messages from patients,” says Copeland. “You almost become part of their family.”

Seeing unique and complex cases is certainly challenging for these soon-to-be dentists. Even though the daily rigors can be exhausting, the overwhelming sentiment from students regarding their experiences is how glad they are to see smiling patients. Whether they walk out or dance out of the center, these happy patients are proof that a smile really can make a difference.

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