The University of Mississippi School of Dentistry will use a five-year, $2.25 million Health Resources and Services Administration grant to remove dental barriers to lifesaving medical treatment.
The school provides dental treatment to severely ill patients from across the University of Mississippi Medical Center (UMMC), including those receiving cardiovascular surgery, organ transplants, and cancer treatment as well as adults who are developmentally delayed.
While cavities, abscessed teeth, decay, and periodontal disease don’t pose an immediate threat to most people’s lives, they can have a major negative impact on medically compromised people and their ability to be treated.
“Something as simple as a toothache can play an impact on life-giving care,” said Dr. Mark Livingston, chair of the Department of Advanced General Dentistry at UMMC and one of five providers in the department who care for these patients.
Livingston and his four colleagues oversee 11 residents and two clinics. They are stretched thin by their patient loads and have no one to coordinate patient care and scheduling, an important and monumental job that requires a range of medical knowledge, according to the school.
The school will use the grant to hire two additional faculty members and providers, in addition to a registered nurse, to care for more patients and make care more efficient and timely.
“There are many patients who come to UMMC for lifesaving treatments but who cannot proceed with those treatments until their oral diseases are under control,” said Dr. Jason Griggs, associate dean of research for the School of Dentistry and chair of the Department of Biomedical Materials Science.
“This project will not only help patients, but will also increase revenue both for the hospital and for the dental school,” said Griggs.
For example, 26-year-old Catherine Clark has Down syndrome and struggles with depression and anxiety. She requires sedation before undergoing any dental procedures, which terrify her. Last year, she stopped eating and lost 25 pounds over the course of three to four months.
Catherine’s parents Karan and Eric took her to see her dentist, Livingston. But because of the backlog of patients and the small number of faculty in the department who handle such cases, the next available time in the operating room at UMMC was nearly a year out.
The delay led to a domino effect, and Catherine’s parents took her to several doctors trying to figure out why she wasn’t eating.
“We almost lost her,” said Eric. “For six months, nobody could tell us why she was resisting eating.”
After a diagnosis of strep throat, Catherine received a course of antibiotics that triggered a C difficile infection and put her in the hospital for five days. After being discharged and recovering from the infection, she was prescribed increased antidepressants.
Catherine finally told her mother that a tooth in the back of her mouth was bothering her, which is something Livingston would have seen if he had been able to examine her when her parents first brought her to UMMC six months earlier.
“It turned out she had a bad infection,” said Karan. “So all this time, there was something wrong with her tooth, and the pain was interfering with her eating and drinking.”
A local dentist was able to sedate Catherine and extract the tooth. But because many dentists don’t have training in caring for special needs patients, Karan and Eric said the extraction experience was “traumatic,” and by then Catherine had suffered unnecessarily for months.
After having the tooth extracted, Catherine began eating normally and gaining weight. Her story illustrates why the grant is so needed, the school said.
“By having more faculty, we will have a better staffing pattern to allow us to go to the operating room more often, so the backlog should decrease,” said Livingston.
In addition, the grant will expand the services that faculty can provide, said Dr. David Felton, dean of the School of Dentistry.
“The HRSA grant will enable the School of Dentistry to treat the huge backlog of patients in need of presurgical clearance. In the past, due to lack of available faculty, we’ve been forced to provide primarily tooth extractions to provide this clearance,” said Felton.
“Now, we can provide additional dental services and help patients keep their teeth longer. This is a very important grant for the School of Dentistry in our ever-expanding role within the Medical Center,” said Felton.
The grant will make more opportunities possible for patients who cannot afford dental care, which often isn’t covered by Medicaid, Medicare, or private insurance, the school said.
“This will be a safety net for patients,” said Livingston, adding that it also gives them some room to help those who can’t afford even basic care. “If they can’t afford the care they need, they will at least get a minimal level of care where they don’t have to worry about reimbursing the university.”
The grant additionally will enable the training and education of more residents with patients who many local dentists across Mississippi may not feel comfortable treating, the school said.
“It’s going to be even more intensive training for our residents in treating medically compromised patients,” said Livingston. “We’ll be graduating residents who are feeling much more confident about treating patients who have certain underlying diseases.”
The school hopes that some of these residents will remain in Mississippi and provide much needed local care to patients in other areas of the state without the patients having to travel to the UMMC in Jackson.