AHOSKIE — The new, 16-station ECU dental clinic wont open here for a couple of weeks, but rarely an hour goes by without the phone ringing or someone hoping for an appointment walking in through a door left unlocked by a contractor.
This is the biggest thing to happen here since Nucor opened the steel mill, and that was 12 years ago, said Howard Hunter III, a Hertford County commissioner and chairman of the countys public health authority. I just hope they can keep up with the demand.
There is only a handful of local dentists in the multi-county area the clinic will serve. Many people simply drive to Virginia if they need to be seen quickly, Hunter said.
The problem is common in many rural corners of the state. North Carolina has a shortage of dentists, with 4.5 per 10,000 residents, compared with a national average of about 6 per 10,000 and the averages are lower in rural areas.
Many counties have only a couple of dentists. And as of 2010, there were four all of them here in the northeast corner of the state with no dentists at all, according to data maintained by Cecil G. Sheps Center for Health Services Research at UNC-Chapel Hill.
Thats why the new East Carolina University School of Dental Medicine is opening the $3 million clinic in Ahoskie, and making it a prototype for nine others that will be scattered across North Carolina. Those are expected to be completed in the next two or three years.
Theyre aimed at fighting the shortage by treating patients and by training dental students who are interested in small-town practices. Thats part of the dental schools mission.
Indeed, the clinics are an integral part of the school, said Dr. Michael L. Scholtz, the director of community dental practices for ECU.
Its like you lifted the fourth floor off of the dental school, chopped it into 10 parts and spread it around the state, Scholtz said. The model we will have is really unique in dentistry, and something thats badly needed.
Living where they learn
Fourth-year dental students will do three rotations of about nine weeks each in three different clinics. Each dental resident will be assigned to work in a single clinic for a year. The residents and students will live in the communities. Each clinic will have five students, two residents, a full-time faculty dentist and a half-time dentist.
It will be a while before the students arrive, as the ECU schools inaugural class of about 50 is just finishing its first year.
But from the beginning there will be residents and full-time and part-time faculty dentists working at their sides and mentoring them.
The clinic will be equipped with a high-definition video camera linked back to Greenville. When students and residents need help with complicated cases, specialists at ECU can look over their shoulders as they work.
Video links will provide distance learning for the students and residents, and local dentists will be invited to take advantage for continuing education.
Local dentists also will be able to take advantage of the clinics expensive 3D imaging system to help diagnose problems and plan delicate treatments.
The Ahoskie clinic will be adjacent to the new Roanoke Chowan Health Center, a federally-supported nonprofit medical center under construction next door, with 48 exam rooms and a pharmacy. Theyll work closely together, referring patients to each other and sharing records. The dental school will be able to make good use of the 15,000-patient database at the medical clinic, Scholtz said.
Building across the state
A second ECU dental clinic will open this fall in Elizabeth City. Then come the others in towns including Lillington, Sylva, Spruce Pine and Lexington. The university hasnt announced the remaining four sites yet, but the Robeson County commissioners voted in May to buy land for one there.
Many indigent patients will be treated at no cost. Some will pay on a sliding scale based on their income, while others will pay in full, or be covered by their insurance.
Serving the full gamut, Scholtz said, is critical so that the clinics can eventually become self-supporting, which was an expectation by the legislature when it approved their funding.
The learning wont just be drilling and filling. The students will live and breathe the other skills it takes to run a dental practice, including personnel management, team-building, how to run a front desk and billing.
Drawing dedicated students
All of this, and the schools mission statement of trying to increase the number of dentists in underserved areas, drew student Mark Dobransky from a tiny community called Merry Hill in nearby Bertie County. Bertie, according to UNC records, had just one dentist in 2010.
Dobransky was raised in New York, but his family moved to Bertie a few years ago, and he came to appreciate the mellow pace and close community of rural life. At least trying to practice there or somewhere similar is high on his wish list, he said.
Many of his classmates at ECU, he said, are from rural areas, some from the western reaches of the state who have said they want to practice in their hometowns.
The clinic setup, he said, is perfect to help make that possible.
Theyll make sure when we do go out in rural areas, especially if were going to open our own practices, that we understand every aspect of what that will take, Dobransky said.
In Ahoskie, the students also will learn some of the less formal parts of being a dentist in places like Bertie, by performing community service.
Scholtz helped set up an advisory council with members from various parts of the community.
The panel will give ECU feedback on how the clinic is doing, and also help the students and residents find good fits for volunteer work.
ECU plans to replicate that at the other sites, too.
Health care professionals in small towns are essentially treated as leaders from their first day on the job, Scholtz said, so they need to become part of the community quickly.