December 17, 2006

State and national leaders hope that by working with men and women such as Hernandez - blacks and Hispanics with promise, but perhaps a shortfall in their academic preparation - they can help solve a critical shortage of dentists willing to treat low-income patients. The premise is that minority dentists will be more likely to devote at least part of their careers to treating people in underserved communities.

"We don't know all the reasons for this, but there is ample evidence that black dentists treat a much higher percentage of black patients and Hispanic dentists treat a much higher percentage of Hispanic patients," said Dr. Peter Robinson, dean of the UConn dental school.

The program is being funded, in part, by the Robert Wood Johnson Foundation, which four years ago awarded $15 million to 15 dental schools - including UConn - to find creative ways to attract more minority and low-income students into dental school.

At UConn, Dr. Cynthia E. Hodge, associate dean of the dental school, spends her days identifying promising minority college students and getting them to consider dental careers. The students spend the summer before their senior year of college preparing for the tough national dental school entrance exam known as the DAT.

In the first two years of the program, 12 students from colleges across the country spent six weeks at UConn practicing for the exam under Hodge's no-nonsense guidance. Eleven scored high enough to earn a spot in one of the nation's 56 dental schools.

The students who are admitted to dental school begin their studies during the summer, giving them a two-month jump on the tough medical curriculum they face in the first two years of dental school.

At UConn, the recruitment effort is showing dramatic results. Before 2002, the first year of the grant, about 6 percent of students accepted at the dental school in Farmington each year were black, Latino or Native American.

In 2005, 29 percent of the incoming dental class was from so-called underrepresented minority groups. In Hernandez's class this year, one in five students is black or Latino.

"It's like anything else in our society," Hodge said. "They will treat more people that look like them than don't look like them."

But in 1995, the state adopted a system of managed care for low-income families. And strict rules atop already low pay drove most private-practice dentists out of the program. For thousands of low-income Connecticut residents, including Hernandez, finding a dentist became next to impossible.

At 19, with a job shelving videos at Blockbuster, Hernandez passed the high school equivalency exam and enrolled in a few community college courses. He found that good grades came pretty easily. He transferred to UConn. And last May, Hernandez graduated with a bachelor's degree in molecular cell biology. His grade point average was 3.57 - less than half a point shy of perfect.

Hernandez was already considering a career in medicine when he went to Fischer's office with two impacted wisdom teeth four years ago. He had not been to the dentist since Fischer stopped accepting Medicaid. But the pain forced him to seek help.

During those visits, Fischer asked Hernandez about his plans. Hernandez said he was thinking about neurosurgery. Fischer suggested that he consider becoming a dentist.

"He seemed really happy and he was able to alleviate my pain big time," Hernandez said of Fischer.

Before his senior year of college, Hernandez enrolled in Hodge's special summer dental school boot camp.

While Hernandez says it's too early to know what he wants to do with his dental degree, he said he'd like to combine private practice with teaching.

Asked if he would accept Medicaid in his private practice, Hernandez was shocked to even be asked.

"Of course," he said.

But he enjoyed the challenge of finding a translator, completing a medical history and repairing the teeth of his Spanish-speaking patients in the one hour allotted at the Charter Oak clinic. And he has noticed how comfortable his West Indian patients seem to feel in his chair.

He found that he enjoyed caring for the patients with HIV, hepatitis and cancer, whose teeth had become painful casualties of the diseases and treatments.

The patients were desperate and there were so few community dentists willing to treat them, that they often were grateful for his care.

Now, Findlay is considering devoting at least a portion of his professional life to treating patients who cannot afford care.

"So much changes when you witness the access to care issues," said Findlay, who is completing a one-year postdoctoral residency in the charity dental clinic run by St. Francis Hospital and Medical Center in Hartford. "It's so much different when you see it rather than just read about it."

About Connecticut Oral Health Initiative

The Connecticut Oral Health Initiative, or COHI for short, is a state-wide collaborative of dental professionals, business and community leaders. Our Mission is Oral Health Care for All. We work to persuade, educate and inform decision makers and the general public about the important issues involving oral health. We started in 1992 as a project of the Connecticut State Dental Association and incorporated as a separate 501(c)(3) non-profit corporation in 2003. We are supported by your tax-deductible contribution and grants from progressive foundations and businesses.