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Patients flock when alumnus offers volunteer dental care in Nairobi, Kenya
Dr. Joseph D'Souza ('83) was on his way to enjoy some vacation time visiting his parents and his homeland in Nairobi, the capital city of Kenya, when a turn of events put him back to work. After arriving in Nairobi, Dr. D'Souza was asked by the Lions Club of Greater Nairobi to volunteer his dental services to the people of Mukuru, a severely underdeveloped area. "It was truly amazing," he says. "By the time the Lions Club heard I was in town, it took them only a day to organize the clinic."
The clinic began about 8 a.m. in a hut normally used as a classroom. About 400 people waited patiently in that small area, entering for treatment one at a time. Some people walked up to 30 miles for the chance of having dental work done, regardless of the pain. "Some of these people had been living in pain for two and three years because they couldn't see a dentist," Dr. D'Souza says.
There was no electricity, no dental chairs and no chemicals to sterilize the dental instruments. Instead, volunteers heated three vats of water over coals to clean the instruments. Patients were screened, anesthetized and put in a straight-backed chair. Using only the light from a window, Dr. D'Souza pulled about 350 teeth in a period of only seven hours.
Dr. D'Souza worked with three other dentists. After a short lunch break, however, two of the four decided not to return, which left Dr. D'Souza and a Yugoslavian dentist to care for the remaining 250 people. Dr. D'Souza grew up in Nairobi because both of his parents worked for American agencies: his father for the U.S. Embassy, his mother for the U.S. Library of Congress. Because they were living on an American income and in a developing country, Dr. D'Souza had little exposure to the impoverished areas of Nairobi.
When he visited 20 years later, he was shocked. "I've never seen poverty like this," he says. "The population of Nairobi has exploded in the past five years and that has contributed to the problem. When there were troubles in Rwanda and Somalia, Nairobi became a headquarters for United Nations and U.S. forces. All of these foreigners came in and created this artificial economy."
After high school, Dr. D'Souza worked as a safari tour guide. One guest on safari was the chairman of the board of trustees for Parsons College (now Maharishi University) in Fairfield, Iowa, who arranged for Dr. D'Souza to go to school there and receive a scholarship. When the college closed in 1973, he transferred to the UI. "When I went to the UI, the dental program was at the forefront in education and research," he says. "The high quality of education and the faculty support offered a tremendous opportunities."
Dr. D'Souza earned his B.A. degree in 1974 and his dental degree
in 1983. After graduation, Dr. D'Souza went to work with a colleague
in Davenport. A year and a half later he opened up his own private
practice, serving about 60 patients. Thirteen years after its
founding, the practice now has approximately 2,500 patients. He
is also an adjunct professor of endodontics at the College.
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College innovation yields excellence In my first year here I have been reminded almost daily of the College of Dentistry's innovative programs. The College has consistently been a national leader in many areas of education and research, as well as an invaluable resource to the state of Iowa. In many instances a major program grew from a creative spark among a small group of our faculty and was fueled by hours, weeks and often years of hard work. The combination of faculty, talent and a modest investment from the College has made the difference between a good college and one of the very best in the world. Let me offer a few examples (with the inevitable risk of leaving some out).
The College has advanced general dental programs that have been fostered with great resourcefulness and skills for many years. With the focus on primary care, such programs have been emphasized in reports from the Institute of Medicine and the Pew Foundation. Our Special Care Clinic addresses the emphasis on special needs patients. With more people having medical conditions affecting dental care, this clinic becomes a key to complete primary care. Other examples of innovation in the clinical area include the Patient Representative Program, the Collegiate Recall Program and the Clinic Information System. All of these advances have exposed students to activities integral to a busy, high-quality practice.
In education, individual faculty have developed programs on critical thinking, many of which have been recognized at national meetings. These efforts are beginning to coalesce as the College works to develop an overall approach to methodology, measurement and feedback to students. Many faculty use computer programs to assist students in developing these skills, which are essential for excellence in modern patient care.
Success in teaching critical thinking in clinical programs depends on a good student-faculty relationship. An extension of the concept in critical thinking is seen in our student research program-the largest such program in the country. Student participation in research projects sharpens abilities to pose research questions, to gather and analyze data, and to draw conclusions. Students will be better able to assess new dental supplies and equipment and new articles on clinical techniques. The research program is also an environment in which faculty-student communication is key as mentoring relationships develop.
Applied research activities by faculty have been gathered together to form a clinical center currently supported by the National Institutes of Health. Several major corporations have products, materials and devices tested in the College's Clinical Research Center. The Opportunity at Iowa program has been successful in recruiting talented minority students and faculty to the College. For example, Dr. Ray Fonseca, who started his academic career at Iowa, is now the Dean of the University of Pennsylvania School of Dentistry.
The Implant Center was started by faculty here, along with international visiting faculty, and is now active in teaching, research and providing service to patients. The College is also exploring advances in technology, including the use of lasers, air abrasives and intraoral cameras.
The Student Preceptor Program, an outreach program that has been
on hiatus, is being resumed this year with the cooperation of
the Iowa Dental Association. The program will allow seniors to
spend a month in the offices of practicing dentists in Iowa. One
important source of support for many of these programs was the
Centennial Fund initiated by Deans McLeran and Montgomery. Through
the generosity of our alumni and friends, the College has been
able to provide fuel for eager and talented faculty, students
and staff to develop and refine these initiatives. We continue
to call on private support as we look to the next century.
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Dentist-Scientist Program receives funding.
College of Dentistry has received more than $2.5 million in continued funding for its Dentist-Scientist Program, a distinguished effort to train students for academic careers. The award from the National Institute of Dental Research will support dental graduate students pursuing a five-year program that combines advanced clinical training in dentistry with a doctorate in a basic science subject. The goal of the program is to prepare dentists for success in research and academic dentistry. "This unique program provides students with a blend of clinical skills, research experience and a basic science background," says Dr. Christopher Squier, professor of oral pathology and associate dean for research and graduate studies, who directs the program with Dr. Arthur Nowak, professor of pediatric dentistry. "We are very proud to continue training new generations of dental researchers and academicians."
The UI program is one of only three in the nation funded continuously
for 15 years. Its graduates have gone on to enter academic positions
at Harvard, Michigan, Ohio State and Northwestern universities,
as well as the UI. The grant will provide a generous stipend,
tuition and other funds to 10 students each year for five years.
Top dental students from schools across the United States compete
for the awards. The program encourages interdisciplinary research
that teams dental graduate students with faculty from various
UI colleges and departments. Currently, faculty from the colleges
of Dentistry, Medicine, Engineering and Liberal Arts collaborate
with students in the program.
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Visitors to the College's site on the World Wide Web (http://indy.radiology. uiowa.edu/Beyond/Dentistry/DentistryHP.html) will find a new look, expanded links to Internet dental resources, additional information for alumni, and other changes that make the site more appealing and informative.
Resources especially for alumni have been consolidated in the Alumni Connection, located under the Information for Health Professionals heading. Visitors will find a growing list of e-mail links for College graduates, plus electronic versions of articles from the Dental Link. The latest news from the College, as posted on the UI Health Science Relations web site, is available with a click of a mouse. The College's list of other dental sites on the web is quickly becoming one of the largest collections of its kind. New links with information on trends, materials, organizations and products are continually being added.
Also in the Information for Health Professionals section is a
student project titled "Atlas of Oral Pathology." Located
in the Eucational Materials section, it offers images of oral
lesions and a decision tree to assist in diagnosis. The Information
for Patients section offers additional articles on services from
the College, including detailed information about infection control
and custom mouth guards for sports.
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New department heads to lead endodontics, family dentistry
Two College departments started the academic year with new leadership. Dr. Eric M. Rivera, associate professor of endodontics, assumed the department head position Aug. 1. Rivera joined the endodontics faculty in 1989. He succeeds Dr. Richard E. Walton, head of the department since 1983, who remains with the department as professor.
"I'm certain that Dr. Rivera will carry on the fine leadership provided by Dr. Walton," says Dr. David C. Johnsen, dean. "Dr. Rivera is a nationally recognized teacher, clinician and researcher in Endodontics, and an excellent role model for students and faculty alike." Dr. Rivera received his D.D.S. degree from the University of North Carolina School of Dentistry. He completed a general practice residency at Charlotte Memorial Hospital and practiced general dentistry and endodontics in Durham, N.C., before coming to Iowa.
Noted for his teaching accomplishments, most recently with the 1996 Endodontic Educator Award from the American Association of Endodontics, Dr. Rivera teaches in the undergraduate and graduate programs and is active in developing computer-based education resources. His research focuses on the biochemical and functional aspects of collagen cross-linking and structure of dentin, and the use of calcium hydroxide in root canal therapy.
Dr. Patrick M. Lloyd will join the College as head of the department of family dentistry in November. He comes to the UI from Marquette University School of Dentistry in Milwaukee, Wis., where he is head of the Division of Special Patient Care and associate professor. He succeeds Dr. John Doering, professor of family dentistry, who has served as interim head of family dentistry since October 1994. "I am very pleased to welcome Dr. Lloyd to the University and the College of Dentistry," says Dean Johnsen. "His wide range of expertise, particularly in dental care for older adults, will complement the talents of our outstanding family dentistry faculty."
Dr. Lloyd received D.D.S. (1978) and M.S. (1989) degrees from Marquette University, and earned a certificate in prosthodontics at the Veterans Affairs Medical Center in Milwaukee in 1981. He took his first teaching position at Marquette in 1978 and has held faculty appointments in prosthodontics, preventive dentistry and community health, and geriatrics. His diverse clinical experience includes private practice in general dentistry and prosthodontics.
As a clinician, researcher and educator, Dr. Lloyd has focused
on gerontology and geriatrics. Dr. Lloyd is currently editor-in-chief
of the Journal of Prosthodontics.
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New faculty bring teaching, reserach, clinical expertise to UI
Dr. Murray Bouschlicher, assistant professor of operative dentistry, joins the faculty after earning both his D.D.S. ('76) and M.S. ('96) in operative dentistry from the UI. He was in private practice in Decorah, Iowa, for 17 years before returning for his graduate degree, and will be involved in teaching all levels of dental students, directing the senior esthetics clinic and treating patients.
Dr. Ronald Elvers, assistant clinical professor of oral pathology, radiology and medicine, returns to Iowa after a 22-year career in the U.S. Navy, most recently as director of the Recruit Treatment Clinic at the Naval Dental Center, Great Lakes, Ill. He received his D.D.S. from the UI in 1974, and a master's in education from the University of Southern California in 1980. He will direct the oral diagnosis clinic, staff the admissions office and treat patients.
Dr. Cynthia Kleinegger, assistant professor of oral pathology, radiology and medicine, was an assistant professor of oral pathology at the University of Mississippi before returning to the UI, where she earned her M.S. in 1995. She received her D.D.S. from the University of Colorado. She will teach in the oral diagnosis clinic and treat patients in the mucosal disease/head and neck pain clinics. She will also teach in the oral pathology and systemic disease courses and conduct research on the role of Candida albicans as a possible co-factor in the development of oral squamous cell carcinoma.
Dr. Patricia Meredith, assistant clinical professor of oral pathology,
radiology and medicine, brings 13 years of experience in private
practice and hospital primary care dentistry in Iowa and Missouri
to her new position as director of patient admissions at the College.
A 1983 UI College of Dentistry alumnus, she will oversee the admissions
clinic, teach in the oral diagnosis clinic and treat patients.
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Faculty News
Dr. Daniel Lew, professor and chair of oral and maxillofacial surgery, was recently elected to the Royal College of Surgeons of England, one of the world's foremost surgical professional bodies. Dr. John C. Montgomery, executive associate dean, was the guest of honor at the Iowa Dental Association's annual session in Des Moines this spring.
Dr. Jimmy Pinkham, professor and chair of pediatric dentistry, delivered a series of presentations to dentists, dental faculty and students in Brazil this summer.
Dr. Christoper A. Squier, associate dean for research, was elected to the board of directors of the American Cancer Society (Iowa Division), where he will chair the Tobacco Control Core Team. He was also selected to serve on the editorial board of the International Journal of Oral Biology, published by the Korean Academy of Oral Biology.
Dr. Christine Wu-Yuan, associate professor of periodontics, was
elected vice president of the Chinese-American Microbiologists
Society.
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National apppointment for Nowak
Dr. Arthur J. Nowak, professor of pediatric dentistry, has been
named president of the American Academy of Pediatric Dentistry,
the leading professional organization in the field. He is the
first Iowa dentist to lead the academy, which includes about 4,000
members specializing in oral health care for children and patients
with special health care needs. As president, he will oversee
the academy's activities as it celebrates its 50th year of service.
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UI researchers study permeability of mouth mucosa
Two College faculty members have received a three-year, $490,000 grant from the National Institute of Dental Research to study methods of administering medications through the mucous membranes of the mouth. Drs. Christopher A. Squier and Philip Wertz, both professors of oral pathology, radiology and medicine, and investigators in the College's Dows Institute for Dental Research, will collaborate with Dr. Christopher Cullander of the University of California, San Francisco (UCSF) School of Pharmacy. They will study the permeability of the mouth lining and develop compounds to enhance drug delivery through the mucosa.
Starting from studies of the mouth lining, UI researchers will develop substances designed to make the oral mucosa more permeable. The agents then will be sent to UCSF, where their effectiveness will be evaluated. "Drug companies are increasingly interested in delivering drugs in a non-invasive way," Dr. Squier says. "The mouth provides a permeable and easily accessible site to deliver drugs, and has been used for more than 100 years to give nitroglycerin for angina."
Administering drugs in this way would eliminate the risk of infection associated with needles. It would also provide an alternative to traditional oral delivery of medications, which may be damaged by acid and enzymes in the stomach when swallowed. In addition, the method may reduce adverse drug reactions by permitting a quick halt to therapy, which is not always possible when medications are injected or swallowed.
The award is the first National Institutes of Health Interactive
Research Project Grant received by the UI. Introduced in 1993,
these grants are designed to support studies that involve the
exchange of data, materials and ideas that accelerate the development
and application of knowledge.
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Faculty examine access to dental care
People who face economic and social barriers may have a difficult time gaining access to dental care, but several College faculty members are initiating efforts to improve care for these populations. Drs. Peter Damiano, director of health policy research for the UI Public Policy Center and associate professor of preventive and community dentistry, and Michael Kanellis, assistant professor of pediatric dentistry, recently released a study, "A Report on the Iowa Title XIX Dental Program," which reveals that fewer Iowa dentists are accepting new Medicaid patients.
Dentists cited low fees and patient noncompliance as the main reasons behind their reluctance to take on Medicaid-insured patients. "Dentists' acceptance of new Medicaid patients is one important factor affecting the ability of Medicaid recipients to get dental care," Damiano says. The study began as a project by Dr. Kanellis, who set out to educate dentists and physicians about the oral health omponent of the Early and Periodic Screening, Diagnosis and Treatment (EPSDT) program supported by Title XIX, or Medicaid. The program requires that eligible children from low-income families in Iowa be referred to a dentist for examination by age 1.
"Once we started talking to dentists about EPSDT, we received a lot of preliminary feedback from those who said one reason they may not see these children is because of major differences between Medicaid and other types of insurance," Kanellis says. "We set out to find useful information about why some dentists are reluctant to accept new Medicaid patients."
The report includes a list of recommendations on improving the Title XIX dental care program as suggested by dentists, including increasing fees, selectively reducing services for adults and developing new ways to screen young children. College faculty are also leading a national dialogue on improving access to dental care. Dr. Rhys Jones, adjunct associate professor of pediatric dentistry, served as moderator and project coordinator for the Oral Health Access Public/Private Leadership Meeting in Bethesda, Md., in April, supported by a grant from the U.S. Health Resources and Services Administration and coordinated through the Department of Preventive and Community Dentistry.
Meeting participants discussed ways to improve the relationship between dentists in private practice and public health organizations. "Dental public health organizations have primary responsibility for assuring access to care, and in this country we are very reliant on the private sector to provide that care," Jones says. "The private sector must be involved if we are to resolve these issues."
A recently issued report from the meeting identifies nine recommendations
for further efforts that improve access to care. Among them are
calls for similar public/private forums at state and local levels,
continued advocacy for dental public health programs, and steps
that encourage dental professionals to practice in underserved
areas. Improved partnerships between public agencies and private
practitioners are a central goal. Drs. Steven Levy, professor
of preventive and community dentistry, Damiano, Kanellis and preventive
and community dentistry graduate student Jill Jones also attended
the meeting.
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Dr. Henri R. Manasse Jr., UI vice president for health sciences
Dr. Manasse left the UI to become executive vice president designate of the American Society of Health-System Pharmacists. He began his new duties this fall. UI Vice President for Research David J. Skorton has been appointed to provide interim leadership to the Health Sciences Center.
The second annual College of Dentistry Open golf outing and continuing education program on July 19 was an event "par" excellence. Sixty-eight alumni and friends of the College hit the links at Finkbine Golf Course after a program on dental bonding taught by Dr. Gerald Denehy, professor of operative dentistry.
Top honors for the golf tournament, cosponsored by the University
of Iowa Foundation went to Dr. Fred Ebetino, followed by Drs.
Joe Brennan, John Wollney, Pete Olberding, Travis Schmitt and
Harold Fischer. Dr. Lisa Holst took the women's division title.
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Designate a preferred reunion year
Some alumni prefer a reunion year other
than the actual year their degree was conferred. The Alumni Association
can enter a "preferred reunion year" designation in
the graduate's computer record, thereby ensuring the person will
be automatically included in reunion ailings for the desired year.
Alumni should contact the Alumni Records Department or the Reunion
Director at 800/IOWALUM (469-2586) or write to the Alumni Association,
100 Alumni Center, Iowa City, IA 52242-1797, to request a preferred
reunion year.
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janice-quinn@uiowa.edu