Providing Compassionate Care to Geriatric Patients
Dental Alumna Teaching Care of Elderly Patients
By Teri Speece
For Tam Van, D.D.S, director of the Geriatric Dentistry Clinic at UT Dentistry San Antonio, dentistry involves many gray areas.
“Not a lot is black and white,” she said. “If you have 10 dentists in a room and one patient, it’s very possible that you will get 10 treatment plans, depending on each dentist’s philosophy.”
Dr. Van believes this is even truer for her patients. The practice provides tailored dental services for senior citizens who have a difficult time being seen in a private practice due to systemic conditions, functional or cognitive limitations and complex medication profiles. An elderly patient at her clinic may take more than a dozen medications, have diabetes or suffer from dementia.
Her mission is to teach students how to take these issues—as well as quality-of-life issues—into account.
“Because of their ages and medical considerations, you really have to look at the whole patient—including their well-being—to determine the best options for treatment,” said Dr. Van, clinical assistant professor in the Department of Comprehensive Dentistry in the School of Dentistry at the UT Health Science Center San Antonio. UT Dentistry San Antonio is the clinical practice of the School of Dentistry.
After earning her D.D.S. from the UT Health Science Center San Antonio, Dr. Van’s clinical experience included four years of active duty in the U.S. Air Force, where she developed her expertise in patient management.
“Because my patients were mostly health care personnel from Wilford Hall Medical Center, I learned a great deal about patient management because I could ask them questions about how they would handle different patient situations,” Dr. Van said. “It was a tremendous learning experience.”
Dr. Van also learned how to make treatment decisions under certain constraints, such as time. “With the military, you have a readiness mission—service members have to be ready at all times. So you may end up treating a patient in one appointment with a large filling instead of doing a crown or a casting that would involve multiple appointments.”
After leaving the military, she directed the dental clinic at the Daughters of Charity Services of San Antonio, which sparked an interest in special-needs patient care. The experience also helped her gain acceptance to a fellowship in geriatric dentistry and into the clinic itself, where she has been able to do her favorite work—teaching dental students how to look past the patient’s teeth to see the bigger picture.
“When you’re a young person graduating from dental school, unless you’re around older people, you really don’t know how to treat them. They read it in textbooks and hear about it in lecture, but it doesn’t really mean much until they see it,” she said. “My hope is to try to enlighten them.”
Dr. Van’s students have been not only enlightened but inspired, having named her the school’s Professor of the Year three times over the past five years.
“She takes a very personal approach to treating geriatric patients,” said Justin Felkner, a fourth-year dental student. “She makes sure we understand their conditions, the medications they’re on, and how those affect the treatment that we are doing—always keeping in mind what’s best for them.”