Helping Communities Near the Border
By Salwa Choucair
With a population of more than 261,000, Laredo sits on the Texas-Mexico border and is the only U.S. city bordering two Mexican states. A port city with four international bridges, Laredo has a poverty rate of 31 percent. With that statistic, many of Laredo’s citizens experience health disparities.
In order to reduce such disparities, UT Health San Antonio’s School of Dentistry has been sending students to serve underserved populations of South Texas for more than 30 years. Through partnerships with established community-based clinics in and around Laredo, the school has provided students invaluable opportunities to work with underserved patients.
“Students read about these clinics in class, but the outreach rotations give them firsthand knowledge on how to provide care,” explains Juanita Lozano-Pineda, D.D.S. Class of 1987, M.P.H., associate professor and associate dean for external affairs.
“By completing these clinical outreach rotations, our dental students are participating in public health,” says Dr. Lozano-Pineda who recalls working in Harlingen as a dental student in the late 1980s. “They are part of the solution by delivering care while also receiving training.”
Today, students have three choices for outreach rotations in Laredo. They may work with the City of Laredo Health Department, Gateway Community Health Center, Inc. or Mercy Ministries of Laredo.
Laredo Health Department
The Dental Health Clinic is a partnership between the City of Laredo Health Department and the School of Dentistry. The clinic provides comprehensive dental health services to indigent children from ages 3 months to 21 years with a focus on preventive dentistry and education. UT Health’s partnership includes a pediatric residency program at the clinic with Maria Minerva Garcia, D.D.S. Class of 2000, clinical assistant professor, serving as the clinic’s director.
She holds the Lamar Bruni Vergara Trust Distinguished University Chair in Oral Health, in appreciation of The Honorable Solomon Casseb, Jr. and Mr. Joseph C. Martin, III, Trustees. Dr. Garcia has been a part of the clinic since its inception 10 years ago. She oversees both the dental residents who live in Laredo for the two-year program as well as the dental students who rotate through the clinic for one- to two-week rotations.
She and her husband, Louis Garcia, D.D.S., assistant professor for the School of Dentistry, work together at the Laredo clinic. Both are from South Texas: Dr. Minerva Garcia grew up in Zapata while Dr. Louis Garcia, a graduate of UTHealth School of Dentistry at Houston, is from Laredo. They understand what it is like to need dental care. She remembers receiving dental care as a child from Mexico and the difficulty of making the trip across the border for appointments.
“When they gave us the opportunity to work with UT Health in Laredo, it was like giving back to the communities where we grew up,” Dr. Minerva Garcia says. While she provides dental care to children in the clinic, her husband works with adults.
“I hope students and residents who come through here learn the importance of relating to their patients no matter where they end up practicing,” Dr. Garcia says. “It hasn’t always been easy for our patients to receive care because of accessibility and/or finances. We do what we can here. We do the best for the patient, not just what we have been taught is the best from a textbook. I believe students and residents who work here become better dentists overall.”
The clinic at the Laredo Health Department is busy. In fact, it warranted another faculty member to work alongside Dr. Minerva Garcia in pediatric care. Elva Jordan, D.D.S. Class of 2009, clinical associate professor in pediatric dentistry, joined her in 2012.
Fourth-year dental student Sabrina Chavez recently completed a two-week rotation with Dr. Louis Garcia. Chavez hopes to return to South Texas to practice dentistry near her small town of Port Isabel to give back to her community like the Garcias have done.
“I think the outreach rotation is a great opportunity to experience another environment that you may not be used to—the culture, the population, the socio-economic status of the area. It’s good to be exposed to patients who are from an underserved area who need extra help and attention, and I think it is great that UT Health offers this program so students may be more inclined to go serve in these areas.”
Gateway Community Health Center, Inc.
Gateway Community Health Center, Inc, is a private, non-profit corporation funded by the U.S. Department of Health and Human Services. Gateway serves residents in Webb, Zapata and Jim Hogg counties with five clinics near the U.S.-Mexico border including three in Laredo, one in Zapata and one in Hebbronville. Claudia Cavazos, D.D.S. Class of 1996, M.P.H., is the chief dental officer at Gateway and oversees the dental students who rotate there.
Dr. Cavazos, a native of Laredo, was one of the first students to serve a rotation at Gateway while in her second year of dental school. She has served as the clinic’s dental director for 18 years.
“I oversee five clinics, eight dentists and three hygienists. I believe in the mission of the center and truly enjoy offering dental treatment to those who need it the most,” says Dr. Cavazos. “It is very important that patients who come to our dental clinic receive services in a place where they feel comfortable.”
The need is apparent according to Gateway’s 2018 patient profile which shows the clinic had 107,909 office visits and 26,890 unduplicated patients in just one year.
“We are extremely proud to be able to partner with the School of Dentistry. Through our affiliation with the school, we are able to offer specialty services to some of our patients. Residents from the prosthodontics and periodontal programs rotate through our center once a month and offer specialty services. We truly appreciate their efforts.
“The center also serves as an external rotation site for third- and fourth-year dental students. Through these rotations, we are able to expose students to how community health centers work, what they have to offer, and how they help patients.
“I hope students learn there are other options out there when it comes to dental practice, and that community health centers need dentists to offer services to patients who have great need.”
Dr. Cavazos has made an impact on the students she has supervised and taught through the years. One student in particular, who recently completed a two-week rotation, was inspired by Dr. Cavazos’ leadership.
“I was very fortunate to work under Dr. Cavazos, who is a Mexican-American woman like myself. To see her hold a leadership position really struck a chord with me,” says Madeline Rodriguez, D.D.S. Class of 2019. “Her example encourages me to work hard toward a leadership role of my own one day. All in all, my experience at Gateway solidified my desire to pursue a career in public health and community dentistry.”
Mercy Ministries of Laredo
Mercy Ministries of Laredo provides primary health care services to residents of Webb County. Patients are responsible for co-pays for their services based on the outcome of their financial screening. Mercy Ministries offers adult dental care including cleanings, fillings and simple dental extractions. Sister Rosemary Welsh works with UT Health in this partnership which offers fourth-year dental students a two-week summer selective rotation in general primary care dentistry. Pre-dental students from Texas A&M International University are also able to interact with dental students and observe them providing primary oral health care.
Community Outreach Results
In addition to overseeing these clinical programs, Dr. Lozano-Pineda has conducted research studies determining the number of dentists who work in underserved populations across Texas.
“Overall for the state of Texas, 26.3 percent of the dentists working in underserved counties are our graduates,” she says. “In fact, that’s the other component of the outreach programs: creating a pipeline to recruit students from these underserved areas to study dentistry and to go back and work in their hometowns.”
This continued effort to reach these underserved areas speaks directly to the School of Dentistry’s mission “to improve oral health through excellence in education, research, patient care and community engagement.” In South Texas, dental faculty members and students are continuing to fulfill the school’s mission.