A Safety Net: Pediatric Dental Clinic Offers Oral Care for All Children
By Catherine Duncan
When fourth-year dental student Eduardo “Eddie” Guevara went to the UT Health San Antonio Ricardo Salinas Clinic for a weeklong pediatric dentistry clinical rotation, he kept thinking he had been there before.
The pediatric dental clinic is located on the southwest side of San Antonio and serves a predominantly lower socioeconomic minority population. The clinic is a unique partnership between the San Antonio Metropolitan Health District and the UT Health San Antonio School of Dentistry’s Advanced Education in Pediatric Dentistry Program. It is named in honor of Border Patrol Agent Ricardo Salinas, who was a resident of the neighborhood and was killed in the line of duty in 1998.
After mentioning this déjà vu feeling to Clinic Director Virginia Salazar, staff members searched and found his patient record. “I went there when I was 8 to 10 years old. I received dental cleanings and an amalgam for a cavity. I still have that filling today,” he said.
Guevara said he remembers the dental care experience being a positive one. While a student at Edison High School in San Antonio, he heard about the school’s dental assistant program and was able to get his license as a registered dental assistant while still in high school. During college, he worked during the summer and on breaks as a dental assistant.
At Texas A&M University in Kingsville, Guevara earned his Bachelor of Science in Biomedical Sciences and then started applying to dental schools. “My first choice was UT Health San Antonio. My family is here and this is where I grew up. I was so happy when I was accepted to the School of Dentistry,” said Guevara, who will graduate with his DDS in May 2022.
Guevara said he enjoyed the clinical rotation at the Salinas Clinic. “We were able to work alongside pediatric dentistry faculty and residents. It was great helping treat underserved patients,” he said. “I know how they are living. I could relate to them easily.”
The future dentist said although he enjoyed the pediatric dentistry rotation, he wants to practice general dentistry. “I would like to find a job so that I can care for people in the area where I grew up. There are people out there who may be scared of a health care professional or concerned about the language barrier. Since I am fluent in Spanish, I hope I can help educate patients on oral health care and its effect on their overall health and well-being,” he added.
Claudia Isabel Contreras, DDS, assistant professor/clinical and director of the school’s predoctoral program in pediatric dentistry, said predoctoral students in their second, third and fourth years all participate in clinical rotations at the pediatric dentistry clinic.
As part of the new curriculum, second-year students spend three days watching the faculty and residents care for children as well as providing care, she said. Third-year students have a half-day rotation at the clinic. Fourth-year students rotate at the two outreach clinics—the Salinas Clinic and one in Laredo—and work at each for a full week.
Dr. Contreras said the Salinas Clinic is an ideal location for gaining clinical experience because the School of Dentistry is the sole provider for all dental care. The pediatric dentistry faculty, residents, staff and students care for patients, who are on Children’s Medicaid or Children’s Health Insurance Program (CHIP), have no insurance, or are covered by the Title V Maternal & Child Health Fee-for-Service Program. The cities of San Antonio and Laredo both qualified for grants from the federal Title V program.
“Most of our patients are Spanish speaking. Students are able to take the Spanish elective which is very beneficial,” she said. “We are now seeing more individuals who are refugees. Caring for refugees is a very enlightening experience for our students.”
Working in this clinic also teaches the students about compassion and empathy. “One of our 2021 DDS graduates felt so bad for a male teen patient who she could tell was cold. She asked him and found out that he didn’t own a coat. She took hers off and gave it to him. With her classmates, she gathered money during the holiday season so they could purchase coats for more refugee children.”
Dr. Contreras said the dental students are often shocked to learn that their patients—whether local residents or refugees—have never seen a dentist. “We try to educate the parents and the children about dental care. We try to prevent cavities and other dental issues,” she said. “We also emphasize the importance of a healthy diet and the health issues associated with obesity.”
Maria Jose Cervantes Mendez, DDS, MS, associate professor/clinical and director of the postdoctoral program in pediatric dentistry, oversees 20 pediatric dentistry residents—16 in San Antonio and four in Laredo.
“At the Salinas Clinic, the residents provide comprehensive dental care—preventative and restorative treatment for all children from birth through 17 years,” she said. “We truly are a safety net for pediatric dental care in the area. We are housed next to a WIC [Women’s Infant and Children] Clinic. We are the only clinic that does this.”
While the students and residents are attaining invaluable clinical experience, the Salinas Clinic helps the dental school fulfill its mission of providing community service, Dr. Cervantes Mendez said. “We really become a dental home for these families. And, the experience opens our students’ eyes. It shows them how they can serve an underserved community. Even if they don’t practice in an underserved area, they could volunteer in the community.”
For residents who are first-generation college graduates, they can serve as an inspiration to the patients who are also from underserved areas, she said. “Our residents are able to share their stories. It is a win-win situation for everyone. Our students learn so much while making a huge difference in patients’ lives.”
Kevin J. Donly, DDS, MS, professor and chair of the Department of Developmental Dentistry, said the origins of the Salinas Clinic can be traced back to the 2000 “Oral Health in America: A Report of the Surgeon General” which recommended that oral health be included at all federal care clinics.
“The Surgeon General’s report offered an opportunity for us to say we will provide pediatric dentistry at the city clinic at that time. The clinic, which was established in 2003, is still open while others have closed. We are housed in a San Antonio Housing Authority building with a University Health entity, and we are a not-for-profit dental clinic. We share a waiting room with University Health’s WIC Clinic,” he said. When mothers go through the WIC program, there is an educational aspect that includes a dental component provided by the School of Dentistry.
Dr. Donly said, “Everyone considers the Salinas Clinic the safety net of San Antonio. We will see any kid, whether they have Medicaid or no other coverage.”
He emphasized that the Salinas Clinic has been successful at helping children for almost 20 years because of philanthropic and governmental support. “We wouldn’t be able to continue providing this clinic without the generous support we have received throughout the years.”
Throughout the years, support for the Salinas Clinic has come from Methodist Healthcare Ministries, the American Academy of Pediatric Dentistry Foundation, the Texas Cavaliers, the Delta Dental Community Foundation, BBVA Compass Foundation, and Procter and Gamble Company.
“Together, we have been able to help generations of children who would have gone without dental care. It is a great feeling to take care of these kids. While our residents and students are learning, we are making a difference in these children’s lives,” Dr. Donly added.