A lifelong commitment to accessible care
Written by Kate Hunger
Dental public health initiatives target underserved populations in San Antonio and South Texas
Suman Challa, BDS, MPH, understood the challenges presented by oral health care barriers long before he started dental school. “I grew up on a farm,” Challa said. “So, I realized the importance of access to care and how much of an impact it makes.”
As associate dean for advanced education programs and strategic initiatives at the School of Dentistry at The University of Texas Health Science Center at San Antonio, Challa directs the school’s dental public health residency program — the same program he completed earlier in his career when he spent six years driving to Laredo each week to study the needs of the community. Challa has helped launch a variety of dental public health initiatives that bring oral health education, preventative dental care and comprehensive dental treatment to thousands of South Texans, including schoolchildren, people living in rural communities and nursing home residents.
“We take care of them from cradle to grave,” said Challa about the school’s dental public health initiatives, some of which began during the COVID-19 pandemic.
PREVENTING A LIFETIME OF DENTAL CARIES
More than half of kindergarteners and two-thirds of third-graders in Texas have had tooth decay, according to the most recent Texas Oral Health Basic Screening Survey. To help reduce dental disease among children, the school has collaborated with the San Antonio Metropolitan Health District since 2006 to provide fluoride varnish treatments and dental sealants to elementary school students. The health district’s school-based programs help about 18,000 students annually, Challa said.
About 200 dental students a year are gaining firsthand experience in dental public health through the school-based rotations.
“That’s what we are trying to do — to impress on them that it’s not only a good thing to give back to society but also it gives you a good feeling knowing that you are making a long-term difference in someone’s life,” Challa said.
SERVING SOUTH TEXAS RURAL COMMUNITIES
Specialized dentistry is particularly challenging to find in underserved areas. So, the school in 2020 began sending advanced pediatric dental residents, accompanied by a faculty member, to provide specialized pediatric dental care to children in communities along the I-35 corridor between San Antonio and Laredo — a region in which the ratio of dentists to the population is among the lowest in the country. About 450 patients have been treated since the program began.
“These are patients who have never gotten dental care in their lives,” Challa said. “We take care not only of early childhood caries but of any care they need.”
“Working directly with preschool children and nursing home residents emphasized the immediate impact of preventive measures, reinforcing my dedication to community-level interventions.” — Shikha Puri, BDS, MPH
In another initiative, dental public health residents began visiting community health centers in Luling, Seguin and Gonzales during the COVID-19 pandemic, where they have provided comprehensive dental care to 500 patients as of fall 2023, Challa said. In 2022, the school began sending fourth-year dental students on rotations to the same clinics. The goal is twofold: providing needed care while introducing students to the opportunity to make a difference by practicing in underserved areas.
Dental public health resident Shikha Puri, BDS, MPH, said her clinical experiences have underscored her commitment to working as a community dentist.
“Working directly with preschool children and nursing home residents emphasized the immediate impact of preventive measures, reinforcing my dedication to community-level interventions,” Puri said.
HELPING PEOPLE SMILE AGAIN
Older adults also can experience a cascade of health issues related to a lack of oral health care.
“If you don’t have good teeth, you can’t eat very well,” Challa said. “And if you can’t eat very well, you end up losing weight. It’s harder to keep healthy. And psychologically, one is impacted by avoiding smiling.”
An initiative launched in 2021 has already helped thousands of seniors in the San Antonio area receive comprehensive care, from routine exams and extractions to dentures, all free of charge. Residents in 55 nursing homes have access to top-of-the-line care through the program, called Holistic Oral Health Program for Elders (HOPE). Supported by a $5.7 million grant from the Centers for Medicare and Medicaid Services, HOPE is on wheels, using two vans to transport equipment used to set up dental offices inside of nursing homes.
“We take the latest and greatest equipment,” Challa said. “We didn’t want the nursing home residents to feel they are getting anything different than going to a private dental office. This is a complete, one-stop solution.”
The team had treated about 5,000 patients as of September 2023, with a goal of seeing 7,000 patients. Challa described one of the patients treated in May 2021.
“She was so depressed, she didn’t want anyone to turn the lights on in her room because she had abscesses in her mouth and didn’t want anyone to look at her like that,” he said.
After treatment, the shift was dramatic.
“She is no longer depressed; she comes out of her room, she has the lights on, and she smiles at people. This changes their lives completely.”
