Addressing a dental drought
Clinical outreach, pipeline programs and mentorship in public service is how the School of Dentistry plans to combat professional shortages
By Norma Rabago
DDS, MPH
“We send the students in rotations so they can understand the communities we serve.”
– Juanita Lozano-Pineda, DDS, MPH
In a 2024 report, the Health Resources Services Administration designated 256 Texas communities as dental professional shortage areas with few, if any, dental professionals. These areas often struggle with limited access to care, resulting in longer wait times for appointments, travel challenges for patients and an overall gap in preventative and restorative care — by all accounts, dental deserts.
According to the U.S. Census Bureau, the state’s population has surpassed 30 million and is the fourth fastest-growing state in the country. And while most of the state’s population lives in urban areas, well over 4 million Texans live in rural communities where health care providers are at a minimum.
In sparsely populated rural communities, the need for more patients contributes to the lack of local providers, said Juanita Lozano-Pineda, DDS, MPH, associate dean for external affairs and director of the UT Health San Antonio School of Dentistry’s Hispanic Center of Excellence.
And in poor urban areas, many adults lack dental insurance, resulting in fewer dental practices where they are critically needed.
Lozano-Pineda believes student recruitment is important to addressing the needs of these locations.
“We recruit students from those areas and make sure we consider all students, especially those from rural areas, because we know [they] need more dentists,” she said.
Since 1985, the school has conducted clinical rotations at community health clinics in San Antonio, the Rio Grande Valley and Laredo to combat the dental shortage among lower-income patients. Recently, the school expanded its reach to Luling and Seguin.
Lozano-Pineda said the rotations, while serving as a training ground for students, may also spark a future interest.
“We send the students on rotations so they can understand the communities we serve, but they may see themselves choosing to practice there because that community really needs a dentist,” she said. “If they are from the community, they definitely understand the tremendous need.”
The school’s dental students are seeing more than 36,000 patients annually through community clinics in South Texas, resulting in approximately $5 million of uncompensated care.
A career to mimic
Christina Meiners, DDS, FICD, director of community learning, grew up in Weslaco with dreams of being a medical doctor. Her mother was a nurse, so she chose pre-med during her undergraduate years.
“It wasn’t until I got braces that I realized that being a dentist is being a doctor. I thought, ‘Oh, there’s an opportunity there,’” she said. “Growing up, I didn’t see very many Hispanic physicians or many female doctors even though I lived in the Rio Grande Valley where it’s 95% Hispanic. So, the ones delivering the care didn’t reflect the population [they] served. That’s what we’re hoping to change.” Meiners’ journey is a path she hopes many students will mimic.
“When I graduated, I served in the same community health care center that we rotated through as students,” said Meiners. She ended up staying for 11 years.
The rotations give students a chance to connect with communities they might not have encountered before. They also introduce the profession to a legion of future dentists. Meiners explained that students and faculty deliver presentations to children in elementary schools not only to teach the value of good oral hygiene, but also the benefits of a career in dentistry.
“At the beginning of our presentation, we ask them how many want to be a dentist, and a few hands go up. [Then] we dress them up in little lab coats and tell them how we get to play with little water guns every day. After the presentation, we asked how many would consider becoming dentists, and all their hands went up. It’s just planting a seed and hopefully making their next visit to the dentist a more curious experience,” Meiners said.
A pipeline
Introducing the profession of dentistry to elementary-age children in fun and engaging school visits is just one way School of Dentistry is working to address a projected shortage of dental professionals across the state.
Presentations to high school and college students are part of the Building our Leaders in Dentistry program, known as BOLD. Students learn about dental careers through workshops conducted across the state.
Pre-dental students working on their undergraduate degrees can apply for the Learning Enhancement for Achievement in Dentistry (LEAD) program. The three-week competitive summer program offers mini-courses in the sciences and hands-on dental workshops. Participants can continue in the program after graduation and upon acceptance into the School of Dentistry.
“We guide and mentor some of these students from underserved areas so they can be competitive applicants to dental schools,” Lozano-Pineda said. “Our hope is that some of these individuals we recruit from underserved areas will go back to those underserved areas and help their communities.”
Since 2014, 200 students have participated in the LEAD program. Of those, 122 applied to dental school and 78 have been accepted. Notably, 40% of practicing dentists in South Texas graduated from UT Health San Antonio’s School of Dentistry.
Part of the family
At The University of Texas Education and Research Center at Laredo, clinical rotations help some students step outside their comfort zones and learn the benefits of working in smaller communities.
“I tell students they will become part of their patient’s family and help them see how fulfilling it is to work in an area where maybe there are not many dental providers,” said Magda de la Torre, Dental Hygiene Program director. “Some students are a little hesitant to visit some of our underserved communities, but they come back to the classroom happy with the realization that a patient is a patient regardless of where they live, what language they speak or what their culture may be.”
The call to help others
By Christina Meiners, DDS, FICD
“The best way to find yourself is to lose yourself in the service of others.”
— Gandhi
As a little girl, I remember loading our van full of school supplies, clothes and toys several times a year, traveling to Mexico, visiting family and distributing everything we brought to them and others in surrounding communities. These memories I will always treasure, as they helped me discover that I was happiest when helping put smiles on others’ faces.
Fast forward to my pre-dental years in college when I learned about the Christian Medical and Dental Associations and quickly joined their mission trips across the border. From the moment I served chairside as a professional hand-holder and translator, I was hooked. I knew I wanted to do dentistry, and this was the population I wanted to serve.
As a dental student, I signed up for every community outreach selective I could and looked forward to my South Texas rotations. Some of the best memories I had in dental school were working with promotoras (Spanish for community health workers) and the Sisters of Mercy in Laredo, the homeless population at San Antonio Christian Dental Clinic and my hometown residents at Su Clinica in the Rio Grande Valley, and discovering a high need right in San Antonio at CommuniCare, a federally qualified health center.
My rotation at CommuniCare impacted me so much that I left my information to contact me as soon as there was an opening. I was fortunate to work there for 11 years as a staff dentist and adjunct faculty, overseeing the university’s dental students on their rotations.
The many opportunities to serve the vulnerable populations of South Texas outside of the dental school and the amazing mentors it connected me with — including Vidal Balderas, DDS, MPH, associate professor of comprehensive dentistry, and Juanita Lozano-Pineda, DDS, MPH, associate dean for external affairs — made my dental school experience one that I truly appreciated and reinforced my passion for public health and service to the community.
When the opportunity arose to work alongside my mentors to support and oversee the very programs that had such an impact on me, I didn’t hesitate to return. In this new role, I hope to use my experience to strengthen our outreach programs and their impact on students and to inspire more students to find their calling as service-oriented oral health providers.
