Opening Wider

Federal plans to fund more patients mean both opportunity and disruption for Schulich Dentistry. And that’s a good thing, as the School expands its service-learning opportunities.

A woman holding a child Photo by Rene Johnston via Getty Images

With the federal government finalizing its ambitious dental-care plan for uninsured Canadians, Schulich School of Medicine & Dentistry is anticipating opportunities and potential disruption to its student-delivered dental care clinics.

“Dental schools are major service providers to many of the populations identified as not having reasonable or equitable access to dental care,” said Dr. Carlos Quiñonez, vice dean and director of Schulich Dentistry, who came to the School with a mandate to help students understand their professional responsibilities.

“The federal insurance plan has the potential to be a disruptor of what we do, because if you are a low-income adult or family, and now you have some dental care coverage, the incentive to visit a dental school for low-cost care is lessened.”

As a result of the changing policy picture, but also because Quiñonez strongly believes it’s the right thing to do, the School will be exploring how it can further expand its outreach or service learning programs, which places students in community agencies to offer care to people in need.

“The dental school’s mission is to be of service,” said Quiñonez, who has advised governments at all levels on dental care policy issues. “There will be a much stronger emphasis on equitable access to care and the professional responsibility to meet everyone’s needs, not just those who can pay.”

Dr. Abbas Jessani, Schulich Dentistry’s assistant director of curriculum renewal and service learning, has grown a small 2020 pilot project into a full and permanent part of the curriculum this year.

Schulich Dentistry clinics have approximately 20,000 patient visits a year in clinics throughout the province. Thanks to Jessani’s program, many of those come from disadvantaged groups, including domestic-violence victims, high-risk youth, 2SLGBTQ+ people, as well as those experiencing homelessness and refugees.

Through the newly launched Community Service Learning program, students visit several community centres in London to screen people needing dental care and refer them to Schulich Dentistry clinics.

“These patients would not normally come to us because of social disparities and unpleasant experiences with the health-care system,” said Jessani, whose clinics and placements range from downtown London to Moose Factory in Northern Ontario and to East Africa in Uganda, Rwanda, and Kenya.

“These community members have several competing priorities and unfortunately have no means to seek any form of dental care; they have no bus pass, they’re extremely anxious about dentistry and sometimes experience stigma and discrimination when interacting with the health-care system. So, we take our students to them to show that we are here for them, and that we care.” Dental students need to be trained in trauma-informed care and poverty-related issues, he stressed.

“I want our students not just to think about teeth. I want them to think about human beings.”

—Dr. Carlos Quiñonez

“Our goal is to not only alleviate financial constraints but also assume the role of primary health-care provider to deliver ‘risk-based dental care’ to these high-in-need individuals.”

Through service-learning, approximately 140 students a year are exposed to patients who lack many opportunities, including the ability to meet basic hygiene, Quiñonez said.

“When you’re sitting beside a homeless person who needs dental care, that’s a very different reality than the populations traditionally treated in private dental offices,” he said. “How do you, as a health-care professional, behave in that context? What do you consider so that you can effectively do the job in front of you, which is to care for someone in need? I want our students not just to think about teeth. I want them to think about human beings.”

Dr. Abbas Jessani and students prepare for community visits. Dr. Abbas Jessani and students prepare for community visits.

Student Kevin Zhou, who started fourth year this month, has appreciated the opportunity to serve newcomer communities due to his own life story.

His immigrant family lived in Toronto social housing when he was little, and Zhou suffered a double trauma there when he was just six, losing two front teeth in an accident on the same day as another child in the apartment complex fell from a balcony and died.

These accidents made a deep impression on Zhou.

“This serves as a really painful reminder of the social determinants of health,” he said. “As somebody who was a beneficiary of dental services myself, I find it really rewarding to be able to go back now on the other side and provide dental care.”

Accessibility is also top of mind as part of the School’s commitment to serving the needs of the entire community.

In the Paediatric Dental Clinic, doorways are being widened to accommodate wheelchairs and the reception desk is being lowered, thanks to a donation from alumnus Dr. Bryan J. Williams, DDS’74. Similar accessibility renovations were part of the Dentistry Surgical Care Unit (DSCU), making two operatory rooms accessible for people with mobility challenges who use assistive devices.

“This September, persons with disabilities will be better able to access the clinics, and that’s great for students, too,” said Dr. Keven Hockley, associate director of Schulich Dentistry’s clinics.

Children in wheelchairs will be screened in the paediatric clinic and can then receive one-day treatment for all their dental problems in the recently reopened DSCU, which had to stop operations due to the pandemic.

“Now we’ll be able to get these people in, and provide them with the treatment they deserve,” he said.

Dr. Bryan J. Williams pays tribute to career with generous donation

By Cam Buchan

Dr. Bryan J. Williams, DDS’74, is helping improve oral care for children with special health-care needs at Schulich School of Medicine & Dentistry. At the same time, his gift is enhancing the training for future dentists who will provide a helping hand in caring for this often-overlooked part of the community.

Through a generous gift of $50,000, Williams is supporting enhancements to the Paediatric Dental Clinic in the Dental Sciences Building, including necessary renovations, equipment, and ongoing maintenance to provide a safe environment for the care of children with special health care needs (CSHCN). It will also improve the learning environment for dental students to enhance skills and understanding in the care of these children.

Williams, who began his journey with two years as an associate in a general dental practice and a part-time clinical instructor at Western, rose to prominence in Paediatric Dentistry for CSHCN as well as Orthodontics for children with cleft palate and craniofacial anomalies. He credits his time at Schulich Dentistry for the opportunity to give back.

“It has been my privilege to teach hundreds of residents,” said Williams, now “mostly” retired and living in Seattle, Washington. “I have former residents of mine scattered all over the world. So, I can go to almost any city in the world and get a free lunch, which is not bad.”

After practising general dentistry, Williams realized his true passion was both paediatric dentistry and orthodontics.

His training took him to the University of Washington, in Seattle and Seattle Children’s Hospital where he also earned further degrees in dentistry and education. After graduation he returned to the Detroit-Windsor area for 11 years before heading to the west coast where for 15 years he was Chief of Dental Medicine at Seattle Children’s Hospital to fulfill a passion for a hospital-based pediatric and orthodontic practice. Most recently Williams has retired from active practice but continues volunteering as an advisor on research committees and does some consulting.

“I love it when dental students develop some level of comfort and interest in caring for children with special needs”
-Dr. Bryan J. Williams, DDS’74

Reflecting on his career, Williams acknowledged the pivotal role the School played in his success and his gift.

“Throughout my career I have been deeply reflective of the wonderful educational background Western provided and I have been forever grateful that I was so privileged to be able to have that as a foundation for my professional and personal growth. My gifts reflect my deepest appreciation for how well Western prepared me for such an exciting and fulfilling career.”

Given the size of Southwestern Ontario, some of these families of CSHCN have to travel long distances for even basic dental care that’s so important to their children’s well-being, he said.

“I love it when dental students develop some level of comfort and interest in caring for children with special needs,” Williams said. “When they graduate, these dentists can provide so much for a community if they are comfortable with treating children who have milder forms of needs and have the back up of specialists in larger centers for children with more complex health problems.

“My hope is that this gift will help make that happen.”