The Group Dentistry Now Show: The Voice of the DSO Industry – Episode 3

Kim Larson sits down with Dr. Jacob Dent, PDS Foundation dentist, and Kyle Guerin, Director of PDS Foundation and Corporate Social Responsibility, Pacific Dental Services. They join her from Dental Lifeline Network’s headquarters in Denver, Colorado to discuss the new PDS Foundation Dentists for Special Needs Clinic which recently opened in Phoenix, Arizona.

Many parents of children with special needs report that finding dentists willing and capable of treating their children is almost impossible. Although there are more than 52 million people with disabilities in the United States, a mere ten percent of dental professionals are prepared to treat patients with special needs. This new dental practice provides high-quality dentistry to pediatric and adult patients with special needs. Learn more about how the PDS Foundation is serving this extremely underserved community and what more still needs to be done.

Our podcast series brings you dental support and emerging dental group practice analysis, conversation, trends, news and events. Listen to leaders in the DSO and emerging dental group space talk about their challenges, successes, and the future of group dentistry.

The Group Dentistry Now Show has listeners across North America, Australia, Europe, South America, and Asia. If you like our show, tell a friend or a colleague.

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FULL TRANSCRIPT:

Kim Larson:
The Pacific Dental Service Foundation has spent the last few years focused on special needs advocacy and training, because they know there are many barriers for patients with special needs. They have recently opened a brand-new special needs clinic. This new dental practice provides high quality dentistry to pediatric and adult patients with special needs. The clinic has specially trained dentists and team members equipped with behavioral and environmental techniques to ensure successful dental visits. We’re thrilled to have Dr. Jacob Dent, one of the practicing dentists, and Kyle Guerin, Director of PDS Foundation and Corporate Social Responsibility for Pacific Dental Services. Gentlemen, welcome to the Group Dentistry Now Show. So tell us about the need for special needs dentistry in America.

Dr. Jacob Dent:
So, right now, in the United States there is this growing epidemic for special needs dentistry, and it’s just revolving around the fact that, right now, there are about 52 million people in this country with a disability, that being physical or intellectual disabilities. With the 126,000 dentists in America, there’s only about ten percent of those dentists who are even willing to see patients with special needs. So, the math just doesn’t work out. 52,000,000 for 12,000 dentists…there’s too much demand and not enough abilities to see everybody.

Kim Larson:
And why do you think dentists are so reluctant to treat patients with special needs?

Dr. Jacob Dent:
Well, there’s a couple of things. First, there’s lack of training that comes in dental schools. More and more schools now are starting to see the need and incorporating programs, but when I came out of school 16 years ago, it wasn’t even suggested to be part of the program. It was referred to a specialist. And so, for the general practitioner, there’s nothing out there in our curriculum that taught us how to do it. You either decided you want to learn, or you just didn’t do it.

Kim Larson:
Right, so we have dental schools who are listeners and subscribers, and I was just wondering if you have any plans to bring on dental schools for training or dentists for training to learn how to provide access to care for special needs patients.

Dr. Jacob Dent:
Of course, when we look at our office in Phoenix area, we’re committed to an open-door policy for any of the dental students, the residents, anybody that wants to see what special needs dentistry really looks like in the real world. Even in my office in Houston, we’re working with the dental schools there to allow access to anybody who wants to come and learn.

Kim Larson:
Well, that’s great. Kyle, why did they choose Phoenix as a location for the special needs clinic, and do you have plans to expand to other parts of the country?

Kyle Guerin:
There were a couple reasons that Phoenix was considered. One is that one of our PDS Foundation board members is Dr. Jack Dillenberg with A.T. Still University, and they are one of the leading schools in allowing their residents and seeing individuals with special needs in those patients. They had a clinic on the side of town that hadn’t made it, so it was an opportunity to have some resources, to have some knowledge, and then it’s the pair mix. It’s the opportunity to use access and take the insurance plans, as well as the ease of allowing dentists from out of state to get a temporary service license within Arizona to be able to.

As Dr. Dent said, this one clinic is not going to solve the problem, but we’re hoping that it’s the beginning of something where dentists and students can come, they can train, they can learn, they can see. And really this is a pilot program. We have to prove that it’s sustainable, that we can keep the doors open, we can keep the lights on, and if we’re successful, and we can make this sustainable, the sky is the limit to see where those next clinics could possibly be.

Kim Larson:
So, if we just shift gears a little bit. On our website we featured a video, PDS Foundation produced it, and it shows a patient named Benjamin getting access to care there, at your clinic, and it was just a really heart-warming video. A lot of sensory integration going on there, can you talk a little bit about that?

Dr. Jacob Dent:
So, we had to design an office and an environment that adapted to the needs of the patient, instead of trying to get the patient to adapt to a traditional dental practice. We created a sensory room that basically just became a non-threatening, just a fun place to be, and so that allows the patients to just take an opportunity and say this is a pretty fun place, it lowers their anxiety levels, but for the parents too, and the caregivers. The anxieties that you have as a parent going to any dentist or doctor are overwhelming because in the back of your mind you think this isn’t going to go well.

So, in Benjamin’s story, he was the typical patient that we see where parents were just struggling to find somebody that would even be willing to see him. Because a lot of times the parents report when they call and say, “I have a special needs child” or “I have an adult child that I’m taking care of,” they just immediately say, “No, we can’t see them” and don’t even let them in the front door. So, Ben was a great opportunity to see because prior to us, he hadn’t been to the dentist in a while. And now I see him every three months, he comes in, family’s good, and he is getting really used to the routine to a point where he knows where he is at and it’s no longer a threatening or a hard thing for him to do.

Kim Larson:
Well, it was amazing, you wrapped him in, is it called a joey blanket? Is that what it’s called?

Dr. Jacob Dent:
So, in the video with Ben, it’s called a joey board. It’s a protective stabilization board that we use. It’s just two pieces of Velcro, that’s it. The thought is, this is going to end up being leather straps and a white padded room, when people think of stabilization, but it’s literally just two pieces of Velcro.

Kim Larson:
Well, as soon as you wrapped him in that, his face just lit up with a huge smile. It was clearly exactly what he needed to calm any anxiety that he was feeling. So, it obviously works, what you’re doing there. Besides the special needs clinic, what else is the PDS Foundation doing to help people with special needs?

Kyle Guerin:
It’s interesting, this really started a number of years ago, and it started with Dr. Dent and his desire of help this population, and it started with education and training. So, we went around to a number of events and we trained around 1,500 people over this time, and it’s been great. The goal was successful, but I don’t think we were moving the needle quite as much as the foundation liked. Obviously not as fast as Dr. Dent probably would like, and so the clinic has become the epicenter of this movement and so the education is still there. We want to take and see what is possible. Dr. Dent is an amazing clinician, but he doesn’t have any Jeti mind tricks. I mean maybe he does, I haven’t seen it. It’s possible, but it’s teaching confidence, and it’s teaching patience, and it’s teaching compassion. So, we want to continue with the education, but really it starts in the special needs clinic in Arizona and we’re hoping that as we get people, important talks, there’s a number of residency programs that want to come in and want to move forward. We’re moving a little slow because we want to make sure we have our home in order and all kinks lined out, but there’s so much opportunity there beyond just Arizona.

Kim Larson:
Well, speaking of opportunities, Dr. Dent, you work with the Special Olympics, do you plan on developing a relationship with them in the clinic?

Dr. Jacob Dent:
We’ve already done that. We see a lot of the athletes in Arizona right now. Being the clinical director for Texas and Louisiana myself, that was one of the other things that I saw a huge need for, is Special Olympics is a wonderful organization, and they do a lot of great things, but from our healthy athletes program, we would go in, do a screening, and identify patients that had a need. But it always came back to the same point, so who do we go to that will actually do the work? And it was very disheartening for me to say, I’m sorry, I don’t know.

Dental schools, themselves, have always been the fallback for special needs, however, I can speak for Texas, out of the three dental schools there, there was over a year waiting list to even get into the dental school for special needs patients. And if you were a patient, it was almost a year between appointments. So, they were inundated with that. So again, my office in Houston has become even their referral source because it’s not just the kids. I think that’s the big point that we try to make, is that kids are cute and everybody wants to see them, they’re a little easier to manage. Nobody wants to see the six-foot, 200-pound adult who is noncompliant with sitting in the chair and opening wide.

So, what I try to do, in teaching and showing by example. It takes clinical skill to do dentistry, and everybody who comes out of school has clinical skill, but it takes more of the emotional abilities and the patience to say I’ve got to connect with these people. I’ve got to give them time, which is really the most crucial part of this, you have got to give them the time necessary. And then, really be able to empathize with not only them, but their caregivers, because a lot of time, parents or nurses or therapists, whoever comes in, they’re just looking for a little glimmer of hope that there’s improvement that can be made here.

Kim Larson:
Well, it takes a really special person, and you’re a really special person. Why is this so important to you, personally?

Dr. Jacob Dent:
Well, in my own story I have a 15-year-old son, Ethan, who was diagnosed at age three with Autism. And so, as I’ve been going through this day in, day out, residency myself, of being a dad of a special needs child, I saw the struggles that I went through. And it’s that nature of if I’m struggling with things, as a doctor, and as the dad, what is the lay person dealing? What I did, is I took everything I learned from all of the years of therapy and all of the struggles that we did, and we just applied it to dentistry.

And it is a complete, out-of-the-box way of looking at things and doing things, and it violates every time and money factor that most dentists look at. And that’s another concern that we all face, until there’s some changes that are going to happen with actually reimbursing dentists for the extra time it takes to do this right, nobody is going to be really willing to do it. It’s just because, why would dentists who have all of this debt, especially these students with loans which are now ridiculous, come out of school and say, “I’m willing to see a special needs patient. It may take me an hour, or I can see three neurotypical patients in the same hour and make three times as much.” Which one do you think they’re going to pick? They don’t have any training from school in that. So, there’s a lack of confidence, there’s a monetary portion, and most of them just don’t have a personal connection.

Kim Larson:
Well, the PDS Foundation is obviously in a unique position right now to help people. It’s really incredible, what you’re doing. What other plans do you have in the future, Kyle?

Kyle Guerin:
I just wanted to just go back to one of the other point about what we’re doing with the Special Olympics. It’s kind of on two levels, and it ties in both of the for-profit type Pacific Dental Services, who recently just became a sponsor of Special Olympics International, so we sponsor the Special Smiles program. That really has allowed us to open the doors for our supported clinicians to just get a tiny taste of what this is like, doing more screening events. So, with the Pacific Dental Services Foundation, also as mobile dental clinic, it’s a two chair CEREC, all-digital, its beautiful. We’re traveling to more of the Special Olympics summer games and trying to do more of the treatment onsite there. We will be in San Antonio, upcoming. Half of our events on our tour are going to be at Special Olympics events. So, the hope is that the more we can just expose these clinicians to these different events. Once they serve and they volunteer, They get that bug. They get that excitement. What’s been cool, as Dr. Dent said, is that he’s the local clinical director in Houston and Louisiana, and we’re hoping we have somebody who’s interested in taking that position in Arizona. And then, we’re looking at other states to really serve and take that next step.

So, with the PDS Foundation, we continue to serve internationally, where we have our own dental clinic in Guatemala, where we continue to do more trips, partnering with dental schools internationally. And we hope there, even we begin to see some of those special needs patients that really have a lack of existent care internationally. So, between our international trips, we do dental assistant scholarships for individuals interested in getting a career in dental assisting to our special needs clinic. It’s an exciting time with the PDS Foundation.

Kim Larson:
It really is, and you’re in a great position to help so many people. Just to touch back on the clinic a little bit, Dr. Dent, I notice that in your clinic, you’re not always treating patients in the traditional way, in a chair. Can you talk a little bit about that, on how you have to really change your training and methods to best serve your patients?

Dr. Jacob Dent:
It’s an outside-the-box way of thinking. So, if you try to adapt the patient to your environment, go sit in the chair, be still and let me do my work, it’s not going to happen. We’ve designed the offices around the possibility of every objection. We start in a sensory room, and that’s really where it comes to the patient’s sits, enjoys their time, but that’s where we talk about home care. And we work with the parents, so for me, my first visit with a child or an adult child that’s still at home, is we let the parents be the dentist the first visit.

So, if they brush in front of the bathroom sink, we brush in front of the bathroom sink. We do have patients that have a phobia of getting in the chair, and so we created a room that is designed with no chair. It just has a bean bag and a little foam rug on the floor, and so built to sit on that, they’ll play on that, and we’ll brush their teeth just sitting on the floor. So, pretty much anywhere that they will get, we will find them and take care of what they need. So, it’s making them more comfortable. It’s really more about being patient-centric than it is about making it easier about myself, as the dentist. It’s not always ergonomic, it’s not easy, but we do have patients that, for example, can’t get out of their wheelchair. We still treat them, regardless, so it’s one of those, we go where they are, and we get it done.

Kim Larson:
Truly patient-centric care. Kyle, do you have anything to add about the PDS Foundation and anything else you’d like to discuss about your foundation?

Kyle Guerin:
It’s been incredible, and the carry-over that Dr. Dent…I ran into somebody the other day that works at the support center in Irvine for Pacific Dental Services, and she has a special needs sister. And we were talking about her dental care, and we were talking about the situation. She struggled because she can’t get out of this wheelchair and it takes up so much…and just from what I’ve seen with doctor, I was like “what about the wheelchairs that tilt back?” She was like “I never thought of that.” And so then she was able to go in and get one of those wheelchairs and it made it easier for her to just go see her normal GP dentist who sees and takes care of her care. Her’s was a little different because it was more physical, and the transition to…but when we can all put our heads together, and problem-solve, and be willing to do this patient-centric care, it’s incredible the impact we can have on their lives.

And I think with the PDS Foundation, we’re thankful for all of our donors…it’s so great to see all these people coming together, and it’s cool to see the impact with things that maybe Pacific Dental Services Foundation’s doing that inspires other DSOs to do international trips or to get other mobile clinics, or to see private practice dentists that get this idea of service. We just want to be kind of that catalyst and that igniter of this idea of service. And that’s what we’re trying to do.

Kim Larson:
Absolutely, you’re trailblazers. And I know you said it’s a pilot program, so it would be really interesting to see where you take it. There’s obviously a huge need for this special needs dentistry and what you’re doing is absolutely amazing. So, I’d really like to thank Dr. Jacob Dent, Kyle Guerin, for joining us today on the Group Dentistry Now show. I’ve learned a lot, and I’m sure our audience has as well.

The Pacific Dental Service Foundation, Dentists for Special Needs, is located at 4550 E Bell Rd, Suite 106, Phoenix, AZ. For more information or an appointment, please call (602)344-9530 or email care@dentistsforspecialneeds.com or visit their website at DentistsforSpecialNeeds.com.

Thank you for joining us today, the Group Dentistry Now Show
has listeners across North America, Australia, Europe, South
America, and Asia. If you like our show, tell a friend or a colleague.