Homeless Veterans Flashing Big Smiles, Thanks to a Partnership Between VA Maryland Health Care System and UM Dental School

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The continuing partnership between the Veterans Affairs (VA) Maryland Health Care System and the University of Maryland Dental School has helped more than 2,500 homeless Veterans get dental care.

At the University of Maryland Dental School, Dr. Oluwayemisi Akinrefon adjusts denture for Veteran patient Clarence Wallace as part of the School’s collaboration with the VA Maryland Health Care Syste

The collaboration has been a benefit for homeless Veteran patients, but also for Dental School students.

Although Leon Bright, now 61, had seen some very hard times and was homeless, he still expected to see his daughter get married last June. What the former U.S. Marine didn’t expect was to be smiling at the wedding. His ill health had robbed him of some of his teeth.

But Bright did smile at his daughter’s wedding, a lot, flashing a full set of bright, pearly whites. “My mouth needed a lot of work, and I’d been going to the dentist for about a year,” he explained.

Bright got his new teeth just in the nick of time. His newly minted dentures arrived at the Perry Point VA Medical Center Dental Clinic, a division of the VA Maryland Health Care System, the day before the wedding.

A University of Maryland Dental School post-graduate student who knew about the wedding made sure to fit Bright’s dentures the day they arrived, and so the Brights--father and daughter--both beamed brilliant smiles as they celebrated the big day and posed for pictures.

Bright is among more than 2,500 homeless Veterans who are now flashing big smiles these days, thanks to a continuing partnership between the VA Maryland Health Care System and the Dental School.

“We fix up their smiles so they can interview for jobs and continue their lives. Smiling is a very important part of meeting people and socializing,” said Douglas Barnes, DDS, MS, director of advanced education in general dentistry at the School, which is across the street from the Baltimore VA Medical Center.

Although Bright himself received his dental care at the Perry Point VA Medical Center, where post-doctoral dental students often serve their residencies, Veterans who live downtown are divided between the dental clinic at the Baltimore VA Medical Center and the dental clinic at the Dental School. The partnership, which began in February 2007 as part of a program called the Homeless Veterans Dental Initiative, came about when the number of homeless Veterans eligible for the Initiative’s dental care proved overwhelming for the dental clinics’ small staff.

The Veteran population eligible for the program is treated at the Dental School by the 25 dentists enrolled in the School’s Advanced Education in General Dentistry program under the supervision of experienced attending dentists. In addition, they must be enrolled in a VA-supported or approved homeless services program. Patricia Lane, MSW, the Homeless Services clinical manager for the VA Maryland Health Care System, explains that this partnership “ensures a continuity of care.”

“When the program opened, we had a lot of patients we could not serve,” said Julie Bitzel, the business manager for the Dental Care Clinical Center at the VA Maryland Health Care System. Bitzel and her counterparts at the Dental School have developed a close working relationship, streamlining the approval process to assure that the proper scope of care is provided to all Veteran patients.

“The patients can receive fillings or partial dentures, but the treatment first concentrates on preventing infections,” says Barnes. Barnes added that the Dental School is pleased to be able to treat this underserved population, which is also part of the mission of the dental program.

Between April 2003 when the program started and February 2011, more than 2,715 Veteran patients have benefited from the collaboration between the School and the VA Maryland Health Care System.

“Patients are being seen at the Baltimore VA Medical Center, at the Dental School, and at the Perry Point VA Medical Center Dental Clinic,” Bitzel said. “The first referrals to the Homeless Veterans Dental Initiative were made in April 2003. From that date through January 2007, Veterans were treated at the Baltimore and Perry Point VA Medical Centers and then in February 2007, we began referring eligible Veterans to the Dental School due to the volume of those requesting care.” The School’s dental students also can rotate into the Dental School clinic at Perry Point in Cecil County, Md.

The collaboration is a win-win. Just ask Clarence Wallace of Salisbury, Md. This former U.S. Marine and Maryland National Guard Veteran experienced some softening of the bone structure in his mouth. He’d lost two teeth while a third tooth broke. Without his front teeth, Wallace used to cover his mouth when smiling and laughing.

Seeking help through the VA Maryland Health Care System, he underwent 11 extractions and needed dentures. Wallace said it was not as painful as he had expected, and dentists at the School fitted him with dentures. “I’m a person who likes to smile. It saved my life and I would recommend the program to anyone. To be able to smile again is awesome,” Wallace said.

The collaboration has been a benefit for homeless Veteran patients, but also for Dental School students. As part of their requirements at the Dental School, students must learn to act as a primary care provider, including providing emergency and multidiscipline oral health care, health promotion and disease prevention, and using advance dental treatment methods and technologies on patients.

Air Force Veteran Ralph Vanderhall, originally from Dillon, S.C., is “overjoyed,” he said to receive a partial denture and cavity fillings. For the former Air Force cryogenics laboratory technician, preserving his teeth was a secondary concern when he walked into the VA medical center for other health diagnoses and treatments. “It is an excellent program,” Vanderhall said. “With the advances in the equipment, there is very little pain. Thanks to the program, I have my self-esteem back.”

Although participating patients are homeless and living in a VA-sponsored or VA-supported homeless services program before they can qualify for the Dental Initiative, there is a 60-day rule.

“They have to be in a services program bed for 60 days before they can qualify for dental care,” Lane said. “The homeless dental program closes the circle of the continuum of care. It’s one of the essential elements in that circle for medical reasons and for psycho-social reasons. Dental care is so important for many reasons. Over the years of working with homeless Veterans, dental care had long been mentioned as one of the top needs, for both social and medical reasons. Dental pain can cause numerous setbacks to homeless Veterans who are making a heroic effort to climb back to a secure footing.”

The VA Maryland Health Care System (VAMHCS) provides a broad spectrum of medical, surgical, rehabilitative, mental health and outpatient care to Veterans at two medical centers, one community living & rehabilitation center and five outpatient clinics located throughout the state. More than 52,000 Veterans from various generations receive care from the VAMHCS annually. Nationally recognized for its state-of-the-art technology and quality patient care, the VAMHCS is proud of its reputation as a leader in Veterans’ health care, research and education. It costs nothing for Veterans to enroll for health care with the VA Maryland Health Care System and it could be one of the more important things a Veteran can do. For information about VA health care eligibility and enrollment or how to apply for a VA medical care hardship to avoid future copayments for VA health care, interested Veterans are urged to call the Enrollment Center for the VA Maryland Health Care System, Monday through Friday, from 8 a.m. to 4:30 p.m. at 1-800-463-6295, ext. 7324 or visit http://www.maryland.va.gov.

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Rosalia Scalia
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