Students treat senior patients in van equipped as dentist’s office

Dental VanStudents and faculty at Case Western Reserve University’s School of Dental Medicine are treating Cleveland-area seniors in a dentist’s office on wheels—a 38-foot van, in fact, renovated to provide full-service oral care.

The “Lifelong Smiles” van—believed to be the first of its kind in Northeast Ohio—also serves as a teaching tool for dental students, who began clinical rotations on the van this fall semester as part of a new curriculum requirement.

“There’s almost no difference between our van and a traditional dentist’s office,” said Nicole Harris, a visiting assistant professor in the dental school’s Department of Community Dentistry.

Dental students, under supervision of faculty, provide oral exams, digital X-rays, cleanings, fillings, dentures, extractions and cancer screenings on the van for many patients who haven’t visited a dentist in years. The van is driven to and parked outside Cleveland-area nursing homes and assisted-living facilities for residents to come aboard. In addition, two portable dental chairs are set up in facilities for those patients who cannot get on the van.

The van is the centerpiece of a new dental school initiative known as the Geriatric Dental Program. Third-year students take classes in providing oral care to seniors, while fourth-year students complete clinical rotations in the van. Completing the geriatric program is mandatory for all dental students.

“There’s a perception it’s more difficult to treat seniors, which has kept many dentists in their comfort zones, avoiding these patients,” said James Lalumandier, chair and professor in the dental school’s Department of Community Dentistry. “We want to reverse that—and need to—given our current and future dental needs.”

Dental van interiorThe Geriatric Dental Program was created, in part, as a response to changing demographics nationally, said Lalumandier. The nation’s senior population—ages 65 and older—is expected to surpass 72 million by 2030—more than double the number from 2000, according to the U.S. Department of Health and Human Services.

“Often, underserved elderly populations cannot go out and get care on their own. So we’re building a model where we go to them,” said Suparna A. Mahalaha, a visiting assistant professor in the Department of Community Dentistry and co-director of the new program, along with Harris. “At the same time, by providing students experience with older patients, we’re planting a seed in them to serve seniors during their careers.”

Soon, Case Western Reserve medical, nursing and social work students also will accompany dental students in assessing patients in facilities where the van is parked, as part of a university-wide emphasis on increasing interdisciplinary training in the health sciences.

“It used to be people just lost their teeth,” Lalumandier said. “In today’s world, seniors are retaining a good portion of their teeth and need specialized care that’s in fitting with their overall medical histories. Across the health sciences, students are opening their eyes to the idea that oral health is key to a patient’s complete wellbeing.”

The van pays weekly visits to two assisted-living residential day programs in Cleveland, and the dental school is looking to expand the number of locations students serve. Program leaders also are recruiting active and retired dentists willing to volunteer on the van in various roles.

The Ohio Department of Health donated the vehicle to the university after reviewing competing proposals from across the state. Funds for the van’s overhaul were provided by the McGregor Foundation, the Dental Trade Alliance Foundation and others.