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Restoring smiles

April 2002

by Natalie Gutierrez

Seventy-year-old Fayetta Frances and her 93-year-old mother, Albertha Peacock, have a lot to smile about these days, thanks to the Clinical Geriatric Dentistry Program at the Health Science Center.

Frances always worried about her aging mother's health. In 1999, she and her husband admitted Peacock to a long-term acute care home for the elderly. There, her mother received excellent health care

24 hours a day and was surrounded by other residents her age. Although she made many friends at her new home, Frances said her mother was not her "social butterfly" self.

"She was embarrassed to talk to the other residents because she had only five teeth," said Frances. "She didn't like her teeth, she didn't care to brush them and she had difficulty eating with them."

A history of limited access to dental care, heart disease, diabetes, limited dexterity due to osteoarthritis and the side effects of a long list of prescription medications caused her gradual tooth loss. Peacock's age, delicate medical condition and fixed income made her a high-risk patient, but a prime candidate for the Clinical Geriatric Dentistry Program.

The program, run through the Dental School, is the only one of its kind in South Texas. It offers seniors accessible dental care and consultative geriatric oral medicine evaluation. Dentists and hygienists are taught to identify and understand the complexities of treating patients who have serious medical conditions, functional limitations and long lists of prescription medications.

Michéle Saunders, D.M.D., professor of dental diagnostic science, established the program in 1988. In 1992, under the leadership of Eleonore Paunovich, D.D.S., it evolved into a full-time clinical activity.

"We started the program because we saw a growing need for specialized dental care for the elderly," said Dr. Paunovich, associate professor of dental diagnostic science. "Modern medicine and medical technology are keeping people alive longer, but not necessarily in the best of health."

More than 150 care facilities in San Antonio collaborate with the Clinical Geriatric Dentistry Program. In 1999, the staff at Peacock's care facility introduced her and her mother to the program. In a series of about eight visits - sometimes Frances would take her mother to the clinic at the UTHSC, and other times the dentist would visit Peacock at the nursing home facility - Peacock received a comprehensive cleaning, gum surgery, an upper denture and
a lower partial.

Frances recalls the day her mother returned to the nursing home with her new set of teeth. "As soon as I rolled her in her wheelchair through the front door of the building, she began to shout, 'look at my new teeth everyone! I've got new teeth!' She is so proud of her new teeth," Frances said. "She has also gained back the weight she lost, as well as her social demeanor."

Frances said she was so impressed with the dental care her mother received that she decided to become a patient of the Clinical Geriatric Dentistry Program.

Dentists receive specialized training through a geriatric dental fellowship program before they can practice at the clinic. The post-doctoral clinical program is a collaborative effort between the Health Science Center Dental School, the geriatric medicine program and the clinical oral health program at the South Texas Veterans Health Care System.

Health Science Center graduate Sarah Dirks, D.D.S., entered the geriatric dental fellowship program last year. "I am learning a great deal about specific diseases such as cardiovascular disease, respiratory disease, cancer, diabetes and neurological disorders and how they directly impact a patient's oral health," Dr. Dirks said. "The fellowship reminds me daily that all people should be treated with compassion and respect, regardless of their condition or limitations."

George Miller recently became one of Dr. Dirks' patients. He and his wife, Gerry, came to the Clinical Geriatric Dentistry Program last year, after they had nearly given up hope of finding a dentist who could properly treat George. The 82-year-old former Marine takes 11 medications daily to control his high blood pressure, heart valve prolapse and back pain.

"Dr. Dirks' knowledge of George's medical condition and her confidence level made us feel comfortable," Gerry said. "She provided George with new upper and lower dentures and some fillings. We are thrilled with her work and with the caring, compassionate and affordable treatment George receives."

Dr. Paunovich recently received a $409,500 grant from the Kronkosky Foundation. She hopes to expand the Clinical Geriatric Dentistry Program to include pre-doctoral students and to allow first-year dental students the opportunity to participate in the program through clinical rotations.

Since its inception, the Clinical Geriatric Dentistry Program has treated more than 600 elderly patients with everything from cancer to diabetes to Alzheimer's disease.

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Updated 7/30/14