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Dr. Van visits with a paitent and her daughter

Tailored treatment
Dental clinic caters to elderly


September 2012

by Natalie Gutierrez

Priscilla Lane, 86, always prided herself on caring for others. She’d raised 10 children and worked in education for 25 years. After surviving breast cancer in 1999, a fall that fractured her left hip in 2009, and the loss of her husband of 66 years in 2010, Lane came home from the nursing home frail, fatigued but resilient. Confined to a wheelchair, Lane’s memory was fading as was her hearing. Not wanting to be a burden to her family, Lane failed to mention that something else was bothering her. She couldn’t chew. She couldn’t eat.

"My mom is tough, yet she is the kindest and most generous woman you’ll ever meet," said Lane’s daughter Casandra Zupancic, 55. "She didn’t want to trouble anyone with her problem. But my brother Chris and I knew something was wrong with her teeth and we needed to help her."

While seeking a dentist in private practice who could treat her fragile and ailing mother, Zupancic was referred to the Senior Care Dental Clinic at The University of Texas Health Science Center at San Antonio. The clinic is one of only a handful in the country dedicated to providing oral health care solely for patients aged 55 and older.

Tam Van, D.D.S., is director of the Senior Care Dental Clinic.

"The mission of our clinic is to enhance the quality of life for older adults by improving access to dental care, both physically and financially," she said. "We focus on elderly patients who have physical, medical, mental, social or pharmacological considerations that may present management issues for a private practice provider. Some of our patients have dementia or other diseases such as Parkinson’s, uncontrolled high blood pressure or diabetes. Some are disabled or take up to 25 different medications a day. Our staff recognizes the impact that age-related or other diseases can have on the elderly and their families. So we tailor dental treatment in the context of their lives and well-being."


  Dr. Van treats a paitent in a wheelchair at the Senior Care Dental Clinic
The Senior Care Dental Clinic provides patients in wheelchairs a wheelchair lift so they can sit during treatment without having to stand before or after an exam.
Zupancic said the clinic was the right place for her mother.

"As soon as I brought my mom in, the staff immediately took great care of her. Dr. Van knew exactly what she needed."

Within two months, Lane was chewing and eating normally again with her new dentures.

Zupancic was so impressed with the care her mother received, that she, herself, decided to become a patient in the clinic. She had been diagnosed a few years earlier with a rare autoimmune disorder called Churg-Strauss syndrome or allergic granulomatosis. The disease, which has no cure, is marked by blood vessel inflammation, which can restrict blood flow to vital organs and tissues, oftentimes causing permanent damage. Over time, the disease damaged the bone in her jaw and Zupancic would need nine teeth, including some molars, removed. She also would need to undergo a surgical procedure called alveoloplasty in which the bone in the jaw is smoothed.

After a series of visits over the course of a year, Zupancic’s dental work was completed, and by the spring of 2012 she was fitted for new upper and lower partials.

"I wouldn’t have gone anywhere else," Zupancic said. "My mother and I are so grateful for the Health Science Center’s Dental Clinic. Dr. Van took the time to consider everything my mom and I needed. She was so patient. I trust her with my life."

The Senior Care Dental Clinic was established in 2000 by Eleanore Paunovich, D.D.S., M.S., associate professor in the Dental School, with funds from the Kronkosky Charitable Foundation.

When finances present a barrier to treatment, the clinic offers patients the opportunity to apply for a discount based on their income and national Federal Poverty Level guidelines. Funding and space provided by the Dental School, operational revenues as well as grants and philanthropic support, when available, keep the clinic and its services in operation.

The clinic operates seven dental exam rooms and is staffed by Dental School faculty who complete a geriatric dentistry fellowship. Third-year dental students rotate through the clinic providing faculty supervised care to patients.

Student Meagan Garcia completed her rotation in the clinic this past spring and later volunteered to continue working alongside Dr. Van.

"I was a little nervous at first because of the patients’ complex medical histories," Garcia said. "But Dr. Van was so thorough that I was always ready and prepared. After reviewing patient charts and making notes, Dr. Van met with us to discuss each patient and mapped out step-by-step the care we would provide. Spending time in Dr. Van’s clinic with patients who ask, ‘so how’s school been for you?’ was the highlight of my week. We call our patients ‘family.’"

Faculty members take pride in training the next generation of oral health care providers.

"Students appreciate learning from each other and from their patients in an environment that encourages understanding of the total patient needs," Dr. Van said. "Everyone deserves the best oral health care. It is our goal and privilege to provide it."

Excellent care for elderly

  • The Senior Care Dental Clinic is housed in the Dental School
    at The University of Texas Health Science Center at San Antonio at
    7703 Floyd Curl Drive.

  • Hours of operation are from 7:30 a.m. to 4:30 p.m.
    Monday through Friday.

  • The clinic will move to the new Center for Oral Health Care & Research at 8300 Floyd Curl Drive in 2014. Expansion will include more parking and accessibility for the disabled.

  • For information about supporting the Senior Care Dental Clinic, contact
    Sara Piety, director of Institutional Advancement for the Dental School, at
    210-567-6536 or at piety@uthscsa.edu.

  • To make an appointment and to learn more about qualifying for financial assistance, call 210-567-0327.

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