Dental Students at Indian Reservation

Contact Judith Bailey, 216-368-4442 or [email protected]

Twenty-one senior dental students from Case Western Reserve University and four other schools are serving externships this summer at the Pine Ridge, S.D., Indian Reservation in a pilot project designed to assist the U.S. Public Health Service (PHS) in providing much-needed dental care for the reservation's 40,000 residents.

Dennis Tommasone, an associate professor of dentistry at CWRU, developed the project in collaboration with the Indian Health Service, an agency of the PHS. Tommasone also supervised the externs during the project's first two weeks. Since then, CWRU Assistant Clinical Professor Ned Robertson has been supervising.

"There is a tremendous shortage of health care providers, both dentists and physicians, in the Public Health Service," Tommasone said. Just three dentists currently staff the 17-chair clinic that serves all 40,000 residents of the Pine Ridge Reservation.

Moreover, the dental needs of the Lakota Oglala Sioux residents are four times the national average, according to the PHS, which is in the U.S. Department of Health and Human Services. "There is a high rate of Baby Bottle Syndrome, untreated decay, and periodontal disease," the PHS reports.

The 21 students, including 12 from CWRU, are serving one- to three-week-long externships. The students deliver 40 hours of direct patient care per week and receive academic clinical credit for their service. Room and board are provided, but the students are not paid, nor are they compensated for their transportation costs. The first externships began June 1, and the project will end August 11.

Along with delivering clinical care, the project is designed to serve as a recruitment tool for the Indian Health Service program at Pine Ridge, which "has experienced some difficulty in recent years in recruiting suitable dental school graduates to fill entry-level dental officer vacancies," according to the externship agreement. Officials believe that students who participate in such externships are more apt to apply for commissions with the PHS upon graduation.

Tommasone served two years as a PHS officer at a reservation in Oklahoma after earning his dental degree at CWRU in 1968.

Officers in the PHS have Naval ranks and wear uniforms, he explains. A four-year tour of duty carries a $30,000 signing bonus, which is proportionally reduced for those who depart early. In addition, commissioned officers are entered into a lottery for an additional $30,000 tax-free stipend, which can be used to repay student loans. The chances of winning "improve enormously" for those who apply for a post in an underserved area, Tommasone said.

In addition to CWRU, dental students from Indiana University and the Universities of Maryland, Pennsylvania, and Missouri are participating in the externships. Four hygienists from the University of Michigan are also serving along with the dental students.

If the externship project proves to be successful, it could be expanded to include other dental schools and additional reservations, Tommasone said. He believes it could also serve as a prototype program for recruiting dentists and physicians to serve at Coast Guard facilities and with the Bureau of Prisons, which the PHS also staffs.

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