July 13, 1998 By Connie Daughtry
GAINESVILLE, Fla. -- In a unique partnership, the University of Florida is using new technology to join with private dentists in an effort to erase a critical shortage of specialists trained to meet children's dental needs.
On July 1, the UF College of Dentistry and Miami Children's Hospital formed an affiliation to train UF pediatric dentistry residents in Miami. Technology such as distance videoconferencing will be key to the program's success.
Health-care trends dictate more pediatric dentists are needed to enter the field to help in preventive dental care -- a practice that should start early in dental development. Pediatric dentists not only are trained to treat children with emotional, physical and mental handicaps, but also children under the age of 5. "Parents should want their child to see a pediatric dentist because they are primary-care providers like ediatricians," said Dr. Robert Primosch, a professor and director of the UF College of Dentistry's pediatric dentistry residency program. The shortage of pediatric dentists is critical throughout the country.
"The key problem is there are fewer training sites for dentists specializing in pediatric dentistry. The American Academy of Pediatric Dentistry reports that in 1980 there were 200 first-year training residencies, but by 1997 the number dropped to 160," Primosch said.
"As Florida's population grows, the demand for more dentists specializing in children's dental care is increasing," Primosch said.
The program will bridge UF's strong academic pediatric residency program with the equally strong clinical training program of Miami Children's Hospital. Primosch said the relationship will be unlike any other in the country because it merges a private children's hospital with an academic university through distance videoconferencing. The trade-off: The hospital will provide valuable clinical space that UF lacks to train the residents and UF will provide qualified faculty to educate residents in an effort to help the hospital stay within its mission to serve children.
"We are confident that the synergistic affiliation will produce some of the best pediatric dentists in the country," said Dr. Arnold Mannis, site coordinator at Miami Children's Hospital.
The concept of the two-year program was initiated through conversations between Mannis and UF College of Dentistry Dean Dr. Frank Catalanotto. The dean, a pediatric dentist himself, was interested in expanding the college's presence in South Florida to improve access to care for the area's underserved patients. Two UF pediatric residents will train at Miami Children's Hospital each year. They will join the three residents UF currently trains in Gainesville each year. With the increase of the two pediatric dentists, an additional 10,000 children will have access to specialized care within a five-year period.
"For a long time, pediatric dentists throughout Florida have let it be known that more associate pediatric dentists are needed," said Primosch. "Many hospitals and practitioners hire generalist dentists because they can't find pediatric specialists. Because their patient load is so heavy, many have had to turn away Medicaid patients and the indigent. So I see our link as a needed public service without taking business away from other professionals."
According to AAPD, 15 percent of children received dental care from pediatric dentists in 1983. In 1997, the number rose to 33 percent. If a 1995 study holds true -- that by the year 2020 the number of children under the age of 15 will have increased by 8.1 million between 1993 and 2020 -- then the problem will only worsen. Other factors contributing to the low number of pediatric dentists include: dental school closings; hospitals' inability to afford dental clinics; the number of foreign dentists who return to their country after their residency; and the increasing number of retiring pediatric dentists. Last year, UF had more than 75 applicants vying for three coveted residency spots.
By traveling to UF's dental clinic in Hialeah, the Miami program's residents will be able to interact with faculty and other residents at UF's main campus via videoconferencing.
"The distance learning link will provide us the tools to accomplish a truly innovative resident training program," said Dr. Frank Courts, associate professor and chair of UF's department of pediatric dentistry. "This will be the first opportunity the college will have to use the funds provided by the Florida Department of Health to create a distance learning education program. The success of the program will determine if we will include some of our other sites in this endeavor."
AAPD Executive Director Dr. John Bogert said he believes the UF/Miami Children's Hospital affiliation is the first of its kind. "They have formed a program that appears to be a workable model for others to follow," Bogert said.
Professional dental associations such as the American Academy of Pediatric Dentistry, the American Dental Association and the American Association of Dental Schools are lobbying the U.S. Congress through the Health Education and Training Act, which funds general dental practice residencies, to include support for pediatric dentistry training programs. "We are hopeful in the next session that Congress will approve the new act, thus allowing pediatric dentistry the chance to compete for needed funds," Bogert said. -----------------------------------------
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