Her father, Darrell Powers, DDS, has served patients in the Northern Moore County town of Robbins for many years.
Now she is a dental student who wants to return to Moore County after she completes her training at the School of Dentistry at the University of North Carolina at Chapel Hill.
Last summer, Powers got a different look at dentistry while working as an “extern” with the FirstHealth Dental Care Centers, a program that provides dental care for underserved children in Moore, Montgomery and Hoke counties.
It was a memorable experience, so much so that Power plans to do another four-week rotation with the clinics this summer.
“The most memorable part of the externship was meeting all the kids,” Powers said. “I don’t get to work with many children at the dental school, so this externship gave me more experience. I know I want to work with children when I finish school, so this externship was very valuable. The children were adorable.”
Dr. Sharon Nicholson Harrell, the director of the three FirstHealth Dental Care Centers, is herself a graduate of the School of Dentistry at UNC-Chapel Hill. When Dr. Eugene Sandler was looking for locations for the school’s extern program, he turned to FirstHealth and to Harrell, whom he describes as “one of the shining stars of our dental school.”
“I have been involved in the FirstHealth program from the very beginning,” Sandler said. “I met with Lisa Hartsock (Administrative Director of FirstHealth Community Health Services) eight to 10 years ago. We talked, and I advised and suggested. When FirstHealth was lucky enough to hire Sharon, I knew it was going to be a good program.”
According to Sandler, the School of Dentistry’s extern program, so called because the training occurs outside the school environment, has three focuses: “a real world experience outside our ivory towers,” a look at different ways of delivering dental care and choices in career planning.
“This gives students the opportunity to know that dental care is delivered in different manners, usually for different populations,” he said. “We also want them to utilize rotations and give them choices in picking where they want to go to aid in career planning. You don’t have to open an office and be a dentist in your own practice. There are other opportunities.”
Each dental school class of 80 has a half-dozen or so students who want to specialize in pediatric dentistry, which requires additional training and certification. An extern rotation at the FirstHealth clinics provides a good pediatric perspective, not to mention an up-close-and-personal look at in-the-trenches public health.
“Pediatrics and public health, these are the two experiences that we can provide so well,” Harrell said.
Real World of Dentistry
The first of FirstHealth’s three Dental Care Centers, the Southern Pines clinic, opened in the fall of 1998 and the program accepted its first extern in the summer of 1999.
Externs work in Troy, Raeford and Southern Pines, where they are exposed to the spectrum of pediatric care and a diverse patient population.
“For most of the students, this is their first time to practice in the real world of dentistry, outside the dental school walls,” Harrell said.
About two externs a year spend time with the FirstHealth clinics.
“I try to limit the number we have on purpose, because we want to provide quality time,” Harrell said. “We don’t overload them so we can spend quality time with each one, and it takes time to teach.”
Having newcomers on board slows down the process, because they are learning the ropes of a professional office while actually on the job. But adapting to the pace is part of the learning curve. So is developing professional confidence.
“It makes you aware that you can do what you thought you couldn’t do,” Harrell said.
According to Harrell, FirstHealth’s role in the externship program has three goals:
n To familiarize students with pediatric and clinical procedures
n To help them become more confident with behavior management in children
n To help them increase their speed
Students in the dental school see on average one patient every three hours.
“That wouldn’t work around here,” Harrell said.
At the Dental Care Centers, the students see two or three patients in the morning and another two in the afternoon. “It varies, depending on what the procedure is,” she said.
“The main thing is getting them used to practice-based scheduling, working with schedules and assistants,” said Dr. Amy Moubry of the Dental Care Center staff. “In school, things are pretty slow. Here, it’s a lot faster-paced.”
Admittedly, there are some things that dental students can’t and don’t do.
“They don’t do complex procedures on very young patients or extremely uncooperative patients,” Harrell said.
But they can always watch, and observation is an important part of the training process.
Some parents don’t want their child to be treated by a student. But they are in the “extreme minority,” according to Harrell.
“We post a notice that we have a dental extern training with us and include this fact in the patient’s initial paperwork,” she said. “Parents are informed that the student’s work will be monitored by a staff professional.
“I tell the parents that we’re checking everything that is done. Their child is getting the same level of care. It just may take a little longer.”
Moubry said, “Most parents are very receptive to having the externs do the procedures. They know there is back-up if it’s needed.”
While most of the students who extern in the FirstHealth setting will probably enter general practice, some have honed in on pediatric dentistry.
One such student is Antonio Braithwaite, who like Powers externed with the Dental Care Centers last year.
“He really hoped he could spend time at FirstHealth,” Sandler said. “He was an undergraduate in public health and is the first dental student to win an Albert Schweitzer Fellowship, which provides funds for people who want to do things for the underserved in the spirit of Albert Schweitzer. Antonio applied and won one of these. He wants to do a project on teaching oral hygiene and how to achieve ideal dental health for children.”
A Successful Pairing
According to Harrell and Sandler, the School of Dentistry plans to continue to send students to the FirstHealth Dental Care Centers and the Dental Care Centers will continue to accept them. They see the FirstHealth externship program as a win/win experience in terms of training and attracting young professionals into the realm of pediatric and public health dentistry.
“If students are exposed when they are in dental school, they will be more receptive to taking at least some underserved in their offices,” Harrell said. “We try to teach them the compassionate piece of working with the underserved.”
On the practical side, Sandler has been impressed by the physical quality of the clinics, noting that FirstHealth has “spared nothing” in providing the best equipment and appropriate decor.
“Students who are interested in computers have the opportunity to be in a dental clinic where computers (which connect the three centers) are used to the utmost,” he said.
Sandler also praises “the caliber of people Dr. Harrell hires to work with her” and the interest that FirstHealth’s administration takes in the Dental Care Centers.
“FirstHealth feels that dentistry is an important part of health care and treats it appropriately,” he said. “That’s why you have such good clinics.”
