Dental Center's Faculty Practice What They Teach

By Eileen K. McCluskey

Special to the Gazette

In the heart of the School of Dental Medicine, the same world-class faculty who teach the School's problem-based curriculum also deliver their specialized services to a host of patients in a state-of-the-art facility, shoulder to shoulder with postdoctoral students.

The Harvard Dental Center's Faculty Group Practice was renovated five years ago, as part of an expression of renewal throughout the School. The old clinic was stodgy-looking, sparsely populated, and hidden away from the School's main activities. The new digs are tastefully decorated with teal-and-gray carpeted hallways, and sconces that welcome the patient into one of 27 examining and procedure rooms. The practice also hosts two large operating rooms, as well as the latest in diagnostic radiology facilities.

"This facility sits in the middle of the School of Dental Medicine because it is an integral part of the School's problem-based curriculum. It's also central to the concept that dentistry is part of medicine," says R. Bruce Donoff, Dean of the School. "Our practices allow pre- and postdoctoral students to work next to faculty. Faculty also mentor students in treatment teams.

"This is the only school in the University that owns and runs a clinical facility," adds Donoff, who, garbed in a green gown, speaks briefly with a visitor between his morning's surgical procedures. "And it's one of the only dental schools with a financially successful faculty group practice."

"Prior to these changes, the faculty practice was like a typical dentist office with no more than two or three doctors practicing, and even they for very limited amounts of time," says John Da Silva, director of postdoctoral education at the Dental School. "The patient population was also very small then."

But now, in the bustling Harvard Dental Center, two busy practices are carried out. While downstairs, the faculty and postdoctoral students work side by side on cases, predoctoral students deliver care upstairs, in teams and under the supervision of faculty and senior tutors. In all, 32 doctors, 12 dental assistants, and 6 dental hygienists see 2,000 patients every month in the faculty practice.

Class Act

The Dental Center benefits from having world-class clinicians on-site six days a week. Faculty member Joseph Fiorellini, for example, who directs the Postdoctoral Periodontology Program, regularly travels to Germany, Italy, and Japan to present his latest research and to demonstrate up-to-the-minute surgical procedures live for colleagues on closed-circuit television.

Students in the teaching practice rely on the back-and-forth aspect of the School's teamwork, which forms the backbone of the practice-and-problem-based curriculum.

"Working alongside doctors is the only way to learn dentistry," comments Jennifer Epstein, a third-year student. "You need to dive in, to learn by doing."

Epstein finds it rewarding to practice with the active guidance of her professors. "Each doctor does things differently, and this translates into a lot of helpful feedback," Epstein says. "For instance, I may hear 'Well, here's a faster or more effective way to do that procedure.'"

Da Silva explains another benefit of the School's hands-on approach. "One thing students can't learn by simply studying cases is the skill of presenting information to a patient. This can only be learned through observation and practice. You have to impart the sense that you know what you're doing, and to communicate why it's important to look at what's involved in the total care plan."

Faculty members' confidence in their students' skill arises through this close, ongoing participation in the students' education. Small class size also plays an important role in the clinically strong curriculum.

"We all know the students very well -- what they're capable of, what their strengths are," says Da Silva. "We know what's appropriate for each student in terms of patient care, because our student body is small, with a very large faculty working with them."

"B.U. and Tufts graduate more than 100 dental students each year," notes John Brouder, assistant dean for clinical affairs. "Our graduating classes have 30 students. So it's a very different, very intimate atmosphere."

"We're small so we can be different," agrees Donoff. "Our students enter a wide funnel of opportunity when they come to the School of Dental Medicine, and, unlike other schools, they leave through an equally wide funnel."