Bulletin of Dental Education

UNMC Clinic Shares Compassion, Treatment with Community

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Mr. Daniel Kreis awaits his turn for treatment; photo courtesy University of Nebraska Medical CenterOn a cold November evening, Mr. Daniel Kreis rode his beat-up mountain bike five miles to the University of Nebraska Medical Center College of Dentistry, seeking relief from the pain of two cracked molars. He got that and much more.

Employees at Clinic with a Heart, a local relief agency in Lincoln, Nebraska, that serves the underinsured, uninsured, and homeless, referred Kreis to the dental clinic known as SHARING. He is one of 64 men, women, and children who, without the student-run clinic, would have no access to dental care.

"Tonight we are Daniel's dental office," said Dr. Michael B. Houk, a practicing dentist from Sioux Falls, South Dakota, who teaches part-time at the dental school and helps facilitate the clinic.

"We can't train students to be dentists using just manikins, so he provides just as much of a service to us as we do him," Dr. Houk said. "And what better way to teach these students the value of giving back than through this type of clinic."

Mr. Kreis had been to the dental school before, when he had insurance from one of his numerous welding jobs. This is the second time he's come to the SHARING clinic.

At 52, Mr. Kreis struggles to find work in his trade. He admits he's made some mistakes, but he's grateful that there's "somewhere, anywhere" he can go for help. "The students really work hard to take care of you," he said.

In his desire to get help, he accidentally mistook the start time of the quarterly clinic for 5:00 a.m. only to find out he would have to come back. Driven by the dull ache in his mouth, Mr. Kreis returned that evening.

At the clinic, his mouth reveals a mess of plaque, cavities, and nearly abscessed teeth. Unfortunately, two cracked molars must be pulled, which leave two gaping holes in the back of his mouth. Third-year dental student Ms. Natalie Fendrick would later fill them with gauze. Making rounds to check on the students' work, Dean John W. Reinhardt stops by to observe. There are three cavities left to fill.

The overall condition of Mr. Kreis' teeth concerns the dean, and he asks about the patient's diet. "I eat whatever I can get," is the reply.

"How often do you get to brush?" the dean inquires.

"Whenever I can, I've made a toothbrush out of a stick before," Mr. Kreis explains. "I took my knife and whittled it down to make bristles. I've used string or paper to floss with. You use whatever you can get your hands on."

"It doesn't get any worse than that," Dr. Reinhardt replies. He quickly retrieves a toothbrush and several tubes of toothpaste.

Smoking, the inability to pay for routine dental care, and poor nutrition are all common threads in the cases the students and dental faculty see at the clinic. Since the dental college started its SHARING clinic in 2008, an estimated 650 patients have come through the doors and received $225,000 in care.

The severity of cases is an opportunity for the students to learn, said Dr. David G. Brown, Executive Associate Dean of Academic Affairs at UNMC College of Dentistry. "Treating patients like Mr. Kreis provides valuable experience for our students," he said. "There are many very low-income people here and elsewhere who have urgent dental needs, including painful and dangerous infections, but don't have the resources to find dental care. I am very proud of the commitment of students, faculty, staff, and community volunteers, typically more than 100 per session, who make this clinic successful."

The dean and a few other dentists chat at the front of the clinic. Someone mentions how a patient rode a bike to the college that morning. It was Mr. Kreis, another replies.

"Is that how he's getting home?" someone asks. Eyebrows raise in concern.

"Oh, no!" Dr. Reinhardt replies. "We can't let his heart rate get up, given those extractions."

Just after 9:00 p.m. a cold rain begins to fall. Dr. Reinhardt walks out the door with Mr. Kreis, who goes to the side of the dental school to retrieve his bike. Then the dean loads it into the back of his gray SUV. Mr. Kreis is getting a ride home.

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