Bulletin of Dental Education

A.T. Still University-Missouri and Affinia Healthcare Partnership Focuses on Comprehensive Special Care Dentistry

 Permanent link   All Posts

Providing dental care for patients with severe disabilities and special needs is a priority at the St. Louis Dental Center. Located in the city of St. Louis, MO, the center is operated by A.T. Still University Missouri School of Dentistry & Oral Health (ATSU-MOSDOH) in partnership with Affinia Healthcare. As a federally qualified health center, its mission is to provide a full range of oral health care services to underserved populations while providing innovative, hands-on clinical education experiences for ATSU-MOSDOH third- and fourth-year dental students, as well as international dentists seeking a D.M.D. or D.D.S. degree in the United States. Students work under the supervision of ATSU-MOSDOH faculty and are supported by Affinia Healthcare staff.

The St. Louis Dental Center offers comprehensive special care dentistry for patients with intellectual, physical and emotional disabilities and other unique health care needs, including immunocompromised patients. Services in special care suites include exams, cleanings, fluoride, sealants, fillings, crowns, root canals, implants, bridges, periodontal therapy, oral surgery, complete dentures, removable partial dentures and digital radiographs. Medicaid and most dental insurance plans are accepted. A compassionate, caring staff works with uninsured patients to determine a care plan.

Leading the effort to ensure people with disabilities and special needs receive needed dental care is Paul Bigg, D.M.D., ATSU-MOSDOH Assistant Professor and Director of Special Care Unit and Special Needs Dentistry. It can be a significant challenge to help patients with disabilities and special needs, especially those with severe disabilities who may refuse to open their mouths for any length of time or at all. Dr. Bigg sensitively treats patients with disabilities in the outpatient clinical setting at the St. Louis Dental Center.

For many years prior to the discontinuation of Jewish Hospital in St. Louis, special needs dental cases were handled in the operating room. “In 1978-79 as a dental resident, I was doing cases in the OR, and then teaching residents as a dental staff member well into the 1990s,” said Karl Shanker, D.D.S., St. Louis Dental Center, who specializes in caring for special needs patients.

When general anesthesia is needed, Dr. Bigg now continues with his patients in the hospital, thanks to a more recent collaboration—piloted in 2021 and launched in 2022 —between major health institutions in St. Louis: ATSU-MOSDOH, Affinia Healthcare, Barnes Jewish Hospital and Washington University School of Medicine.

“All parties worked diligently to achieve this pioneering agreement, making it possible to provide a higher level of dental care for patients with special needs,” said Dwight McLeod, D.D.S., M.S., ATSU-MOSDOH Dean. “We are the only such public-private partnership in eastern Missouri dedicated to special needs dental care for underserved populations. Our experienced team of highly skilled providers delivers compassionate dental care, at an affordable cost, close to home. This is the kind of access to dental care that families, loved ones and advocates for people with severe mental and developmental disabilities have wanted and have been asking to receive for many years.”

Dr. Bigg has also developed a comprehensive oral health curriculum to teach the next generation of dentists to care for patients with special needs. As these graduates disburse, they will now have the needed skills wherever they practice in the United States. Hopefully, they will also follow Dr. Bigg’s lead by making time to volunteer for the Special Smiles Special Olympics, where he serves as clinical director, to provide dental screenings for athletes with special needs. 

According to the World Health Organization (WHO), an estimated 1.3 billion people in the world with disabilities have twice the risk of developing conditions such as depression, asthma, diabetes, stroke, obesity or poor oral health. On, May 26, 2024, the Global Strategy and Action Plan on Oral Health 2023–2030 was released to define WHO’s global oral health agenda towards 2030.

“WHO supports member states in the implementation of these policies, within their own national context. Together, we can reverse the pattern of neglect in oral health, improve coverage and access around the world and make sure that everybody gets the care they need for preventable and treatable oral diseases. There is no health without oral health,” said Tedros Adhanom Ghebreyesu, Ph.D., M.Sc., WHO Director General.

For further information:

Curiosus Magazine, published by Barnes-Jewish Hospital and Washington University Physicians, features this story: https://www.youtube.com/watch?v=qgdckB4WeMg


A.T. Still University Missouri School of Dentistry & Oral Health

Established in 2013, ATSU-MOSDOH offers an innovative curriculum with an emphasis on public health, leadership and practice. ATSU-MOSDOH addresses the oral health care disparities in Missouri and across the nation. In addition to the issues of oral health and skills of dentistry, students learn from and are encouraged to become caring, community-minded health care providers.


Affinia Healthcare

Established in 1906, Affinia Healthcare is a dynamic and transformative health system, providing affordable primary and preventive healthcare, including medical, dental and behavioral health services across 12 locations in St. Louis, MO. Affinia Healthcare is a community health center, a 501 (c) (3) nonprofit organization and is accredited through the Joint Commission and National Committee for Quality Assurance organizations.


St. Louis Dental Center

Located at 1500 Park Ave. in the Lafayette Square neighborhood, the St. Louis Dental Center is a state-of-the-art 79,000-square-foot clinical education facility with 93 dental chairs. Dental care is provided by A.T. Still University Missouri School of Dentistry & Oral Health faculty and dental students and by Affinia Healthcare dentists and staff. To learn more about St. Louis Dental Center, visit stldentalcenter.org or Facebook.com/stldental.center.


About the Partnership

In 2015, ATSU-MOSDOH and Affinia Healthcare established a unique partnership to address the critical shortage of dentists and paucity of oral health services for underserved, vulnerable populations in St. Louis, who lack access to high quality oral health care. Through this innovative partnership, ATSU-MOSDOH’s third- and fourth-year dental students complete their hands-on clinical education curriculum at the St. Louis Dental Center in a community health center learning environment, providing dental care to Affinia Healthcare’s patients. 

Affinia Healthcare’s experienced clinical operations and skilled oral health care teams are essential to the partnership because of its comprehensive primary medical, dental and behavioral health services provided to over 43,000 patients per year, of which 90% have incomes under 100% of the federal poverty line. Collaboratively, ATSU-MOSDOH and Affinia Healthcare help dental students develop a comprehensive understanding of the negative determinants of dental and overall health for patients at the St. Louis Dental Center, while improving access to dental care for otherwise underserved individuals in our community. 

About Washington University School of Medicine

WashU Medicine is a global leader in academic medicine, providing  biomedical research, patient care and educational programs with 2,700 faculty. Its National Institutes of Health research funding portfolio is the fourth largest among U.S. medical schools, has grown 54% in the last five years, and, together with institutional investment,  commits well over $1 billion annually to basic and clinical research innovation and training. Its faculty practice is consistently ranked among the top five in the country, with more than 1,790 faculty physicians practicing at over 60 locations and who are also the medical staffs of Barnes-Jewish and St. Louis Children’s hospitals of BJC HealthCare. WashU Medicine has a storied history in M.D./Ph.D. training, recently dedicated $100 million to scholarships and curriculum renewal for its medical students and is home to top-notch training programs in every medical subspecialty as well as physical therapy, occupational therapy and audiology and communications sciences.

About BJC HealthCare

BJC HealthCare is one of the largest nonprofit health care organizations in the United States, delivering services to residents primarily in the greater St. Louis, southern Illinois and southeast Missouri regions. Serving the health care needs of urban, suburban and rural communities, BJC includes 14 hospitals and multiple health service organizations. Services provided by BJC include inpatient and outpatient care, primary care, community health and wellness, workplace health, home health, community mental health, rehabilitation, long-term care and hospice. BJC’s nationally recognized academic hospitals, Barnes-Jewish and St. Louis Children’s hospitals, are affiliated with Washington University School of Medicine.

Courtesy of A.T. Still University Missouri School of Dentistry & Oral Health

Published on September 11, 2024

Duggan ad 2013