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Homeless Veterans Flashing Big Smiles These Days

Although Leon Bright, now 61, had seen some very hard times and was homeless, he still expected to see his daughter get married last June. What the former Marine didn't expect was to be smiling at the wedding. His ill health had robbed him of some of his teeth.

But Bright did smile at his daughter's wedding, flashing a full set of bright, pearly whites. "My mouth needed a lot of work, and I'd been going to the dentist for about a year," he explained.

Call it kismet, call it karma, call it coincidence, or the finger of the "bright" god, but Bright got new teeth just in the nick of time. His newly minted dentures arrived at the Perry Point Veterans Affairs (VA) Medical Center Dental Clinic the day before the wedding.

A University of Maryland Dental School postgraduate student who knew about the wedding made sure to fit Bright's dentures the day they arrived and so the Brights--father and daughter--both beamed brilliant smiles as they celebrated the big day and posed for pictures.

Bright is among more than 2,500 homeless veterans who are now flashing big smiles these days, thanks to a continuing partnership between the VA Maryland Health Care System and the Dental School.

"We fix up their smiles so they can interview for jobs and continue their lives. Smiling is a very important part of meeting people and socializing," said Douglas Barnes, DDS, MS, director of advanced education in general dentistry at the School, which is across the street from the VA hospital in Baltimore.

Although Bright himself received his dental care at the VA Perry Point Medical Center, veterans who live downtown are divided between the dental clinic at the Baltimore VA Medical Center and the dental clinic at the Dental School. The partnership, which began in February 2007 as part of a program called the Homeless Veterans Dental Initiative, came about when the number of homeless veterans eligible for the Initiative's dental care proved overwhelming for the dental clinics' small staff.

The veteran population eligible for the program is treated at the Dental School by the 25 dentists enrolled in the School's Advanced Education in General Dentistry (AEGD) program under the supervision of experienced attending dentists.

"When the program opened up, we had a lot of patients we could not serve," said Julie Bitzel, the dental care manager at the VA Maryland Health Care System. Bitzel and her counterparts at the Dental School have developed a close working relationship, streamlining the approval process to assure that the proper scope of care is provided to veteran patients.

"The patients can receive fillings or partial dentures, but the treatment first concentrates on preventing infections," says Barnes. He added that the Dental School is pleased to be able to treat this underserved population, which is also part of the mission of the dental program.

Also, dental students are required to provide treatments based on patient needs and affordability. Between April 2003 when the program started and February 2011, more than 2,715 veteran patients have benefited from the collaboration between the School and the health care system. The School submits monthly billing statements for each veteran patient, and the School's dental students also can rotate into the Dental School clinic at Perryville in Cecil County, Md.

"Patients are being seen at the Baltimore VA Medical Center, at the Dental School, and at the VA Perry Point dental clinic," Bitzel said. "The first referrals to the Homeless Veterans Dental Initiative were made in April 2003. From that date through January 2007, veterans were treated at the Baltimore and Perry Point medical centers and then in February 2007, we began referring eligible veterans to the Dental School due to the volume of those requesting care."

The collaboration is a win-win. Former U.S. Marine and Maryland National Guard veteran Clarence Wallace of Salisbury, Md., experienced some softening of the bone structure in his mouth. He'd lost two teeth while a third tooth broke. Without his front teeth, Wallace used to cover his mouth when smiling and laughing.

Seeking help through the VA Maryland Health Care System, he underwent 11 extractions and needed dentures. Wallace said it was not as painful as he had expected, and dentists at the School fitted him with dentures. "I'm a person who likes to smile. It saved my life and I would recommend the program to anyone. To be able to smile again is awesome," said Wallace [pictured above with Oluwayemisi Akinrefon, DDS, resident, University of Maryland Dental School].

The collaboration has been a boon for formerly homeless veteran dental patients but also for Dental School students. As part of their requirements at the Dental School, students must learn to act as a primary care provider, including providing emergency and multidiscipline oral health care, health promotion and disease prevention, and using advance dental treatment methods and technologies on patients.

Air Force Veteran Ralph Vanderhall, originally from Dillon, S.C., is "overjoyed," he said to receive a partial denture and cavity fillings. For the former Air Force cryogenics laboratory technician, preserving his teeth was a secondary concern when he walked into the VA hospital for other health diagnoses and treatments. "It is an excellent program," Vanderhall said, "With the advances in the equipment I guess there is very little pain.Thanks to the program, I have my self-esteem back."

Although participating patients are technically homeless, they must be living in a VA-sponsored or VA- supported homeless services program before they can qualify for the dental initiative, according to Patricia Lane, MSW, Homeless Services clinical manager. Lane oversees the homeless domiciliary program, currently housed at Perry Point. In short, there is a 60-day rule. They have to be in a services program bed for 60 days before they can qualify. This is to ensure the continuity of care.

"The dental program closes the circle of the continuum of care," said Lane, "and it's one of the essential elements in that circle for medical/health reasons and for psycho-social reasons."

Posting Date: 05/10/2011
Contact Name: Steve Berberich
Contact Phone: 410-706-0023
Contact Email: sberb001@umaryland.edu