Wednesday, March 11, 2015 12:00 AM

Creating brighter smiles, making dental care more accessible

More than 14% of Valley children younger than age 11 have never been treated by a dentist, despite the fact that tooth decay is the single most common childhood health problem – five times more frequent than asthma. Untreated childhood dental problems can lead to difficulty chewing, swallowing and speaking, needless pain and lost school days.

Surabian Dental Care Center patient Mariah Chan, 4, tries out her new toothbrush on her mother Sokunthea Mok after a checkup.

The Surabian Dental Care Center on Community Regional Medical Center’s campus provides low-cost care for patients from infancy throughout adulthood, treats patients under general anesthesia in the hospital, and provides on-call emergency care in the Emergency Department. Limited orthodontic care is also available one day a month. The center – which treats an average of 25 patients a day, nearly 40% of them children – also trains 11 dental residents annually in a region that has a shortage of dentists. Fresno County has one dentist for every 2,000 people compared the statewide average of a dentist for every 1,400 Californians.
 

“Having dental residency graduates practice here raises the level of care available in Fresno County,” said Stanley Surabian, DDS, Chief of Dental Services and residency program director. Dr. Surabian helped create the Fresno General Practice dental Residency Program (GPR) in Dentistry in 1975 and is an associate clinical professor of the University of Pacific's Arthur A. Dugoni School of Dentistry, San Francisco. Nearly a third of the 274 dentists who trained in Community’s residency program have established dental practices in the Valley.

Rosaura Pacheco, DDS, FACD, a faculty member of the dental residency program, supervises dental resident Dr. Paul Hsiao as he performs a root canal on a 10-year-old girl.

 

 


 

“I’m one of those who stayed,” said Rosaura Pacheco, DDS, who is board certified in pediatric dentistry and leaves her private practice one day a week to help train dental residents in pediatric dentistry at the Surabian center. She also wants to give back to the community where she grew up: “Few of the pediatric dentists locally take Denti-Cal or Healthy Families government reimbursement. This is why I’m here for these patients. Many of them also have special needs.”

As she talked, Dr. Pacheco encouraged dental resident Paul Hsiao, DDS, on difficult case. Dr. Hsiao was doing a root canal on a 10-year-old girl who had been to see six other Fresno area dentists who declined to take her as a patient because her case was too complicated.
 

“Many times we get the ‘un-wanted’ patients referred from other hospitals, and dental offices,” said Stacy Avila, RDA, supervisor of Surabian Dental Care Center. “This includes many pediatric patients under 3 years old, uncooperative children who need general anesthesia, physically and mentally disabled adults, skilled nursing patients, cancer patients, and the homeless. We do not turn anyone way.”
 

Avila said, Community Regional is the main location in Fresno County treating dental patients, including pediatric patients, under general anesthesia in the hospital operating room. “Many people travel from Bakersfield here for that because no one else will see them.”
 

Four-year-old Mariah Chan had her first dental experience under general anesthesia, said her mother Sokunthea Mok, because Mariah was so upset and frightened about getting her broken tooth fixed. “Now she comes to her cleaning and she just smiles and says ‘Ahhh’ right away,” said Mok. “I really like the clinic because it’s right next to the hospital and it gives me a lot of trust how much time the dentists spend with us. The people are so nice.”
 

Those broken front teeth on children get special treatment, said Dr. Pacheco, not the typical silver crowns used in some low-cost clinics. Avila chimed in, “We do tooth colored crowns so these children can smile with pride.”
 

Erin Kennedy reported this story. Reach her at MedWatchToday@communitymedical.org.

Long history of training Valley dentists

 A dental residency program was the first “accredited” medical training program in Fresno County, established in 1947 at the former Valley Medical Center campus – 28 years before the UCSF Fresno program began training physicians here.  In 1975, Stanley Surabian, DDS, Chief of Dental Services, and Ray Doumanian, DDS, Assistant Chief of Dentistry, started the General Practice Residency with two post-doctoral residents and the program has grown to 11 residents a year. 
 

Residents rotate between Community Regional’s Surabian Dental Care Center and the Fresno Veterans Administration Hospital. “We’re affiliated with the University of the Pacific, Arthur A. Dugoni School of Dentistry in San Francisco and frequently have senior dental students externs rotate to the program from dental schools nationwide,” said Dr. Surabian. “While dentists can become licensed out of dental school and go into practice, many graduates prefer to obtain additional training in a Commission on Dental Accreditation approved, hospital-based program, the General Practice Residency in Dentistry, like ours, based in a Joint Commission accredited hospital. We have the ability to see a variety of complex patients.”
 

The Fresno dental residency program has been continuously accredited since 1976. And 31% of the 274 dental residents who have gone through the program have established their practices in the Valley after training. Find out more.