Jennifer Holtzman

First-year dental students are eager to care for the underserved, a new survey shows.  But as the freshman students progress in their studies, their feelings become mixed on a host of issues surrounding the obligation to close the healthcare access gap.

Researchers Jennifer Holtzman and Hazem Seirawan at the USC School of Dentistry nonetheless have identified a strong positive attitude among students serving community needs through the School’s Doctors Out to Care program and the Neighborhood Mobile Clinic.  The results of the study appear in the March 2009 issue of the Journal of Dental Education.

In the article, “Impact of Community-Based Oral Health Experiences on Dental Students’ Attitudes Towards Caring for the Underserved,” Holtzman and Seirawan write that Dental School freshmen reported positive attitudes about caring for underserved patients.  However, the study shows that over time, those students became less certain of what facet of society should be most responsible for fulfilling such obligations: church, government, or health professionals themselves.

Holtzman, the study’s principal investigator and a driving force behind the School’s community outreach education, does not see the survey results as a sign that students will forego altruism in their professional careers.

“You just can’t go out and provide free dental care and solve the problem,” said Holtzman, clinical assistant professor in clinical dentistry Health Promotion, Disease Prevention and Epidemiology. “So many things are involved and that’s what my students understand now.”

Indeed, she said, as dental students are exposed to community service, they gain a greater awareness of the array issues surrounding such care.  Probing questions for the budding health professionals to ponder include who pays for the care, who should have access, and whether dentists themselves or the community at large have an obligation to provide free or affordable care to the underserved.

“You have good, idealistic students who are now more realistic,” she said. “They now recognize the breadth and depth of the situation.”

Holtzman helped create the Neighborhood Mobile Dental Van Prevention Program, known to the School of Dentistry community as the “Sealant Van” and runs the DOC program, which places freshmen DDS students in neighborhood classrooms to teach schoolchildren about oral hygiene.  The mobile clinic and DOC are the sole pair of outreach programs specifically designed for freshman students.  The School of Dentistry has a long tradition of older students and faculty providing comprehensive dental care to underserved children, as well as homeless, elderly, and special-needs populations in the community surrounding the School’s central Los Angeles locale.

Freshman DDS students were surveyed before, during and after completing their introductions to community health care service.  Holtzman and Seirawan asked the students to respond to such statements as: “Dental care should be provided without charge for those who cannot pay,” and “All dental students should become involved in community health efforts.”

Students were asked whether churches, state government, and health professionals should provide money, access, or facilities.  The study also looked at the dental students’ backgrounds, showing that students with previous experience in volunteer work reflected a greater willingness and confidence in the ability to be “an agent of change” on the issue of healthcare access.