ATSU dean focuses on access to dental care

Dec. 10--Dr. Dwight McLeod isn't the type to brag about professional accomplishments.

When Dr. McLeod was recently chosen as the Dentist of the Year by the Missouri Dental Association, his colleagues at A.T. Still University didn't hear about it from him.

"He never did mention it," said Kristen Blunk, who works closely with Dr. McLeod as the director of student success at ATSU's dental school. "He's very humble, one of the most humble people I've ever worked with."

Dr. McLeod is the dean of ATSU's Missouri School of Dentistry and Oral Health as well as a periodontist, a dentist who specializes in studying the supporting structures of teeth, who maintains a private practice in Hazelwood.

Dentist of the Year is not the only major professional award Dr. McLeod has received recently. Along with ATSU President Dr. Craig Phelps, Dr. McLeod was awarded the Samuel U. Rodgers Achievement Award from the Missouri Primary Care Association in November. The award recognizes excellence in both clinical practice and leadership.

Dr. McLeod joined the ATSU dental school in 2016, three years after the school was founded. He supervises day-to-day operations at the school in addition to recruiting both employees and students. Dr. McLeod said an important part of the school's mission is attracting students who will help improve access to dental care where it is needed most: in rural and urban communities where incomes are low and medical professionals are less available.

"I think that's very important in fulfilling our mission, being that ATSU is known for its community service and for its advocacy of underserved communities and access to care," Dr. McLeod said.

Dr. McLeod said ATSU-MOSDOH is working to attract "the next generation of dentists." The school is small; in the next academic year, it will have 61 students. Dr. McLeod said the school is also unique: it is the only dental school in the U.S. where pre-doctoral students are taught in a community health center.

During their first two years at ATSU-MOSDOH, students take classes at the Kirksville campus. During their third year, they complete a clinical education experience at the St. Louis Dental Career. In their fourth year, they divide their time between the St. Louis Dental Center and rotations at some of the over 30 community health centers affiliated with ATSU. These are called Integrated Community Service Partnerships and aim to give students a fuller picture of patients' health care needs.

Students begin performing some tasks in a clinical setting sooner than that. In their first two years, they can provide services like nutritional counseling and cancer screenings.

Dr. McLeod said another positive of this approach is that it allows students to interact with other medical professionals and learn about their jobs.

"What the studies have shown is that when we all know a little bit about what each person is doing, then guess who benefits? The patient," Dr. McLeod said.

After four years of school, students emerge with a certificate in public health in addition to their dental degree.

For patients in Missouri, access to a dentist can be out of reach both economically and geographically. According to the Centers for Disease Control, 61.3 percent of Missourians visited a dentist in 2016, but that percentage decreases the further you move down the economic scale. It's 76.1 percent for patients making $50,000 or more per year, but 42.2 percent for people making less than $25,000 per year. In the lowest income bracket, people making $15,000 per year or less, only 34 percent had seen a dentist.

In addition to the cost, rural patients may not have many dentists in their area -- or any at all. In Missouri overall, there are 1,810 people for every one dentist, according to the Robert Wood Johnson Foundation, a non-profit focused on improving health care access. But that's not the case everywhere in the state.

In Schuyler County, for example, there are 4,390 people for every one dentist. In Sullivan County, 6,260 people for every dentist. In some counties in the bootheel of the state, the ratio is as high as 17,000 to 1. At least one Missouri county, Mercer, has no dentists at all. On a national scale, according to the CDC, Missouri ranks 41st out of the 50 states for access to a dentist.

Dr. McLeod said that lack of access to a dentist can lead to a range of problems, including severe pain from untreated infections. However, he said, the issues affected low-income people's dental health are often even more basic than ability to access health care. He said low-income people in both rural and urban communities are more likely to smoke or eat a high-sugar diet and less likely to be aware of how it can impact their teeth.

He hopes ATSU can help fix some of those problems.

Part of that mission is getting students involved in community service projects, like the Missouri Mission of Mercy free dental clinic that treated approximately 2,000 patients in Kirksville this August. Dr. McLeod runs a similar mission to his native Jamaica every year.

It also involves sending students out into the communities -- schools, assisted living facilities, homeless shelters -- and educating them about dental health care.

"When they interact with us and when we inform them in a non-intimidating way, then the ones that are interested will make an appointment," Dr. McLeod said. "All these things are taught within the dental curriculum."

Dr. McLeod said focusing on a mission of social change is integrated into ATSU-MOSDOH's approach on every level.

"We look for a particular type of student," Dr. McLeod said. "We look for students who have a particular type of background, who may be the first person in their family to pursue a doctorate degree, who may have attended a disadvantaged high school, who are from rural underserved areas or urban underserved areas. The whole goal is that we hope that these individuals from disadvantaged areas of the state will obtain this coveted dental degree and go back to their communities and become leaders."

There's often little financial incentive to establish a dental practice in a rural area but, Dr. McLeod said, strong family ties and a desire to make a difference in one's own community can be more powerful motivators.

Dr. McLeod was one student who came from a community where dental care was not always accessible. He was born in Jamaica, where the ratio of patients to dentists is as high as 100,000 to 1 in some parts of the country and only about 6 percent of people have dental insurance, according to the country's Ministry of Health.

Dr. McLeod founded the Jamaica Dental Mission in 2000; it now operates three clinics and has served more than 16,000 patients. He worked as a professor for 21 years before joining ATSU-MOSDOH.

"What really attracted me here was the mission of the university and what it stands for, and the opportunity to be able to work with a new school and shape that new school into becoming a premier dental school not just in the local region here, but in the state and in the nation," Dr. McLeod said.

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