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Inside the NYU Dentistry/Nursing Collaboration: DDS Students Learn to Medically Assess Their Patients

From left: Patient Benjamin Jones, Ms. Lloyd, Dr. Schenkel, and Mr. Sarembock, '09
“We tell our DDS students that they are primary healthcare providers, but that doesn’t mean very much unless we equip them with the knowledge, skills, and experience to act competently and confidently in that capacity,” says Dr. Andrew B. Schenkel, Clinical Assistant Professor of Cariology & Comprehensive Care at the NYU College of Dentistry. “Now, with the introduction of a formal, collaborative teaching program uniting dentistry and nursing, we are on our way to closing that gap.”

Dr. Schenkel is referring to a new initiative that he is overseeing in collaboration with Madeleine Lloyd, Practice Director of the NYU College of Nursing Nurse Practitioner (NP) Faculty Practice that opened last year at the NYU College of Dentistry. Every Wednesday morning Ms. Lloyd is on the clinic floor, where she helps students become more focused on the oral-systemic link as a two-way street; on how systemic issues can affect the timely delivery of dental care; and on the opportunity and the obligation they have to intervene in their patient’s medical care to ensure that problems are addressed before they worsen.

With help from Ms. Lloyd, students become adept at identifying issues such as high blood pressure, diabetes, irregular heartbeat, atrial fibrillation, potential prescription medication interactions, and other conditions that require medical clearance before dental treatment can proceed.

When such issues arise, rather than having to find oral medicine faculty to refer the patient outside of NYUCD to get medical clearance, as they would have done in the past, students can now consult immediately with Ms. Lloyd, who can do an instant, chairside consult, to help clarify specific medical concerns and questions. For example, with innovations like instant read technology, Ms. Lloyd can determine on the spot if someone has a high risk of bleeding, and can select from a range of therapies so that the patient can quickly be cleared for treatment, thus eliminating a waiting period.

In other cases, when a patient has serious medical needs like untreated diabetes or high blood pressure that must be addressed prior to treatment, especially periodontal treatment, the patient is referred to the NYU College of Dentistry’s onsite NP Faculty Practice, where they can get the treatment they need. Emphasis is always placed on disease prevention and health promotion and students are taught to assess their patients’ primary and secondary preventive needs. This is a holistic approach to care that is earning rave reviews from both patients and students.

Benjamin Jones, 67 years old, hadn’t seen a physician for 20 years, because, as he explained, he was “afraid of doctors.” “I’ve never been more grateful to have a sore tooth, because it sent me to the NYU Dental Clinic, where I found out what I need medically, and the Nurse Practitioners are making it easy for me to get the care I need, so I’m not afraid anymore.”

Students are equally delighted. “I’m excited to be in a position to bring general healthcare to an untapped population -- those with dental disease,” says Mitch Sarembock, Class of 2009.

Indeed, a recent survey found that 15 percent of NYUCD patients had medical problems that were not being adequately addressed because they did not have a primary care provider. As a result, it’s common for these patients to present for dental care with a litany of serious, undiagnosed medical issues. Now, because dental students are working with NPs both to identify those who should be referred for medical care and to provide more timely dental care, they are learning that as healthcare providers, dentists share the responsibility for their patients’ overall health.

For patients, it’s one-stop shopping at its best. Indeed, the attention that NPs pay to lifestyle issues such as smoking and nutrition is value added to the healthcare services they provide. And for dental and nursing students, it’s the gratification of moving in new, interdisciplinary directions to provide greater access to better care for more people.

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