UW School of Dentistry’s money woes impact regional health

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Special to The Seattle Times

The University of Washington School of Dentistry, ranked No. 5 in the United States and No. 15 in the world, is facing significant challenges that may soon affect you.

You probably have a dentist you go to for routine evaluations, X-rays and cleanings, and maybe the occasional filling or crown. If you've had a biopsy or gum surgery, you've likely been referred to a specialist who's had an additional two to six years of training.

But what happens when you need a procedure even more complex that requires a team of advanced specialists, such as facial reconstructive surgery after an auto accident or rebuilding your jaw after cancer surgery?

Those cases are frequently referred to the UW School of Dentistry, which partners with Harborview Medical Center, UW Medical Center, Seattle Children's Hospital and the Veterans Affairs Hospital to provide advanced services by their faculty, residents and postgraduate trainees.

On Oct. 30, the UW announced it would suspend the recruitment of new student trainees into the school's residency and graduate programs for oral and maxillofacial surgery and pediatric dentistry. The university also announced it would end hospital-based general practice residency programs. These decisions came just days after the dean of the school, Joel Berg, announced his resignation amid a $36 million deficit.

As a graduate of the UW School of Dentistry, where I later taught as an affiliate professor, I am deeply troubled by these developments. Residency programs are vital because they provide additional training for dentists to become specialists, who not only handle complex cases but also recruit others into the field to ensure our state has a sustainable workforce of dental specialists.

During their residency programs, these dental specialists-in-training work in conjunction with faculty to provide care to some of the most vulnerable individuals in our state. They are often the only referral destination for certain procedures to be performed. Residents are the first responders for dental and facial emergencies, trauma and infections at all area hospitals.

If these departments close, we will not only lose the existing workforce of residents, but also a vital element of our region's health and welfare. If these programs are eliminated, what will happen if you need facial reconstructive surgery after an auto accident, if your medical condition interferes with your ability to seek dental treatment, or if your sick or special needs child requires dental care?

The answer is community dentists will experience an increased burden and backlog, and complex and emergency cases will likely get referred out of state. And patients who are disabled or on Medicaid (Apple Health) will be disproportionately affected and face greater wait times — that is if they are able to find a provider willing to treat them at all.

The School of Dentistry is under the gun to demonstrate to the UW Board of Regents that it has a plan to become financially sustainable. The provost of the university, who plans to retire next year, had said his plan was to narrow the scope of the school to focus only on pre-dental education (i.e., the training of “dentists”), while targeting specialty training programs for elimination. However, due to the intense backlash he received after this plan was unveiled, he's since announced he would be rescinding his decision to eliminate these programs.

While that is welcome news, it does not mean the school's residency and postgraduate programs are safe from future cuts. They could end up being cut months from now after further evaluation, which would be a shame because residents cost the school nothing. They are employees of the hospitals. If, after new leadership is installed at the school, it is determined that residency and advanced training programs fall outside the school's mission, then so be it. But given how critical these residents are to the health of so many individuals, I find it hard to believe that could be the case.

I strongly encourage the leadership of the university to permanently reverse the school's current course of action and save these vital programs.

Rep. Michelle Caldier, R-Port Orchard, is serving her second term in the state House of Representatives. She serves on the House Appropriations, Education and Health Care and Wellness committees.

State Representative Michelle Caldier, 26th Legislative District
122H Legislative Building | P.O. Box 40600 | Olympia, WA 98504-0600
(360) 956-7562 | Toll-free: (800) 562-6000