My theme this month is "advocacy." Each of us are advocates  for comprehensive health care, including mental, vision and oral health care for underserved populations.  More than 20 percent of California's young children do not have access to oral health care.  More than 20 percent of California's elderly population do not have access to oral health care. These are the most vulnerable populations. They benefit most from our collective advocacy.  Get involved.   Take time to influence our city, county and state as well as our federal government to provide comprehensive health care that includes mental, vision and oral health care for all people! Write to your legislators. Volunteer your talents. Now is the time to make a difference.

This month is "back-to-school" for just under a million children in Los Angeles.  These children need nurturing, mentoring, motivation and all the other values of education.  They also need to come to school healthy and to enter safe and supportive environs.  In the early 1990s, USC President Steve Sample took the position that our University will sustain our contributions to the quality of life within the Southern California region and the City of Los Angeles. In other words, we would be part of the solution to the complex and often seemingly intractable problems of urban Los Angeles.

What are we doing for advocacy? Since we were founded in 1897, the School of Dentistry (USCSD) continues to shape what is thought, what is taught and what is practiced in the oral health professions. For 110 years, our USCSD (faculty, staff, students and alumni) have engaged in bold innovations in education and learning, research of significance to the larger society, patient and community health programs, and leadership within the professions, university and beyond.

Professional health education is shaped by content (curriculum), learning approaches (pedagogy), sequence of learning, and venues for learning.  These elements are significant.  At USCSD the curriculum embraces and extends from prenatal care through hospice care—the entire human lifespan.  Our focus is learner-centered education and this commitment is shared throughout our University.  At USCSD, this means problem-based and case-based learning coupled with service learning models.  Service learning describes student and resident rotations through Southern California hospitals—including USC-LA County Medical Center, Childrens Hospital-Los Angeles, Childrens Hospital-Orange County, Miller Memorial Hospital—community-based clinics, school-sites, and mobile clinics that traverse the region from Bakersfield to the Mexican Border. Our learning, research, and patient and community health programs extend from conception through senescence.

Today, the School of Dentistry includes seven divisions and these are: Health Promotion, Disease Prevention & Epidemiology; Diagnostic Sciences; Surgical, Therapeutic & Bioengineering Sciences; Primary Oral Health Care; Craniofacial Sciences and Therapeutics; Biokinesiology & Physical Therapy; and Occupational Science & Occupational Therapy.  Our human resources include 200 full-time faculty, 50 half-time faculty, 600 part-time faculty, 320 full-time staff, an undergraduate and graduate school student body of over 1,000 learners, and 3,000-4,000 continuing education participants each year.  We screen and/or provide car for almost 75,000 people per year.  Our populations treated include the homeless, the underserved, the working poor with an emphasis upon the most vulnerable populations (infants, children as well as poor elderly).

What follows is a brief description of a few of our USCSD programs that are making a difference for access to care, quality of care as well as health literacy and health promotion advocacy and disease prevention:

USC and First Five Oral Health

USCSD's Offices of Community Health Programs and Continuing Education have partnered with the California Dental Association Foundation in a statewide project to implement one of the largest education and training programs in California. In January of 2004, The California Children and Families Commission awarded a $7 million grant to the California Dental Association Foundation (CDAF) and the Dental Health Foundation to support a new statewide education and training program titled "The First Five Oral Health Education Initiative."  The purpose of this initiative is to significantly reduce the incidence of dental decay in young children through age 5, including children with disabilities and other special needs.  This program focuses on reaching general dentists, dental office auxiliaries and staff, physicians, nurses and the consumer. 

In addition, Children's Hospital Los Angeles has partnered with Child Health Works and the USCSD Office of Community Health Programs to provide similar CE courses to Los Angeles Unified School District Early Education Center school nurses.  The Office of Community Health Programs is privileged to be a central element of this revolutionary oral disease prevention strategy. 

USCSD Mobile Dental Clinic

Thirty-nine years ago when the Mobile Dental Clinic began it was no more than a few portable chairs, a van, one USCSD faculty member and a handful of students.  Today, the USCSD Mobile Dental Clinic travels throughout the Southern California terrain and consists of a fleet of state of the art vans and trailers outfitted as dental operatories, staffed by dedicated faculty and dental students and residents.  The Mobile Clinic provides more than one million dollars worth of comprehensive care to over 1200 underserved children annually, most of whom have never seen a dentist previously. 

While mostly traveling to remote, rural sites, the Mobile Clinic has struggled to find the resources and the time to provide dental care to South Central and East Los Angeles communities desperately in need of dental care.  This year, with the generous support of the California Community Foundation, the Patterson Foundation and the Los Angeles Unified School District, the clinic has been able to increase operational days by 17 percent and provide dental care to some of the poorest communities in Southern California by adding additional week-long clinics at West Vernon and Rowan Avenue elementary schools in Los Angeles.     

Caries Prevention and School-Based Programs

Oral bacterial infections are the number one chronic disease of children and the primary reason for absenteeism in school age children in Southern California as well as around the nation (see Surgeon General’s Report “Oral Health in America” 2000). USCSD's Neighborhood Mobile Dental Van is dedicated to improving the oral health of inner-city school children in Los Angeles (city and county). Today, almost 900,000 people in Los Angeles County are completely vulnerable to the insults of disease and are without any financial resources or insurance. Focusing on preventive oral health care delivery for second and third graders—an age when, due to the stage of tooth development, prevention is likely to have the greatest positive effect—oral health screening exams, education, fluoride treatments dental sealants and referrals for comprehensive care are provided. Dental students participating in this experiential training program deliver these preventive methods and are introduced into a new role where they become health educators. This program has already made a huge impact on the USC partner schools by serving more than 3,000 children since its inception in 2001.

The USCSD-Union Rescue Mission (URM)

The USCSD/Union Rescue Mission Dental Clinic is a partnership between the University of Southern California School Of Dentistry and the Union Rescue Mission, a non-profit organization serving the poor and homeless residents of inner-city Los Angeles located at 5th and San Pedro within so-called “skid row.”  The clinic, which opened in May 2000, is the first comprehensive care dental clinic on Skid Row and the first clinic to care for the oral health needs of homeless children in the area.  Great strides have been made in health care for the homeless, yet the homeless population is growing at an alarming rate and the demand for oral health services continues to multiply. This last year alone, the USCSD/URM Dental Clinic was able to increase the number of homeless seen in the clinic by 24 percent. In an effort to further increase its capacity, a 30 percent expansion to the clinic has just been completed (two additional operatories). The goal of this expansion is to better accommodate the often overlooked and growing population of homeless, including women and children, by providing greater access to oral health care in a more efficient and effective manner.

USC School of Dentistry – Sharing Smiles with Multi-Cultural Southern California

USCSD students, faculty and staff participated in more than 30 health fairs in and around Los Angeles County last year and increased by 63 percent the number of attendees who received important messages regarding the link of oral health to overall systemic health. In the past three years more than 6,000 individuals have been counseled in one-on-one sessions at these community events.  Typically these health fairs staged in underserved communities where the oral health information is not often available.  Participating in health fairs has given culturally diverse populations an opportunity to ask questions, seek assistance and gain oral health knowledge in a fun, safe and non-threatening environment, while getting to know our faculty and students.  In turn our USCSD students, residents and faculty become appreciative of the cultural diversity and richness of our city's populace through their exposure to native song, dance and ethnic cultural health beliefs that are on display at various health fairs.

USCSD at Childrens Dental Clinic in Inglewood

USCSD students have defined rotations in the Childrens’ Dental Center located in Inglewood and provide oral health care to underserved children.

USCSD in East Los Angeles for the Elderly (Hollenbeck House)

USCSD students have defined rotations in the Hollenbeck House to provide comprehensive oral health care to the elderly.

USCSD is unconditionally dedicated to be “part of the solution” for access to quality comprehensive oral health care for all people.  Ryan White federal grants help us support special needs patients, especially people afflicted with HIV.  Donations from alumni, friends and industry enable USCSD to address many issues of inequity especially people living in poverty with special attention paid to children and the elderly.  Finally, USCSD is proud to be located in Los Angeles, be part of the Los Angeles health community, and to also be a resource on national and global scales.

Join me with pride in acknowledging what and how our Trojan Dental Community is working to enhance the human condition for underserved populations in Southern California. Fight On!

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