Building on a Legacy of Education
The 2007 death of 12-year-old Deamonte Driver from an untreated abscess sparked national attention and outrage.
It also prompted reflection and shame: How could a seemingly benign toothache kill a healthy young boy?
Unmet oral health needs are the major reason for primary school absences. Studies also show that dental problems are a common source of emergency room visits. A report issued in August 2013 found that hospitalizations and deaths resulting from untreated oral infections are on the rise.
“Untreated” is the crucial detail in Driver’s death. His family was poor and medically underserved. An $80 tooth extraction could have saved Driver. So could preventive dental care.
Of the three major spokes in the oral health care wheel—access, insurance, and prevention—it’s the last that draws the least notice. Yet Renee West, DDS, believes it’s the most essential.
West, 33, an alumnus of the Robert Wood Johnson Foundation-funded Summer Medical and Dental Education Program (SMDEP), is committed to educating her patients about early preventive care.
“I want to focus on dental education—educating the community about prevention,” she says. “It’s important to go into the schools and catch kids when they’re young so they can create those good, healthy habits early on.”
Education = Power
West, a Georgia native, sees education as the linchpin of good health. For her family, it has been both a guiding principle and a birthright.
“Seeing how knowledgeable my uncle was, and how that knowledge could remedy my pain, opened my eyes to the great things a health care provider could achieve.”
Her paternal grandmother Estella, known as Mama Stell, insisted that each of her seven children get a college education—a path not easily walked by low-income Black families in rural Georgia in the mid-20th century.
“Although she only had a sixth-grade education, Mama Stell understood the power of education and its ability to liberate one from poverty and oppression,” wrote West in her application to the American Associated Dental School Application Service (AADSAS). The money Mama Stell’s children earned picking cotton and working in a frozen-food plant funded their college tuition—and every one of her seven earned a degree.
As a graduate of Spelman College, America’s oldest historically Black college for women, West follows in the footsteps of her mother, also a Spelman alumna. “When I was growing up, my mother was active in the alumna association,” she explains. “During the college search, the students and faculty I met at Spelman were all very smart, goal-oriented, and service-oriented. That was a big draw for me.”
By the time she entered Spelman, West had set her sights on a medical career, thanks to her uncle. “I had a painful infection in my ankle when I was about 6 or 7,” she says. “We went to all the doctors in town, and nobody could give us a definitive diagnosis or treatment.” From a description given by her mother over the phone, West’s uncle, an orthopedic surgeon, identified the problem: septic arthritis. West had surgery the next day.
“Seeing how knowledgeable he was, and how that knowledge could remedy my pain, was powerful,” says West. “It opened my eyes to the great things a health care provider could achieve.”
The Journey—and a Few Speed Bumps
Her journey to medicine had begun. She hit a speed bump, however, when she graduated from Spelman in 2003 and applied to medical school.
“I was denied admission,” she says. She took a job as a lab assistant at a medical testing lab; what followed were two years of midnight shifts, Saturday shifts, and overtime. But the desire to become a physician never dimmed. Calling once more on her educational roots, West decided to resume her course work.
“My mom and dad, who have been a huge support throughout, were doing some research on the Internet and across SMDEP,” she says. In 2005, as nontraditional student, she joined the SMDEP program at the Case Western Reserve University site.
Then began an eye-opening transition and a behind-the-scenes experience, replete with the joy and inspiration of becoming a health professional.
“The science courses, the seminars, learning from faculty and professionals in the field—it all set the foundation for my career,” she says.
“SMDEP set the foundation for my career.”
Of equal benefit was the insight students got into the admissions process. “The students, admissions committee, and professors tell you about the things you can do to strengthen your application and at the interview,” she explains. “It’s like we were given the inside track on how to apply, what the admissions board is looking for, do’s and don’ts for completing the application, even test-taking tips.”
It seemed the stage was set to reapply to medical school after the six-week program…until a presentation by Francis M. Curd, DDS, DMD, then a Case Western dentistry professor, compelled her to revise the plan.
“The talk with Dr. Curd altered my perspective,” says West. “It was the way he spoke about dentistry—the passion he had for the profession. The MDs didn’t have that. It made me realize how much I wanted that same kind of passion about my work.” Motivated by Curd’s presentation, she began researching a career in oral health.
Advised to complete more advanced course work as preparation for the Dental Admission Test (DAT), West earned a master’s degree in biotechnology at West Virginia State University and was accepted at Case Western’s School of Dental Medicine in 2008. Then she primed the pipeline, returning to SMDEP before dental school—this time as a teaching assistant.
“It was good to get to know students who shared my curiosity about dentistry, and to talk about shared experiences,” she says. “I had the opportunity to show them why it’s important to get a jumpstart on things, since I’ve been on both sides.”
“I’ve always said that I don’t think I would have been admitted to dental school without SMDEP,” she adds. “It changed everything.”
Healthy Habits, Early On
Since completing dental school and residency, West has carved out a place for herself at the Family Health Centers of Georgia, an Atlanta community health center (CHC). The majority of the patients she treats there are from underserved—and often uninsured—populations.
Through the Affordable Care Act (ACA), Medicaid has been expanded in 27 states. Georgia is not one of them, despite ranking sixth in percentage of uninsured residents (19 percent). Moreover, the state has a dentist-to-patient ratio of 44-to-100,000—and only one dental school.
“Prevention is easier—and much less expensive—than treatment.”
Amid this perfect storm of insufficiency, reminders of the need for affordable treatment and preventive care are ever-present. Many of her patients, says West, come for emergency care, with abscesses and sizeable cavities that—through lack of access, information, or both—have gone untreated.
“We’re seeing patients well down the road, when they already have a lot of issues,” she explains, adding that many find themselves opting for extraction because “it’s cheaper to have the tooth pulled than to get a root canal and a crown. We’d rather save the tooth, but it’s hard for patients to choose that option when they have no insurance.”
Her work at the CHC affords her the opportunity to show patients how to take care of their teeth long before they face such a dismal choice—or, worse, a fate such as the one that befell Deamonte Driver.
“Prevention is easier—and much less expensive—than treatment,” she says. “I tell my patients that no matter their circumstances, they can still learn to brush and floss twice a day and use a mouth rinse.”
It’s her way of building upon the legacy of Mama Stell.