Preventive dental care can cost anywhere from $60 to $200 and, according to the Kaiser Family Foundation, is why more than a third of Americans skip it. But at Howard Community College's Dental Hygiene Center, which opened its doors to the community this fall, patients receive these services for a flat fee of $20 per visit.
"The students are learning so we can't make profits, said Susan Seibel, director of the college's Dental Hygiene Program. "So we only charge enough to cover materials."
The Dental Hygiene Center offers students in Howard Community College's two-year dental hygiene program the opportunity to work with patients before graduating. In return, patients with and without dental insurance pay the same affordable price to get their teeth cleaned and examined by the students and double-checked by licensed hygienists who serve as instructors in the program.
"In dentistry, there aren't a whole lot of [affordable] clinics that people can go to," Seibel said. "We've had patients [at the center] who've never been to the dentist, or it's been 10 years or 15 years. We've had a couple of patients with suspicious lesions, who have gone undiagnosed."
65 percent of uninsured Americans reported skipping dental care over the course of a year because of cost, according to a survey administered by the Kaiser Family Foundation in 2013.
While dental hygienists are not able to treat cavities or oral disease, they examine patients for signs of these issues. At Howard College's dental center, students not only clean patients' teeth and teach them proper hygiene practices — they also perform oral cancer screenings and take radiographs, or x-rays, of a patient's teeth.
"This machine here takes the whole panoramic radiograph, which in a dentist office costs maybe $200," Seibel said while pointing to brand new equipment. "But that's part of the $20 here."
If students or instructors find cavities or other serious issues in a patient's teeth or gums, the center's supervising dentist writes a referral for the patient to take back to his or her family dentist.
"A lot of patients don't have insurance or and even a regular dental office that they go to, so we're hoping to get a referral network set up so we can say, 'Go to this dentist, he will see you'," Seibel said. In the meantime, the center often sends patients without insurance to Chase-Brexton Health Services in Columbia, which provides affordable healthcare.
Since the Dental Hygiene Center opened to the public earlier this fall, Seibel said that the training program's 12 second-year students have served approximately 120 patients. In the spring, when the center opened its doors to the college's students and faculty, students saw 150 patients.
"This is my 19th patient this semester," said second-year student Brittany Fiore, who had just examined and cleaned her boyfriend's mother's teeth. "This time last [semester] I was seeing my seventh patient. I'm amazed at how fast I'm getting."
"They feel nice and clean," said Fiore's patient, Kathy Hartman, who drove from Anne Arundel for the visit. "She did a good job."
"Appointments take about three hours right now, but in the spring they will probably take about two hours," Seibel said, because students get quicker at examining patients.
Before students in the program begin working in the dental hygiene center, they learn how to clean and examine teeth by practicing on dummy heads.
"[The dummy is] hooked up to air, water, suction and all that and he has teeth," Seibel said. "We have a demonstrator model at the front and we have a screen that comes down so the instructor can show the students, and they can watch on the screen and they can practice."
Second-year student Kylie Ordovensky demonstrated how she practiced dental checkups on a dummy during her first year.
"Sometimes the calculus, or tartar — you can see it on the teeth — but sometimes it goes under the gum," Ordovensky said while probing the dummy's mouth. "When we explore, we search for the calculus and that it makes it easier to remove when we get the [tartar removal instrument] out. It's important to remove because it can cause gum disease and damage bone structure, which is needed to keep all them teeth in your mouth."
Once a student proves certain competencies on the dummy during his or her first semester, he or she then practices on student partners.
"Then they get competent real quick," Seibel said, "because you have someone that says 'ow' or 'stop' or whatever."
During the second semester, students start seeing their family and friends as patient volunteers and in their second year, they see patients from the community.
Graduates of the dental hygiene program, which began accepting students in the fall of 2014, receive an associate of applied science degree in dental hygiene. Afterwards they must obtain a license to practice dental hygiene professionally.
Dental hygienists earned an annual median income of $70,210 in 2012, the most recent year for which this figure is available from the Bureau of Labor Statistics.
Seibel said that there were more than 50 applications to the program this fall, out of which 15 students were accepted. Tuition to the program, which is one of five such programs in Maryland but the only program in Howard County, costs $132 per credit plus fees and requires completion of 43 credits, in addition to prerequisite courses.
"It's been great," said Aran Song, a second-year student who graduated from Marriotts Ridge High School. "It's all new facilities, and I can bring my family and friends to get comfortable in the clinic. And I like my instructors — they're so nice."
The college's dental clinic is currently open from Monday to Wednesday, with six students working in the morning and six working in the afternoon. In the spring, Seibel said, the clinic will be open five days a week in order to accommodate the first-year students who start working with patient volunteers.