Originally Posted on October 25, 2018 by Chris DeFrancesco

While Dr. R. Lamont “Monty” MacNeil will be completing his 12 year tenure as dean of the UConn School of Dental Medicine this June, his impact will continue as a faculty member after he completes a sabbatical experience.

MacNeil is most proud of UConn’s distinctiveness as a dental school and the continuance of its 50 year history of excellence in dental education, research, clinical care and community service.

“We are unique as a dental school,” said MacNeil, describing it as a place where dental students learn in an integrated curriculum with medical students and faculty actively collaborating in research and other endeavors with colleagues in the School of Medicine.

During his tenure MacNeil maximized the contributions of Bioscience Connecticut and transformed the physical infrastructure of the school with renovated academic areas, simulation training centers, state-of-the-art dental clinics, and advanced technology.

“The physical renewal we have accomplished here lifts a heavy burden off the next generation of faculty and school leaders,” said MacNeil. “The focus can now be on high-caliber people and programs, by attracting the best faculty, staff and students, and supporting the already talented people we have to keep our school on the leading edge. Our school has amazing faculty mentors and leaders, so people early in their academic careers can come here and be successful.”

MacNeil believes that the School has a bright future. He sees further growth in inter-professional training for students and residents with their colleagues in the other health professions and envisions faculty demonstrating their competency as extenders of the primary care team and introducing a greater medical or general health care dimension to their clinical activities.

“We are the perfect place for such experimentation because of our integrated structure and our academic interests,” said MacNeil. “We should be the school testing new approaches and new models, being the leaders in this new world of collaborative health care.”

He also notes the many avenues for faculty to bring their ideas and discoveries into action, with UConn Health’s new incubator labs, entrepreneurial pursuit guidance, and a more robust campus amenable to wider scientific collaborations including with The Jackson Laboratory for Genomic Medicine. “The key is looking beyond roadblocks and limitations and seeing the many opportunities that surround us and maximizing them.”

MacNeil will spend a large part of his upcoming sabbatical on the national stage as chair of the Board of the American Dental Education Association (ADEA), an organization with over 20,000 members and representing 76 U.S. and Canadian dental schools. ADEA will provide MacNeil with an opportunity to pursue a number of interest areas, including reform in national dental licensure, encouraging interest by students in academic careers, and expanding the international dialogue in dental education.

“I’ll maintain an office at ADEA headquarters and will be doing a fair amount of travelling for the association nationally and internationally this year, all great opportunities to advance discussion on these topics and, in parallel, promote UConn,” MacNeil said.

MacNeil’s greatest passion however, is in two additional areas: student assessment and the integration of dental care within larger medical or health systems. Both areas are critical priorities for dental education. “It’s been 20 years since dental education took the lead in converting to a competency-based education platform,” explained MacNeil. “As part of this, we devote huge amounts of time and effort to student assessment. It’s now time to look ahead and consider new, innovative methods, some emerging from other health professions. My hope is that is that we’ll bring thought leaders together this year to describe a path for the future.”

MacNeil greatest focus will be in researching the benefits of integrating oral health care into primary or general medical care systems. Several large national health care originations have done this and are reporting quite remarkable early outcomes, according to MacNeil.

“We now know that by reducing the inflammation burden of oral diseases, overall health outcomes are improved, especially for those suffering from chronic, inflammation-based diseases like diabetes, rheumatoid arthritis, cardiovascular disease and asthma,” said MacNeil. “This is also being seen through rather dramatic reductions in health care costs, both for acute and chronic care, in these groups. I hope to gain a deeper understanding of this interplay this year.” He will be working with ADEA and other organizations with the goal to formulate a national symposium on the topic. He also believes the implications to dental education will be profound.

In discussion of these new endeavors, MacNeil acknowledges that he probably embraces change a bit more readily than most, recognizing that change can be difficult for many people, even those in education and research.  “I guess I’d credit or blame that on my background. I come from pretty humble beginnings, part of the first generation in my family to attend college,” MacNeil shared. “Every step forward necessitated significant adjustment, so I guess I equate change with progress. The two don’t necessarily have to occur together but, from what I’ve seen, change and progress almost always go hand in hand.”

He adds: “Looking back, it has been quite humbling to be the dean of a dental school with such a great national reputation and part of such a distinguished university,” said MacNeil. “It has been a phenomenal experience and a privilege to work with the talented faculty, staff and students here.”

MacNeil joined the dental school as a graduate student in 1986 after six years in private practice. In 1998 he started his twenty year span on the school’s leadership team first as an associate dean, then as senior associate dean, and was named dean in 2007. He has shepherded the dental school through three perfect accreditation reviews, and witnessed the School of Dental Medicine’s national ranking rise from 18th to 11th in funding from the National Institute of Dental and Craniofacial Research. The School was awarded the prestigious William J. Gies Award for Achievement in 2016. MacNeil helped establish a new cross-campus Biomedical Engineering Department in partnership with the UConn Schools of Medicine and Engineering.

“My endpoint goal as dean was to leave the school in a better state than when I took office,” said MacNeil. “I am confident that has been accomplished. We are stronger than ever before and I know we will keep pushing the boundaries of dental medicine further to accomplish even more.”

UConn is expected to name its next dental dean this summer.

Oral pain, bleeding and swelling can happen for any number of reasons, and they don’t restrict themselves to regular business hours.

It’s why UConn Health has had around-the-clock coverage for dental emergencies since the early 70s.

“We have the largest dental emergency service in the state,” says Dr. Steven Lepowsky, senior associate dean for education and patient care at the UConn School of Dental Medicine. “The service exists to address a significant unmet need. There are still, even in today’s world, people who do not have access to dental care and, unfortunately as a result of that, experience dental emergencies. But it’s also for patients who may be going for regular care but just have an emergent situation.”

On an average day, UConn Health sees nearly 60 dental emergencies in a 24-hour period. The most common are toothaches related to a cavity, root canal, or abscess.

The dental clinics, staffed by students and residents from the UConn School of Dental Medicine who work under faculty supervision, provide urgent dental care weekdays from 8:30 a.m. to 6 p.m. After 6, patients with dental emergencies are treated in the emergency department.

And while the hours are nothing new, the setting for the after-hours care is.

When UConn John Dempsey Hospital moved its emergency department to the new University Tower in May, it opened a new patient room dedicated for dental emergencies—one that features a dental chair in place of a stretcher.

“It replicates a full dental operatory, so it expanded the scope of what we could offer on an emergency basis after hours,” Lepowsky says. “It’s a much more pleasant environment for the patient. They don’t feel like they’re in an emergency room. Many emergency dental services are providing care on a hospital bed. This is one of the few where it’s actually a dental chair.”

From 6 to 10 p.m., a dental resident is on the premises to handle dental emergencies in the ED. After 10, patients who present with a dental emergency are assessed by medical staff with the discretion to bring in the dental resident on call when needed.

“There’s a resident and then there’s a second-year resident who provides backup, then if it’s something that they need additional assistance with, they call a faculty member,” Lepowsky says. “They’re predominantly general dentistry residents, but there are also oral surgery residents and pediatric dentistry residents on call based on what the needs of the patients are.”

That training component makes the emergency dental service a crucial piece of the dental school’s academic mission of teaching tomorrow’s dentists, just as it is to UConn Health’s clinical mission of serving all comers today.

“It’s a good educational experience for the students and residents because it helps them build skills in terms of how to diagnose a problem quickly, identify the source of the problem, and try to provide care that immediately addresses someone’s needs,” Lepowsky says.

While the dental room in the new ED enables a wider range of diagnostic and treatment options than the previous after-hours setting did, the concept has not changed.

“Our emergency dental service is not a 24/7 dental practice. It’s really to specifically address urgent needs that can’t wait,” Lepowsky says. “It’s not the correct environment for comprehensive dental care.”

Sometimes the course of action after hours is relieving the pain and sending the patient home. He or she would then return in the morning when the dental clinics are open.

“You want someone to establish a relationship with the provider and establish what we would refer to as a dental home, so there is someone who’s coordinating all their care,” Lepowsky says.

Jeffrey Pan won’t be the first dentist in the family. Not even close.

His father is a well-known family dentist in Melrose, Mass., and his mother is a professor at the Boston University School of Dental Medicine.

And he won’t be the last. He has a younger brother who’s a first-year student at BU Dental, and a younger sister who is considering dentistry.

“I always joke with everyone that I got brainwashed when I was a kid,” Pan says. “I always wanted to be a dentist at a young age. We actually did live upstairs from the practice, and I would always come home from school and then go down and peak through the door and watch my father.”

When it came time for choosing a dental school, the UConn School of Dental Medicine was little more than a name on the list of institutions in the Northeast.

“I didn’t really know much about the program,” Pan says. “At the interview, I got a really good feeling about the program. Then I heard a lot of great things from people who were in dental school, or who had graduated and had heard about the program. It seemed like a very competitive program to get into, and it looked like it had everything that I was looking for in terms of an education and clinic experience.”

Pan chose UConn over BU, Tufts and Columbia. He describes his experience as a UConn dental student as tough and arduous.

“When they say in orientation this is not an easy program, they mean it,” Pan says. “But I think in the end it really has made us more confident in what we do, and prepared to go out as solo practitioners.”

One of the things he’ll remember most about the UConn School of Dental Medicine is the class size. Pan is one of 35 students who make up the Class of 2016. Because they got to know each other so well, he says they will have a network of people they can call on for questions and rely on as they enter the profession.

“The latter two years of clinic especially, I think it really solidified our knowledge from medical school to dental school, being able to integrate that knowledge and apply that to patients,” Pan says. “I think the workload they give us and the pressure they put on us, after a while it starts to inspire confidence.”

Pan says he’s always wanted to be like his father, and always wanted to work with his father. And that’s the plan: a year in BU’s general dental residency, and then back to the two-story building he grew up in, with Dr. Nelson Pan’s practice on the ground floor. Only this time, father and son will practice side by side.

Dry mouth. It’s listed as a possible side effect for hundreds of prescription and non-prescription medications, and can also be brought on by factors such as aging, tobacco use, cancer therapy, or autoimmune diseases such as HIV/AIDS and Sjogren’s Syndrome.

Also known as xerostomia, chronic dry mouth due to lack of saliva affects the quality of life for an estimated 20 million Americans. Yet over-the-counter mouthwashes are currently the only available treatment.

Dr. Robert Kelly of the UConn School of Dental Medicine has invented new technology to address the problem of chronic dry mouth. (Lanny Nagler for UConn)

Dr. Robert Kelly, a professor of reconstructive sciences in the School of Dental Medicine, and his colleagues have set out to develop and commercialize a technology that could help: an artificial salivary gland that, when surgically implanted into a patient’s mouth, mimics natural saliva production and relieves dryness.

Read more on UConn Today

All but one member of the UConn School of Dental Medicine Class of 2016 will start a residency program upon graduation.

Unlike their counterparts in medical school, who are required to complete a residency before they can be licensed to practice, graduating dental students have the option of becoming licensed and going directly into clinical practice.

But this is an option rarely exercised at the UConn School of Dental Medicine.

Read more on UConn Today