Program Optimizes Clinical Experience and Patient-Centered Care

The School of Dentistry has created a Comprehensive Care Program to optimize the patient care delivered by students as part of their training.

Junior and senior dental students treat patients, supervised by faculty members, in the School of Dentistry building to supplement practice of their skills and serve the community. The new program will centralize the service through the school’s general dentistry clinics.

“The school has always offered comprehensive care to   our patients, but the care was managed and delivered in specialty clinics supervised by specialists,” said Dr. Frank Caughman, associate dean of patient services in the School of Dentistry.

In the new system, which will be fully implemented next summer, the students will be supervised by experienced generalists. This system will optimize continuity of care and preclude the existing problem of student dentists occasionally struggling to arrange appointments in specific clinics, Dr. Caughman said.

“We envision a system where the senior class will be divided into two teams with patients assigned to both the student and the team,” Dr. Caughman said. “The faculty for each team will be consistent throughout the year, so faculty will have a more active role in each patient’s treatment, which should lead to more efficient patient-centered care.”

Each team will be housed in its own clinical area, and staff will be available to help schedule patient appointments, eliminating the existing concern of chair availability. Specialists will be available for consultation and treatment supervision when patients are referred from the general dentistry clinic.

“This type of practice mirrors what takes place in private practice, so it should better prepare our seniors for dental practice,” Dr. Caughman said.

The program emerged, he explained, when MCG School of Dentistry Dean Connie Drisko charged him with creating a system that better reflects the school’s commitment to excellent clinical training and public service.

“My charge was to design a clinical program that builds on our strengths and makes the overall clinical experience better for both students and patients,” Dr. Caughman said. “Over the past year, Dr. Rick Callan (assistant professor of oral rehabilitation) has worked closely with me, borrowing ideas from other schools, bringing in consultants and seeking faculty input to create a program that is unique for MCG.”

For more information or to schedule an appointment, call 706-721-2371.

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Green Tea Linked to Protective Role in Autoimmune Disease

Green tea seems to help protect the body from autoimmune disorders, according to a Medical College of Georgia oral biologist.

Dr. Stephen Hsu, a researcher in the MCG School of Dentistry, has amassed a large bank of research helping document green tea’s health benefits in everything from oral cancer to wrinkles. The benefits spring from compounds in green tea called polyphenols, which help eliminate DNA-damaging free radicals. As an added benefit, a green tea-induced protein called p57 protects healthy cells as polyphenols target cancer cells for destruction.

Dr. Hsu’s most recent findings, which he presented June 17-20 in Atlanta at the Arthritis Foundation’s fifth biennial Arthritis Research Conference, target autoimmune diseases. These diseases, such as type 1 diabetes, rheumatoid arthritis, lupus and Sjogren’s disease, inexplicably prime the body’s immune system to attack its own tissues, with often disabling and even life-threatening consequences. Adverse effects often accompany autoimmune disease treatment, which mainly focuses on the immune system.

One autoimmune disorder--the immune system’s destruction of glandular cells--causes dry mouth, or xerostamia. Dry mouth occurs in about 30 percent of elderly Americans, but only in 1 percent to 2 percent of Chinese seniors. It is one of many health disparities that Dr. Hsu suspected was linked to Asians’ frequent consumption of green tea.

Dr. Hsu is probing green tea’s role in producing autoantigens. Autoantigens are normal molecules in the body with useful functions, but changes in their amount or location can trigger an immune response. “I wanted to know how green tea polyphenols affect the production of autoantigens,” Dr. Hsu said.

He suspected a link because a polyphenol called EGCG is known to suppress inflammation, which results when the immune system mounts a defense to a real or perceived enemy. “If EGCG suppresses inflammation, it should affect the magnitude of the autoimmune response, possibly by suppressing autoantigens,” Dr. Hsu said.

To test the theory, Dr. Hsu studied cells in salivary glands and skin tissue. Cells exposed to green tea showed RNA and protein levels indicating autoantigen levels were suppressed in these normal cells, but not in tumor cells. “We were so shocked,” Dr. Hsu said of the finding that further highlighted green tea’s role in attacking tumor cells while protecting healthy cells.

And because of the low levels of autoantigens in healthy cells, “the immune system now has considerably fewer targets to potentially attack,” greatly reducing the risk of autoimmune disease, Dr. Hsu said.

Dr. Hsu has extended his studies to animal models. He is studying two sets of mice, both programmed to develop autoimmune disease. He is observing one set as the disease follows its natural course. “This model should develop diabetes, dry mouth and dry eyes within 12 to 30 weeks, then die quickly,” Dr. Hsu said.

The other set began drinking green tea at age 3 weeks, immediately after weaning. He is anxious to determine whether green tea delays the onset of autoimmune disease or otherwise affects its course.

Dr. Hsu, who has helped incorporate green tea polyphenols into everyday products such as gum and skin cream, hopes his latest research will ultimately yield a wealth of findings that can help scientists better understand and treat autoimmune disease.

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New Director Draws on Military Expertise

Dr. Henry W. “Butch” Ferguson has retired from the Army, but the work he did there continues.

“There is really no more rewarding a gesture than for somebody to call you from some part of the world who has just received a soldier badly injured in conflict and tell you, ‘I am really glad you taught us how to do this,’” said Dr. Ferguson, the new director of the graduate training program in oral and maxillofacial surgery and interim chair of the department.

“I get calls and e-mails like this from my previous residents. They want to talk about cases. If they did not care about me and did not value my advice, they wouldn’t be calling,” said Dr. Ferguson, who joined the School of Dentistry faculty in April 2004 after retiring from a 24-year career in the U.S. Army.

He has taught in training programs at Eisenhower Army Medical Center, William Beaumont Army Medical Center, Ireland Army Community Hospital and the University of Louisville School of Dentistry, igniting professional passion and compassion in future oral surgeons along the way.

“In reality, for those we teach, nurture and mentor, there will be a little piece of us in each of them as they complete training,” said Dr. Ferguson. “You know in your heart that as they graduate, pass written and oral boards, and mature into poised and caring providers, you had a great part in making that happen.”

“Now, did you do anything else to them? Did you help them to be better people, to develop better personal skills, to be more empathetic, to learn how to talk to families about difficult decisions? Some of the smartest providers lack those skills,” said Dr. Ferguson, who wants to ensure that MCG’s oral and maxillofacial residents are missing nothing. The work he loves--rebuilding faces destroyed by war or stateside trauma or malformed from birth--requires nothing less.

“We do procedures where we manipulate facial bones to restore form, symmetry and function,” said Dr. Ferguson. He shares an image of a man’s face shattered by a bullet that he helped put back together. Another shows grossly mal-posed teeth, known as “kissing molars,” that must be surgically moved before an orthodontist can begin to work. Another patient needs adequate jawbone restored with bone grafts before Dr. Ferguson can put in implants to secure new teeth, improve function and help avoid future bone loss.

In combat zones, the responsibilities of oral and maxillofacial surgeons are even more diverse.

“In the Army, an oral and maxillofacial surgeon is one of the most diversified members of the surgical team because of our many skill sets,” said Dr. Ferguson. “In addition to working within our own area of expertise, we can support other members of the surgical team. As an example, if someone comes in with an open cranial fracture, once the neurosurgeons repair the brain, we put the bones back together and sew them up so the neurosurgeons can go on to the next patient.”

Oral and maxillofacial surgeons complete four to six months of training in anesthesia, another source of vital expertise when treating both soldiers and civilians. “We are seeing people who are sick, young, old… Advanced anesthesia skills help us to treat these patients safely.”

The 48-month curriculum of oral surgeons includes rotations in neurosurgery, general surgery, internal medicine, otolaryngology and trauma where they learn and work alongside medical school graduates. That training is terrific preparation for the life they will lead. For instance, the department provides facial trauma coverage for the MCG Trauma Center 10 days a month.

“Working together makes you stronger,” said Dr. Ferguson. “We have a nice blending,” he says.

In addition to increasing multidisciplinary collaboration, Dr. Ferguson plans to add more faculty to the department and to graduate two rather than one residents a year. Their education is his highest priority

“I realize I can’t teach them everything they need to know,” he said. “But I can give them a broad enough fund of knowledge to develop as surgeons and do their work safely and consistently.”

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Dr. Haywood Named Director of Continuing Education

Dr. Van B. Haywood, professor in the Department of Oral Rehabilitation, has been named director of continuing education for the School of Dentistry.

“Van is an internationally known clinical researcher, teacher, clinician and speaker who brings exceptional leadership and expertise to the continuing education programs offered by MCG,” says Dr. Connie Drisko, dean of the MCG School of Dentistry. “He is planning exciting new programs to expand the solid lineup of offerings we provide our dental colleagues each year across the state.”

“As part of our mission as the state’s only dental school, we want to provide a comprehensive continuing education program that meets the needs of general practitioners and specialists throughout Georgia,” says Dr. Haywood.

“We want our faculty and the teaching and research facilities on our campus to be a hub for hands-on programs in areas such as intravenous sedation, implant restoration and restorative dentistry. One new course for this academic year is CE with the Masters April 4-7, 2006, featuring four days of morning hands-on classes on topics such as bleaching, digital photography, dental materials bonding and principles of layering color into composite restorations.

“We also want to continue our family-friendly gatherings at Georgia’s resort locations that make experts available in a more casual setting,” he says. “And, we want to continue our strong partnerships with groups such as the Hinman Dental Society to provide important regional programs such as the Annual Hinman/MCG Fellowship Esthetic Symposium: Georgia Partners in Dental Education.”

Another goal is to better communicate the offerings, including expanded course information on the MCG Web site at http://www.mcg.edu/ce/dental.html as well as direct electronic notification of upcoming courses. To register for direct notification, contact Jason Norton, office specialist, at jnorton@mcg.edu or call the MCG Division of Continuing Education at 706-721-3967 or 1-800-221-6437.

Dr. Haywood is a 1974 graduate of the MCG School of Dentistry and joined the faculty in 1993. He is a pioneer in the area of cosmetic bleaching who co-authored the first paper published on at-home bleaching as well as the first paper looking at its extended use to whiten tetracycline-stained teeth.

He is associate editor of the Journal of the American Dental Association and a member of the editorial board of the Journal of Esthetic Dentistry, Journal of Operative Dentistry, Contemporary Esthetics and Restorative Practice and Quintessence International.

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