In the old days, dental schools were designed for the convenience of students and teachers. The schools that operated a community clinic in which their students gained experience often put patients to work as well, walking long distances or climbing stairs to see a dentist.
But dental school facilities recently opened or in the planning stages are taking into consideration the comfort of patients as well as the educational experience of students and the needs of researchers.
In August, Marquette University in Milwaukee opened a $30 million building for its dental school, replacing a facility that dated back to 1922 (the dental school opened in 1894).
The University of Maryland Baltimore broke ground this spring for a $124 million building for its dental school, which, dating from 1840, is the oldest in the country. The new facility is to open in 2005.
This fall, the University of Nevada at Las Vegas opened the first dental school in the state. UNLV dental students are attending classes in buildings spread across the campus as they await the completion of renovations on a building, to open for the 2003-2004 school year.
The Arizona School of Health Sciences in Mesa will open a dental school in 2003 with a 100,000-square-foot facility, which is being added onto an academic building. The University of South Carolina is about to embark on a building project at its dental school.
The University of Illinois at Chicago, whose students saw 98,000 patients from July 1, 2001 to June 30 in its community clinic, is studying its facility needs, officials said. The other Illinois college with a dental school, Southern Illinois University at Edwardsville, added a clinic in the 1980s and renovated it a few years ago.
Enhanced lessons
All these improvements will help students as they move from pre-clinical studies to clinical care to a job in a dental office, said Bruce Graham, dean of the University of Illinois at Chicago’s dental school.
“Those transitions should be greatly streamlined and be more seamless and be able to be made more rapidly by the student because of a greater realism in the simulation experience and a closer analogy to real-world practice that they expeirence in the dental school’s patient care clinic,” said Graham, who moved to the school in 2000 after serving for eight years as the dean of the dental school at the University of Detroit-Mercy, which opened a new clinic in 1997.
“I believe it should also result in a more skilled clinician,” Graham added, “because the student can spend more time learning actual patient care and less time tending to peripheral activities, such as sterilizing instruments.
“For the patient who comes to the clinic, the quality of care will be higher. It has always been high, but it will be even higher now.”
Learning from experience
The dental school at Southern Illinois University at Edwardsville built a clinic for its pre-doctoral program at a site in nearby Alton in 1986. The building was renovated in 1995 to add a state-of-the-art lecture hall and a pre-clinical technique lab with computers at every workstation.
The SIUE clinic sited the instrument sterilization area and the X-ray equipment in the center, Graham noted. As a result, the University of Detroit Mercy used those concepts when it built a new clinic in 1997, he said.
The clinic has 140 chairs to provide a variety of services, Graham said. Some have been located in four pods of 24 chairs each, providing a more realistic experience for students and patients.
“There is a move in dental education to change the way that we are designing our clinics,” Graham said. “We are moving away from a large clinical area with maybe 100 or 200 chairs sitting in the open to smaller facilities that have a couple of dozen chairs at the most and simulate a group dental office in the real world.”
Educational goals are also factored into the design.
“In those clinics, we’re attempting to provide the patient with a sense of privacy,” Graham said. “Meanwhile, the faculty member still has to be able to see what the student is doing in providing care. So we have designed the facility typically with cubical dividers around each chair on three sides. Those are 43 inches high, and then we face the patient’s chair inward and the patient’s head is still visible to the instructor, who is in the aisle.”
UNLV opened its dental school with 76 students and will admit 75 per class, said Susan Silverton, the associate dean of academic affairs for the school. Renovating the building will cost about $30 million, she said.
Before completing the design work, UNLV in 2001 hosted a conference on planning new dental school facilities, Silverton said. Representatives from schools in Arizona, Colorado and Nebraska attended, as did officials of the dental school at Southern Illinois.
“It was pretty helpful because most of the schools had been through the planning process for a construction project,” Silverton said. “We have designed a building that is light and airy and one that isn’t the kind of architecture that reminds you of buildings that are boxes.”
The University of Maryland Baltimore, with $104 million from Maryland and $20 million from a donor campaign, is building a facility with 10 stories above ground level and two below it. Academic and sterilization areas will be in the lower levels. The clinic will be housed on the first four floors, and instructional, administrative and research areas will be on floors five through nine; mechanical equipment will be on the top floor.
Every floor will have a study area for students, said Dr. John Hasler, a retired dean who is overseeing the project.
“We feel the design is very contemporary,” he said. “We’re trying to be flexible on education methodology, so the building is technology rich.”
Other facilities in the works include the Arizona School of Health Sciences in Mesa will open a dental school in 2003 with a 100,000-square-foot facility, which is being added onto an academic building. The University of South Carolina is about to embark on a building project at its dental school.
Design improves efficiency
Marquette operates the only dental school in Wisconsin, serving about 300 pre-doctoral students and 20 to 25 post-doctoral students. The clinic in the new 20,000-square-foot building has 96 dental chairs, allowing Marquette to nearly double the number of patients it can treat.
Kahler & Slater Architects of Milwaukee designed the building for Marquette, with a mandate to change the educational setting as well as the way the clinic treated patients, said Larry Schnuck, a principal with the firm. They crafted smaller clinics, more reflective of a dental office, by creating eight areas, each with 12 dental chairs, he said. They also added consultation rooms where patients and students could converse in private.
A centralized administration area supports the clinic, addressing patient admitting, records and financial services.
The school also built specialty clinics for pediatric, advanced care and surgeries and graduate prosthodontic, orthodontic and endodontic clinics. A 99-seat lecture hall contains two large projection screens that allow for video conferencing, so classes in two locations can be linked.
“I think the building exceeded our expectations,” Dr. William K. Lobb, the dean of the dental school, said in September. “I think we did that just by seeing the technology that we talked about developing for programs in place, in the simulation lab, where computers are coming together around a simulated patient. People have come in and looked at it and said, `Wow. We never imagined that it would be like this, feel like this and do all this.'”
Architecture key to change
In seeking to restructure the program, the school focused on architecture as a vehicle, Lobb said. In the past, dental education was traditionally built around an hour of lecture, followed by a clinic or a lab.
Marquette will try to move away from that because eight “break-out rooms,” which can accommodate 10 or more students, have been placed adjacent to the main lecture hall. That allows small groups of students and a professor to explore topics in greater depth.
“The architects focused on some areas that would be gathering places, where people would naturally gravitate and you would get communication taking place,” Lobb said. “In our old environment, that would never happen because people didn’t cross paths. Now there are public places that you have to go through and by to get to somewhere else and now you have an area where you can put a few tables and have people sit and have a conversation.”
Scott Rappe, who is a principal with Chicago-based Kuklinski & Rappe, helped in the design phase for Detroit Mercy and participated in a feasibility phase for the Marquette project.
“As patients walk in the door, they need to feel that the facility is built around their needs,” Rappe said. “So we want to make the spaces warmer and brighter and be less sterile environments.”
Lobb said technological advancements also factor into why dental schools are changing their physical spaces. For example, patient simulation labs of the past had students working on metal heads with teeth. New labs feature mannequins with simulated skin, accompanied by computers that provide treatment instruction.
“I think technology has been a driver in the changes,” Lobb said. “The limitation is obviously that technology changes and you have to anticipate making replacements down the road or make sure in the design that you factor in the ability to change and be flexible. Technology has been an important part of this process and as well as a limitation when you try to renovate an existing building.”
Students, patients pleased
Matthew Smith of Marinette, Wis., in his second year at Marquette’s dental school, has worked in both clinics and endorses the replacement.
“The students are excited about the new building,” Smith said. “In the old building, there was hardly any natural light and with the way that the new building is designed, you can find natural light everywhere, which really helps with patient care.
“We’re really excited about the new technology. The way the clinic is set up is more like a dental practice than a dental school. It is more hands-on learning.”
Patients Shirley and Harrison Desing of Milwaukee turned to the Marquette clinic a year ago after their dentist retired. They give high marks to the facility.
“There is no comparison between the two buildings,” Shirley Desing said. “It is almost a pleasure to go to the dentist. The building is really bright and spacious. It is very nice.”
