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As Alabama faces a growing shortage of dentists, SOD welcomes its largest class in years.

Incoming Dentistry studentsDental deserts are a growing issue across Alabama. In response, the class size of the University of Alabama at Birmingham School of Dentistry is growing as well.

As of January 2022, Alabama had an average of only 41 dentists per 100,000 population, the lowest number in the nation (the national average was 61). The situation is even worse in many rural and under-served communities, where an increasing number of older dentists are retiring, and replacements often can be difficult to find.

It is, in essence, a numbers problem. So the UAB School of Dentistry is confronting that problem by throwing numbers at it, in the form this year of one of the largest incoming classes in school history.

“We absolutely want to increase class size to help with the access-to-care problem, and we’re doing some targeted recruiting efforts for under-represented populations, including socioeconomic and rural,” says Ken Tilashalski, D.M.D., the SOD Associate Dean for Academic Affairs. “But even as we’re increasing our numbers, it’s exciting that we’re still getting a pool of high-quality applicants who meet our standards.”

Those applicants will be needed in the coming years, as many practicing dentists in the state move closer to retirement. In 2022, there were 15 counties in Alabama – mostly rural – where at least half the dentists were age 60 or older. Conversely, 26 counties had no dentists younger than age 40, and another 11 counties had only one dentist that young.

“There has been sort of a slow-burn crisis in the state with rural providers that is starting to come to a head,” says SOD Assistant Dean for Admissions Carly Timmons McKenzie, Ph.D. “A lot of the providers in rural areas skew a little older, so you have this large cohort coming into retirement that’s going to exacerbate the shortage of rural providers. If we have any chance of meeting the needs of the state, then we have to produce more dentists.”

The UAB School of Dentistry began taking steps to do just that in 2019 when SOD Dean Russell Taichman, D.M.D., D.M.Sc, made presentations to the Alumni Executive Council and Alumni Leadership Council highlighting the need for expanding the class size. Plans were developed for changes in both infrastructure and resources needed to accommodate a larger class, and in 2021 the national Commission on Dental Accreditation (CODA) approved the expansion.

“Our vision is to improve health through oral health," said Taichman. "For that vision come to life strategic we are making strategic investments in both the size of our classes, as well as in our infrastructure and our staff and faculty to support these scholars in both their clinical and basic education. At the same time, we are intentionally investing in faculty who will build the future of our profession. It is an exciting time to be a part of a great vision.”

Class expansion involves much more than simply admitting more students. There also needed to be changes made to labs, clinics and classrooms, as well as an increase in faculty members, in order to enhance overall student performance.

For example, the SOD’s first-floor clinic space has been renovated and expanded. Five new treatment bays have been created, adding 40 patient chairs to the 94 that already were in place. Office areas and patient waiting areas have been updated as well, along with the structure for sterilization.

“The amount of clinic space we had was not going to be adequate for a larger student population,” says Daniel Givan, D.M.D., Ph.D. the SOD Associate Dean of Clinical Affairs. “At the same time, we had clinic spaces on our first floor that had not been updated since the 1970s. So it was a wonderful opportunity to accomplish multiple objectives: to update and modernize our clinical facilities, as well as design it to accommodate additional students."

Givan says, “We brought in internal and external expertise to give us an initial map of what this should look like. From there, we had a broad base of individuals throughout the school who contributed to the initial planning about the clinic. We reached out to faculty, staff and students asking what they wanted to see. Then we took all that information and brought it together.”

The SOD also is updating the software used to coordinate the scheduling of students for clinic duties. Givan points out that more than 200 students will be using the clinical facilities for nearly 30 kinds of rotations, ranging from general dentistry to radiology and oral surgery. He says the newer facilities combined with improved scheduling will enhance the learning experience for students.

“The students will be working in a modern facility that gives them the opportunity to perform excellence for their patients,” Givan says. “We have all the right elements needed to help us move forward.”

In addition, the SOD has been able to expand its classroom capacity, beginning last year with the assumption of auditorium space at Cudworth Hall across the street from the SOD building. Meanwhile, a classroom on the third floor of the SOD building has been extended into an adjoining conference room, and there are plans to combine two smaller classrooms on the second floor.

More students and more class space means there is a need for more faculty members as well. As a result, the SOD has been working on strategic faculty recruitment, particularly in the area of Restorative Sciences.

“If you’re going to increase class size, you have to make sure the footprint will work, but also make sure you have the faculty to cover the additional students,” Tilashalski says. He points out that the faculty-to-student ratio for our students’ first two years is the best in the 30 years he has been at UAB.

“We’ve been able to get really quality people who can make sure that those baseline skills are developed so the students are prepared for patient care," Tilashalski says. "We’ve opened up a number of slots, and we’re filling those rapidly.”

SOD Associate Dean for Research Amjad Javed, Ph.D., says four additional research faculty members should be added by this fall, with plans for more in the near future. Javed says the school is working to bring in faculty who specialize in “cutting-edge disciplines."

“We are training the next generation of clinician scientists,” Javed says. To provide for that, he notes that the school is in an active recruitment drive for faculty who can help the students with specialized training and research.

“For example, we are recruiting faculty whose main focus is teaching seamless interaction of patient data, and having that data as a future research opportunity for the students," Javed says. "That way, we can provide practice-based academics, and have our own students do the research to determine what works and why.”

The SOD has been producing such high-achieving graduates for years. SOD students have consistently performed better than the national average in the Integrated National Board Dental Examination, with a 100 percent pass rate each of the past two years, and have historically done very well on clinical licensure exams.

This year, the SOD implemented practice sessions for students, added simulated exams, and held prep sessions for faculty that included hands-on calibration experiences. The school also dedicated time at faculty meetings to discuss concerns, and added preparatory assignments for students.

“Our student success on these exams shows the quality of our students, and also the quality of our curriculum and faculty to prepare our students,” Tilashalski says. “Our students are ready to go practice dentistry as soon as they graduate.”

And there are plenty of places ready for their arrival.

“Our mission is to develop a team of highly capable people who can make a significant positive impact on their communities,” McKenzie says. “So it’s fantastic with this larger class size that we’re able to expand the UAB School of Dentistry’s reach, because there is such a need.”