San Diego Dental Center Provides Integrated Model of Dental, Health, and Wellness Care for Older Adults

Gary and Mary West Senior Dental Center - San Diego, California | Karen Becerra, DDS, MPH, CEO, and Dental Director

The Gary and Mary West Senior Dental Center in downtown San Diego, California, is a one-of-a-kind community clinic that provides affordable, high-quality oral health care for seniors. Poor oral health care in seniors is a significant and overlooked public health issue, largely due to limited or no access to dental care. To address this critical need, the Senior Dental Center was created and opened in 2016 to offer comprehensive education, clinical, and wellness services for seniors who have suffered from years of neglect.

To provide holistic care coordination for its senior patients, the Senior Dental Center is co-located within Serving Seniors’ Gary and Mary West Senior Wellness Center, a popular senior center that provides wellness, social, and community support services, in addition to nutritious meals, to as many as 900 low-income seniors daily. The idea for opening an innovative Senior Dental Center came back in 2014 during a regular meal service at the Senior Wellness Center.

“Mary West and I were serving nutritious meals to help seniors who live on less than five dollars a day and noticed that many of them couldn’t chew the food and would cover their mouths with their hands out of embarrassment because of the condition of their teeth,” said Dr. Karen Becerra, the Senior Dental Center’s CEO, Director, and one of its primary dentists. “When Mary and I saw this, we knew we had to do something about it and decided to help.” Pioneering philanthropists Gary and Mary West, who are passionate advocates for seniors and whose mission in life is to help older adults successfully age in place with dignity, quality of life, and independence through their Foundation, decided to provide the funding necessary to set in motion the creation of a state-of-the-art dental facility inside the Senior Wellness Center. Before they got started in 2014, the Gary and Mary West Foundation and Serving Seniors surveyed more than 300 senior clients and discovered that dental care was the greatest unmet need: 43% of those surveyed had pain in at least one tooth, 35% had trouble chewing, and 58% had not seen a dentist in more than a year.

“Co-locating our dental services within the Senior Wellness Center was key to addressing the transportation barrier low-income seniors face when accessing care,” noted Shelley Lyford, Foundation President and CEO. “It has also been instrumental in building rapport and fostering relationships between the seniors and dental center staff because we are in a place they visit regularly and trust.”

The challenge was to build a modern dental office in a modest second-floor space that would be comfortable enough that seniors would want to visit. Henry Schein was chosen to help design, equip, and facilitate the construction of this ambitious project.

“We selected Henry Schein for several reasons, including the special market pricing, interoperable technologies, and excellent customer service,” explained Dr. Becerra.

Left to Right: Leo Souza, Regional Operations Manager; Shelley Lyford, President & CEO, Gary and Mary West Foundation and Board Chair, Gary and Mary West Senior Dental Center; Keith Vittone, Equipment Service Technician; Tayde Soto, Field Sales Consultant; Drew Horne, Digital Technology Specialist; Dr. Karen Becerra, Dental Director; Kevin Murrey, Equipment Sales Specialist. Not Pictured: Brandon Schmidt, Regional Manager.

Kevin Murrey, an Equipment Sales Specialist, and Tayde Soto, a Field Sales Consultant, led the project for Henry Schein. They began by arranging tours of other local practices, and from there, the team began to narrow down floor plan needs and equipment choices.

Beautiful, Modern Office Appeals to Senior Patients

The 1,400-square-foot dental office opened in June 2016 with four operatories, a fully-digital workflow, and cutting-edge equipment any dentist would be thrilled to have in his/her practice—including 3D digital imaging and CAD/CAM. It’s a full-service dental clinic offering oral health education classes, routine checkups, and cleanings, fillings, crowns, root canals, replacement of missing teeth with partial or full dentures, and even more complex procedures if needed. “We wanted vulnerable seniors to have a welcoming, warm place that provided high-quality, affordable care, along with preventative education,” said Dr. Becerra.

This patient population has varying and often times complex needs, and the team discovered that many require multiple visits to return their mouth to good health. There are currently four additional part-time doctors on staff, including prosthodontist Dr. Vicki Petropoulos, Dr. Denise Frances, Dr. Bashar Dalloul, and Dr. May Chou. There are also two part-time hygienists and three full-time dental assistants. Good communications with each patient is critical, therefore, the multi-cultural, multi-lingual staff members speak Mandarin, Spanish, Italian, and Tagalog, allowing many patients to discuss diagnoses and treatments in their native tongues.

Design Builds Patient Confidence in Level of Care

The Planmeca ProMax 3D Cone Beam unit and its precise imaging is essential for discovering complex health concerns so common with the clinic patients. The clear digital images help patients understand their diagnoses as well as the corresponding treatment recommendations.

The practice is modern, clean, and professional-looking, and uses best practices in its layout, along with enough equipment to maximize the number of patients who can be treated each day. The contemporary and bright floor plan was built to encourage patient confidence, especially because many haven’t visited a dentist in years and are apprehensive about what to expect.

“We wanted to make sure patients would not perceive a barrier in the dental care they could access because of their ability to pay,” explained Dr. Becerra.

The waiting area is minimalistic but warm, with contemporary seating in a lux caramel leather, solid surface countertops, blonde flooring, and a large television monitor on the wall. Throughout the office, calming water-themed photography is mounted, coordinated with cheerful blue accent walls.

Technology Provides Fast, Comfortable Care to Anxious Patients Sophisticated equipment was chosen to help elevate the patients’ experience and streamline procedures, which range from simple to complex.

“We equipped our clinic with cutting-edge technology to yield more thorough, sensitive, and timely treatment tailored to our patients’ needs,” said Dr. Becerra. “Because of the integration of several systems, we have significantly improved the patient experience, increased opportunities to deliver high-quality dentistry, and identified new opportunities to achieve sustainability. The response from our patients has been very positive, and the no-show rate is very low.”

Inside the operatories are soft blue leather Pelton & Crane Spirit 1800 chairs, Helios LED lights, and Centennial cabinetry. The operatories are split into two open-bay treatment areas with an imaging alcove set between them, housing a Planmeca ProMax 3D Cone Beam unit. The office is paperless, and uses Planmeca Pro HD Sensors and ACTEON SOPROCARE cameras to show patients digital images of what’s happening inside of their mouths.

“The digital workflow lets us educate patients continuously, a key aspect of our mission,” said Dr. Becerra. “Every time patients can visualize what is happening in their mouths, it’s easier for them to understand the proposed treatment plan and the ways improved oral health will positively affect them in the long run.”

The clinic is paperless and networked to display patient images and charting on all monitors throughout the practice, including this consultation area. A spacious sterilization room filled with top-grade equipment, including a Midmark M11 autoclave, is connected to the practice’s onsite lab, where the Planmeca CAD/CAM milling unit is located. The entire practice, including the lab and sterilization areas, is eco-friendly.

“When designing the center, we followed American Dental Association suggestions for green dental practices, including an installed amalgam separator, eco-friendly scrubs, sealant adhesives, and restorative materials in which all the package’s contents are used during a procedure.”

To interconnect all of the equipment so seamlessly, the staff uses Dentrix practice management software, and purposely chose technology that works well together, maximizing the productivity of the office. Henry Schein TechCentral handled computer installation and networking throughout the office.

“The first response we get from patients and visitors entering the Dental Center is ‘Wow!’” said Dr. Becerra. “We are excited to provide them with a dental home where we can stabilize, restore, and maintain their oral health.”

In its first seven months of operation, the Senior Dental Center has engaged about 436 seniors in Oral Health Education classes in English, Spanish, and Mandarin; and welcomed over 300 patients across a total of more than 1,400 visits. Dr. Becerra credits the smooth office operations to specific workflow elements, including a morning huddle when the team collaborates together with a senior care navigator, and regular monthly meetings.

“Since the very beginning, we have been working as a cohesive team so that we can all give the best possible treatment and care to our patients.”

Looking forward, Dr. Becerra shares the non-profit’s long-term goals: grow the practice, make it sustainable and replicable in other locations, and one day add a mobile component. ♦

Originally published in Sidekick Magazine.