He knows the drill

Raymond Fonseca

Raymond Fonseca

As his tenure draws to a close, the dean of the School of Dental Medicine looks back and finds plenty to smile about.

Photo by Candace diCarlo

Say the word “dentist,” and the image that probably jumps into your head is that of a man with a slightly sinister smile, getting awfully close to you with that drill.

Never mind that this isn’t what most people who actually go to the dentist regularly see, or what they think about their own dentist or dentists in general. Perception can shape reality. That’s what students learned in School of Dental Medicine Dean Raymond Fonseca’s course on the media portrayal of the dentist.

“We looked at movies like ‘Little Shop of Horrors,’ ‘Marathon Man,’ ‘M*A*S*H,’ ‘The In-Laws’ and several others, and we talked about how the dentist was portrayed in the media and in movies,” he said. “And really, when you think about it, they’re really portrayed as comic relief or as something to be afraid about.” And, he added, there’s never been a series about a caring neighborhood dentist along the lines of “Marcus Welby, M.D.”

The challenge, Fonseca said in an interview with the Current, is to reduce the anxiety of those who have not seen the inside of a dentist’s office.

The brand-new Schattner Center allows SDM to provide better dental care for West Philadelphia and the city as a whole. Community outreach programs like the recently-unveiled Penn Smiles clinic on wheels [photo above] are another way SDM works to get the public more comfortable with dentistry. It’s something Fonseca says dental schools should be doing more of. But as his 15-year tenure as dean of the school draws to a close in its 125th anniversary year, the accomplishment he’s proudest of is the way he has made dental education better for SDM students.

Q. What does the Schattner Center allow you to do for your students and the community?
A.
We’re the major dental healthcare providers for the West Philadelphia community, and we also provide a substantial amount of care for the Philadelphia community in general. Prior to the opening of Schattner, we had two buildings—the Levy [Center], which was a research building, and the Evans Building. The Evans Building is a 1914 building. We spent millions of dollars on the outside and the inside of this building in the past 14 years renovating it to make it a 21st-century facility. And there’s still more renovation to be done.

It became apparent in the early ‘90s that we were going to need another clinical facility to supplement the one we already have, Evans. And what the Schattner building provides us is that. It provides us with additional state-of-the-art clinical facilities. It provides us with a sterilization and instrument management facility, which allows us to provide safe, sterile instruments—we used to have to go to the Hospital to get our instruments, brought over three times a day in a truck. It also creates a community, because it connects the Levy Building to the Evans Building.

Q. What does the PennSmiles van do?
A.
We have a mandatory community service requirement for our students. All of them, before they graduate, have to do 70 hours of community service. So this is one vehicle…This will be a way for our students to satisfy their requirement, and then get out into the Philadelphia community, the schools, screen students, educate students in terms of oral hygiene and oral health, and also [refer] students to local practitioners if they need additional treatment.

Q. Any strategies for helping people get over their fear of dentistry?
A.
I think some of the things we’re doing in the underserved communities, like Penn-Smiles, and going to some of the senior living areas and just getting out into the community to change some of the misconceptions. The other thing, [which] has been shown in the Surgeon General’s report, is that minorities tend to treat minorities. We have an acute shortage of minority dentists in this country. And we’re going to have to increase the percentage of underrepresented minority dentists to be able to build up a trust in the patient pool, and that still has to happen. I think we’re doing an excellent job here at Penn, but the whole dental profession has to come up to the table.

…We have a seven-year biodental program. You go to three years of college and you go to four years of Penn Dental School. We have [agreements] with Villanova and Penn and Muhlenberg and several other places. In the last two years I started one at Xavier in New Orleans and one at Hampton so that I could have a pipeline of students from the historically black colleges. It’s just started, but I’m hoping that we’ll start getting students from that pipeline.

Q. How has dental education changed since you became dean?
A.
When I came here, dental education was in crisis. Six dental schools had been shut down, a couple of more were going to be shut down, and in the ‘90s did get shut down. The applicant pool decreased to the point of crisis levels. And Penn’s dental school had gone through a year and a half of interim leadership, and the morale was low.

To my fortune, 1989, which was when I came here, was the bottom point of the applicant pool. And things turned around, the external environment [for dentists] improved. The need for dentists has increased, there is a shortage for dentists right now. The demographics changed—a profession that was 90 percent male has become, at least in our dental school right now, 50 percent female. And funding for dental research increased in the 1990s. All these things came together to make my job easier.

Q. Why did you decide to accept the Penn position?
A.
My motivation was to change dental education. I had been chairman of the department of oral-maxillofacial surgery at [the University of] Michigan and had run the residency program. And I had changed the oral-maxillofacial surgery at Michigan, and again at Iowa. This was a yet bigger challenge, and I felt that the quality of the institution and the legacy of the excellent dental school, that this would be a wonderful opportunity to impact on dental education.

Q. What sort of changes took place?
A.
I made the school, I think, more user-friendly to students. Traditionally dental schools had been not very user-friendly places to be for students. I’ve been an advocate of the students, I’ve made them more competitive, to move on to graduate and specialty programs. I’ve made it more user-friendly for them to stay in school if they get into academic difficulties.

Q. What do you mean by “user-friendly”?
A.
More user-friendly in this context is teachers that interact with students better. Remember, our teaching pool comes from dentists who are practitioners. And they have so much to give the students, but they may not have the pedagogical skills, because they weren’t trained as educators. So we worked very hard to impart to our faculty the importance of being an educator, and positive feedback, and working with the students, learning that students learn differently and at different paces and being more understanding and tolerant of these differences.

Q. Do you have any advice for your successor?
A.
Don’t take yourself too seriously. That sets the mood.

Originally published on January 30, 2003