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Top graduate’s sure bet: community dentistry

Reno, Nev.—Here, where it's not uncommon to play hunches and weigh the odds, Dr. Brandi Dupont left no room for chance.

"Once I found dentistry, I fell in love with it. Community dentistry is my passion. I love the work I do and the population I'm serving," she said.

In 2007, Dr. Dupont graduated from the School of Dental Medicine at the University of Nevada, Las Vegas, and immediately returned to Health Access Washoe County, a community health center in Reno where she is a staff dentist seeing a regular schedule of patients, plus 5 to 10 "work-in emergency patients per day."

This would not be very surprising except that Dr. Dupont graduated first in her class from UNLV's dental school. It's an accomplishment that typically sends the top graduate on to an orthodontics or oral surgery program, said Dr. Bernard Hurlbut, assistant professor of clinical sciences at UNLV and a former president of the New Mexico Dental Association. But Dr. Dupont's aim was clear from the outset, he recalls. "Her primary motivation is to serve others. She came to UNLV with the purpose and intent of returning to work in Reno with the underserved."

Dr. Dupont agrees, saying she's puzzled by all the attention paid to her postgraduate path. "For as long as I've known, I have wanted to help people in need. I knew that when I finished school, I wanted to work at HAWC providing community dental care."

Instead, she says, the focus should be on dentistry and public health. "Most dental professionals give back to their communities already," she stressed, but more assistance is always needed "to help the dental underserved in our communities, whether it is seeing Medicaid or pro bono cases once a month or volunteering for a local clinic. We especially need more help from specialists" whose expertise, she believes, could save more teeth.

HAWC's first dental clinic opened in 1998; last year, nearly 16,000 dental patients were served, 73 percent of whom are not insured. Most of her patients, said Dr. Dupont, can be described as the working poor; 35 percent have incomes at or below the 100 percent of the federal poverty level.

Dr. Dupont joined HAWC some 10 years ago as a grant writer. She had earned her bachelor's degree from the University of Nevada, Reno in 1995 and considered going on to medical school. Watching a former dentist colleague at work at HAWC and realizing that through dentistry, she could help children, in particular, convinced her to pursue her professional degree at UNLV. While in school, Dr. Dupont returned to HAWC to complete externships that helped her to "learn even more about community dentistry."

"She's the kind of person who was able to look around, see long lines of people in need, and realize what more she could do to help," said Dr. Debra Markoff, HAWC's dental director and Dr. Dupont's supervisor. Describing Dr. Dupont as "conscientious, hard-working and a joy to work with," Dr. Markoff adds that her colleague "helps to improve the image of public health and the quality of care."

Today, Dr. Dupont says her daily work consists of exams, extractions, fillings, oral hygiene and nutrition instruction, tobacco cessation counseling, some crowns and endodontics, and dentures. With some urging, she describes handling—and resolving—far more serious cases such as the woman who lost most of the use of her tongue due to surgery to remove laryngeal cancer. "Several of her teeth required extractions. We were able to restore the rest of her mouth with crowns, bridges and a mandibular partial denture. She has probably been my hardest patient to treat but one of the most fulfilling because I watched her move from hopelessness to hope in her future and what she can accomplish," said Dr. Dupont.

To those who question whether as a top graduate, she is now making the most of her skills and potential, Dr. Dupont is adamant. "I feel I am using my skills, talents and training to their best use. Community dentistry is difficult. You have to be able to see many patients (many in pain and with serious infections), make good judgment calls and sound decisions, and discuss multiple, often creative, treatment plans."

Dr. Dupont also points to the need for a "good background" across a list of specialties, ranging from oral pathology, oral surgery and pediatric dentistry to endodontics, prosthodontics and restorative dentistry, "because you may be the only dentist to provide care at an affordable price for the patients we see." In fact, she believes she's already outpaced many of her classmates in applying lessons learned to treat pathologies that her former professors presented "just in case." In community dentistry, she adds, "what you thought you might never see, you will."

Dr. Wendy Woodall, associate professor in residence at UNLV's School of Dental Medicine, describes Dr. Dupont as a "shining example" of targeting education to address the underserved. The state of Nevada has recognized the need for more dentists in this state and invested in the growth of dental education at UNLV, said Dr. Woodall. "Our students are very active in the communities of Nevada and even internationally. Achieving an excellent education gives them the skills to operate with confidence in the isolated areas where they are most needed."

Dr. Dupont plans to continue working at HAWC and "provide the very best care to my patients." Returning to Reno also has enabled her to spend more time with her husband and now 15-year-old son, a soon-to-be high school sophomore. The years spent commuting between home and Las Vegas to complete dental school meant missing some of his earlier experiences, but she says her family has been very supportive. "My son thinks what I'm doing is great. I hope I can be an inspiration to him to want to give back to the community as an adult."

Her future plans may include pursuing a master's degree in public health. "I would like to find more opportunities to increase access to care in my community," she said. "Nevada has a lot of outlying areas and rural communities that lack access to care and education about dental health. I would love to work in those communities."