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By Karen Fox

Two new dental schools are in the works—one in North Carolina and the other in Arizona—and recent developments show both are likely to become a reality.

Officials at the East Carolina University and the University of North Carolina at Chapel Hill are working together to develop plans that would significantly expand dental education in North Carolina, including a new dental school on the ECU campus in Greenville.

In the next six months, Midwestern University—a private, not-for-profit, health care university—will begin building a dental clinic for its new dental school on the university's Glendale, Ariz., campus.

Last month, the University of North Carolina board of governors approved a legislative request for $7 million in planning funds for a joint dental education proposal that calls for a dental school at East Carolina University, expands the capacity of UNC-Chapel Hill School of Dentistry from 80 to 100 students a year and finances the replacement of two outdated facilities at UNC-Chapel Hill.

"The new UNC-Chapel Hill dental sciences building will focus on state-of-the-art teaching facilities and technologies, basic and translational research, and entrepreneurship and economic development," said Dr. John N. Williams, dean of the UNC School of Dentistry.

ECU and UNC-Chapel Hill are two of the 16 campuses in the University of North Carolina system.

The plan goes to the state's general assembly for approval during a session that begins this month. If all goes well, the UNC board of governors will have final say on the proposed new dental school in November.

"We are working collaboratively in the university system with Chapel Hill to find ways we can each play to our strengths and improve oral health in North Carolina," said Dr. Greg Chadwick, ECU's associate vice chancellor for oral health and a past ADA president. "There are many things we can do collaboratively such as distance learning, and we're exploring all of those options."

There could also be opportunities for collaborative research between ECU and UNC-Chapel Hill, said Michael Lewis, M.D., ECU's vice chancellor for health sciences.

"We are excited about the collaborative process and we think it will be win-win for both institutions and the citizens of North Carolina," said Dr. Lewis.

North Carolina is facing a shortage of dentists, say ECU officials. The state ranks 47th in the nation in the dentist-to-population ratio. Four counties have no dentists and 28 have two or fewer practitioners.

The ECU component of the plan includes at least 10 rural dental health clinics in eastern and western North Carolina. ECU's dental school would be modeled on the university's Brody School of Medicine, a program that has been highly effective in training primary care physicians who stay in North Carolina to practice. Nationally about 30 percent of all medical students pursue careers in primary care, say ECU officials, compared to about 76 percent of ECU medical students.

"We will be looking for students from North Carolina who want to practice as general dentists in rural and underserved areas of the state," said Dr. Chadwick.

Pending approval of the UNC board of governors later this year, the first class of 50 dental students is projected to enroll around 2010.

Midwestern University's board of trustees approved a plan in February to found the Midwestern University College of Dental Medicine in Glendale, Ariz., and named Dr. Richard Simonsen, a former faculty member from the A.T. Still University of Health Sciences, Arizona School of Dentistry and Oral Health, the school's first dean.

The dental school is part of a $140 million expansion of the university that is the largest in the school's history.

Among its health science education programs, Midwestern University offers degrees in osteopathic medicine, pharmacy, podiatry, biomedical science, and occupational and physical therapy. Midwestern has campuses in Downers Grove, Ill., and Glendale, Ariz.—where the dental school will reside.

"There is an extensive campus here in Glendale with all the basic sciences necessary for dental pre-clinical education available as part of the university," said Dr. Simonsen. "We expect that our simulation clinic and offices will be here on the Glendale campus with a new building slated for construction in the next six months."

The dental school will help provide access to dental care for the state's low-income populations, said Dr. Simonsen. Thirty-one percent of Arizona children have never had a dental checkup and 42 percent of Arizona seniors have bleeding gums and/or calculus present, he added.

Midwestern University officials have a "forward-looking perspective" on the school's dental clinics, said Dr. Simonsen.

"We are a traditional model dental school, but we recognize the need for our students to be out in more than one community in order to learn how to treat various patient populations," he said. "Should we be ultra-traditional and have a big clinic on campus here, or should we place the clinic somewhere where dental treatment is needed, near our patients? And why should we have one clinic? We may need two, three or four smaller clinics of perhaps 50 chairs each."

The university is also considering new cross-discipline clinics where dental students treat patients alongside medical, podiatry and pharmacy students.

"We are very excited about this new opportunity," said Kathleen H. Goeppinger, Ph.D., Midwestern University president and chief executive officer. "We are only a health care university, and one of the things missing in our mission was dentistry."

Funding sources for the dental school include cash reserves, grants and tax-exempt bonds, said Dr. Goeppinger. The project is one of the largest in the state's higher-education history, exceeding the $122 million for a University of Arizona medical school in Phoenix.

The university has an excellent credit rating, added Dr. Goeppinger. "We spent a number of years to make the commitment to do a first-class dental program," she said.

Midwestern University is preparing its dental accreditation process now and hopes to matriculate its first class of 100 students in 2008.

Dr. Rick Valachovic, executive director of the American Dental Education Association, does not see the two new schools as a sign that dental education is safe from the financial pressures that led to seven closings in the past 20 years.

"All of us are aware of the prominence of the access to care issues in the United States," said Dr. Valachovic. "Whether these new schools are the result of a workforce shortage or a maldistribution, we believe that all of the factors related to the problem should be considered, and new schools be developed only after careful deliberation of the alternative options."