U of M dental students bring smiles to underserved communities

Becky Klein needed a dentist for herself and her two teenage sons when she returned to Atlanta in northern Michigan after years living down state.

She settled on the Thunder Bay Community Health Service dental clinic. She felt fortunate to find dental care that came recommended and was only 10 minutes from her home, a very different situation for many people in this part of the state.

After her sons’ initial six-month dental check-up appointments, she was surprised to learn that the dentists were students from the University of Michigan School of Dentistry. They turned out to be just as competent and professional as seasoned practitioners, she said, and excellent communicators.

“I was really impressed with the whole clinic. … The appointment worked out like any other dental experience. And my boys were happy,” Klein said. “They communicated with my boys directly. They didn’t go through me, which was very nice.”

The three interns who work two two-week rotations with a month off back on campus in Ann Arbor are invaluable to the clinic—seeing 18 patients a day and helping keep up with 48 new patients making appointments each week, said Dana Arnold, dental operations manager at Thunder Bay Community Health Service. Under a contract with U-M, she manages the clinic and the interns that she selects from the U-M dental school’s Community-Based Collaborative Care & Education program.

Each year, the CBCE places batches of U-M dental school students in 17 federally qualified health centers across the state. Year-round, dozens of the interns join the clinics’ staff and work as pros, learning and being challenged by complex procedures while increasing options for care in communities that lack resources and access to dentists. Between 2004 and 2024, CBCE dental students completed 862,449 procedures valued at nearly $202 million.

Without our U of M interns, we honestly would not be able to serve the patients that we do.”

Dana Arnold, dental operations manager, Thunder Bay Community Health Service

Serving the community

In Atlanta, population 700 and the “Elk Capital of Michigan,” dentists are few and far between, like most rural areas. The Atlanta clinic and another smaller one in Onaway are part of the Thunder Bay Community Health Service network, which serves six counties-Alpena, Montmorency, Oscoda, Presque Isle, Cheboygan and Otsego.

Lack of access is a critical issue and worsening, Arnold said. The small number of dentists that there are are retiring, and lately, at a faster rate, she said. Many are closing their practices instead of selling.

Complicating the access issue is that many dentists no longer accept Medicare or Medicaid or they demand up-front payments, she said. About 50% of the clinic’s patient base relies on Medicare or Medicaid. Others pay with insurance or have payment plans.

Many patients drive as many as two hours for their dentist appointments at the Atlanta clinic, said Arnold, who has lived and worked in the area for decades and knows the landscape of federally funded health care well.

“Part of our collaboration that we have with the University of Michigan, not only is it meeting the needs of our patients for access, but it’s also a gateway for the interns to be able to see what we offer here in northern Michigan,” Arnold said. “When they come here for an internship they can see what it’s like to be in a small community, to work at a federally qualified health center. … We’re here to serve the patients of our community. I think that just brings a really different approach.

“I think you have some interns that come into it and they absolutely love it. And others are more private practice. But for those that love to be a servant to the community this is their avenue.”

Learning their profession and people

A day in the life of the Thunder Bay Community Health Services dental clinic has Hasan Khaliq, Mitchell Selin and Joey Wilmot—all in their final days before graduating from the U-M School of Dentistry—donning scrubs and medical gear and reviewing packed schedules each morning: a surgical extraction, a filling, a dry socket, a nervous pediatric case.

They go on to spend hours chair-side, each treating six patients daily, comforting them, educating them, often confronting complex cases, darting from chair to X-rays to consultations and completed procedure to completed procedure.

Khaliq, Selin and Wilmot are one step away from adding DDS to their names. After completing their time in classes and the on-campus clinic, they capped their education with internships at the Thunder Bay clinic, a coveted placement in the CBCE program.

For patients like Klein, it may have been hard to tell that these students, the latest from U-M to rotate through the Thunder Bay dental clinic, aren’t full-fledged professional dentists.

What’s clear, however, is that their experience has shaped them both professionally and personally—while also benefiting the local residents who may be turned away from the busy dental clinic if not for the interns.

Khaliq recalls caring for patients who seldom see a dentist, whose drinking water is nonfluoridated and who bring drastically different backgrounds, needs and experiences to their appointments. Many have family histories of going into dentures in their 20s and 30s, and see it as their only option.

“One of the main things is that patient access to dental care is very low … so one of things that stands out in my mind is you see these 12- and 13-year-old kids with bombed-out teeth,” Khaliq said. “One of the main things that stuck out is just seeing what kind of privilege we may have elsewhere and coming out here and seeing what ways we can help these people out.”

It’s a mutually beneficial relationship. The patients receive expert treatment from the freshly educated providers who are overseen by a professional and at prices they can afford. The students are exposed to patients and procedures, independent decision making and career-preparing experiences like never before. The clinic can care for more patients and make more appointments with the extra help of the students.

Selin called the internship “the highlight of my dental school experience. It’s really the first time we’ve been exposed to the real world.”

Arnold said that is the goal: “This is real life. They’re seeing the harder side of dental and that is their chance to make a difference, and coach and teach them that you don’t have to lose your teeth, that you don’t have to go into a denture. We want to teach them to prevent that from happening.”

Khaliq said the experience was even more than expected.

“Definitely this rotation at Thunder Bay has been one of the highlights of my fourth year in dental school,” he said. “I got to dive deeper into bread and butter dentistry, stuff I was more comfortable with and also experience new things that I’ve never done before.”

On the last day of his internship rotation, Wilmot said he was grateful for the growth.

“The biggest part of Atlanta for me has been the team atmosphere. You can see with a really high-quality team how well things run and just being able to trust your assistants, to bounce ideas off other clinicians … that’s been really influential in how I want to build my practice in the future.”

Chase McNamara, aka “Dr. Mack,” is a former intern who did his first and only two-week rotation in 2022 and decided he wanted to stay. He is now a licensed dentist and was recently named dental director of the Thunder Bay Community Health Service, and now leads the interns, along with other retired professional dentists.

McNamara had planned to move out of state to work in private practice after graduation.

“Looking at private practices it felt more like I was just a cog in the machine versus when I came up here,” McNamara said. “I realized if I wasn’t the one helping people then they weren’t going to be seen. The amount of appreciation people showed was extremely rewarding for me.”