By Anne Blythe
As Tropical Storm Ophelia showered the North Carolina Piedmont with a windy drizzle Saturday, dozens of people at High Point University gathered inside the Congdon Hall auditorium for an unusual ceremony.
After several years of planning, campus leaders and guests were ready to break ground for the new Workman School of Dental Medicine. The weather wasn’t cooperating, so they headed indoors, where 10 gleaming shovels on a table awaited them near a shallow dirt-filled pit on the patterned carpet.
“I’m not sure we’ve ever done a groundbreaking in another building,” President Nido Qubein told the crowd before turning the soil. “This is a big step. A really, really big step. You can do a lot of things at a university, but when you start talking about dental medicine, you are talking about something big.”
The indoor groundbreaking was not the only extraordinary part of what was happening at the High Point campus.
The new dental school, scheduled to open to 60 students in the fall of 2024, will be one of only three such academic programs in North Carolina — and the only one at a private institution. UNC Chapel Hill and East Carolina University house the state’s two public dentistry schools.
The UNC dental school was established in 1950, the first in the state. Sixty-one years later, ECU enrolled its first students in a state-funded dental program created to address a shortage of dentists in rural North Carolina. In the lead-up, there had been much debate among dentists and others about whether the state needed a second dental school, even though at the time, North Carolina had one of the lowest per capita rates of dentists in the nation.
Not just ‘another dental school’
Planning for the third dental school, at High Point University, has been in the works for nearly a decade and a half. The Great Recession sidelined the project for a while, but momentum picked up again several years ago.
Scott de Rossi, founding dean and professor of the High Point dental school, was dean of the UNC dental school when he first was approached about the new project. Initially, he was reticent.
“I had no interest in creating ‘another dental school,’” de Rossi recalled in a phone interview with NC Health News.
While dean of the UNC dental school, de Rossi and some of his younger colleagues tried to “do some innovative things,” he said. But entrenched bureaucracies and the slow-turning wheels of government funding for long-established public university programs often made cutting-edge change difficult, he added.
So when de Rossi found out High Point University was willing to entertain the development of a different kind of academic model, he drafted a business plan.
Then the opportunity to build a program from the ground up lured him away from his deanship at UNC after four years on the job and into uncharted territory in High Point in January 2021.
Trying a new model
One of the drivers of the new model is the development of High Point University satellite dental practices throughout the Triad.
The city of High Point straddles four counties — Guilford, Randolph, Davidson and Forsyth — all of which are considered dental health professional shortage areas, according to the Rural Health Information Hub.
For several decades, North Carolina has ranked in the bottom 25 across the country for the number of dentists per 10,000 people in the state.
In 2001, according to a report compiled by the Cecil G. Sheps Center for Health Services Research at UNC Chapel Hill, the state was ranked 47th in the country with only 4.2 dentists for every 10,000 residents. There was a bit of improvement by 2013, when North Carolina was 44th in the country with 4.8 dentists per 10,000. The numbers climbed to a ranking of 37 in 2017, and by last year the state was 24th in the country with 5.6 dentists per 10,000 people, slightly lower than the national average of 6.1 for every 10,000 residents.
Most of the dentists who practice in North Carolina, who were not educated at one of the state’s two dental schools, are from Texas, South Carolina, Virginia, New York and the nation’s capital, the Sheps Center report found. Dentists who leave North Carolina head to Virginia, South Carolina, Texas and Florida, the report said.
The state added 586 dentists between 2017 and 2021, but they were hanging their shingles mostly in urban counties. Sixty percent, or 351, went to five counties — Durham, Guilford, Mecklenburg, Pitt and Wake. Another 20 percent, or 119 dentists, were added to the rosters in Brunswick, Moore, New Hanover, Orange and Union counties. Only 116 dentists went to the other 90 counties.
Forty-five percent of the population growth from 2017 to 2021 was in Durham, Guilford, Mecklenburg, Pitt and Wake counties, according to the Sheps Center. Those same counties account for nearly a third of the state’s overall population of almost 10.7 million people.
Care in the community
There are five dental practices in High Point University Health, an LLC owned and operated by the university, according to de Rossi. The goal is to have 30 practices in the network within a 60- to 65-mile radius of High Point, helping to address shortages in some of the areas that don’t have a wealth of oral health care providers for the size of the population.
In addition to serving counties in need of more dentists, the satellite offices will provide opportunities for HPU dental students to get hands-on experience as part of their clinical rotations during their years at school. Additionally, some of the revenue from those businesses will go to the dental school to help offset costs.
A $32 million gift from the Rick and Angie Workman Foundation also will go a long way to helping with building and operational costs.
Rick Workman, founder of Heartland Dental, a network with more than 1,650 offices across the country, was in High Point on Saturday for the groundbreaking. He recalled his first meeting with Qubein and how drawn he was to the didactic philosophy the president had for the dental school he wanted to build.
“Some of us of a certain age have memories of our education in dentistry — and I know it’s come a long, long way since then — but back in the day, it wasn’t very humanistic, and we weren’t really valued as people,” said Workman, a 1980 graduate of the Southern Illinois University dental school. “It seemed like sometimes, maybe it was just for me, that the things you needed to learn was kept a mystery. … I understand it’s supposed to be difficult, but it doesn’t have to have psychological trauma with it.”
Workman talked about training dentists to have community leadership skills, compassion and understanding of the science and technology needed to run a modern dental practice.
“They need to know that while they have to learn the sciences, and they have to learn the technical clinical skills, that to learn that leadership and interpersonal communication, how to lead a team, your staff, how to interact with patients, how to be a valued member of your community, is very important to yourself, very important to the dental profession,” Workman said.
Workman told the crowd gathered for the groundbreaking that he never dreamed coming out of dental school that he would be in the position he is today to be able to contribute to the development of a new dental school.
“When I entered dentistry, it was 98 percent male, 98 percent white,” Workman said. “My class had the highest percentage of women in the United States, 15 percent. That was seven. Two of them were named Luanne.”
“But by the late ’80s, one could begin to see that tuitions were coming up, women were rapidly advancing as a percentage of the population, it was becoming much more diverse,” Workman added. “And you could see, I felt, that how it had always been done — that dentists graduate, put out a shingle, spend 30 to 40 years of their life in one community, in one office — that might not be how it’s going to be for the next 40 years.”
The Workman School of Dental Medicine will be housed in a 77,000-square-foot building with labs that have mannequin and haptic-augmented reality simulation, which has been described as something similar to a flight simulator that can replicate the feel of a real tooth and its pulp.
In some of the more established dental schools, students practice their skills on patients, often not hearing from the practitioners overseeing them until after they’re done with a procedure. At some schools, students practice on plastic teeth placed inside a fake mouth, which might not reflect distinctions they encounter when working on someone in the chair.
The haptic simulators, de Rossi said, will give High Point University dental students feedback in real time as they try procedures virtually before testing their skills on people.
State-of-the-art technology and innovation were common refrains at the groundbreaking ceremony, which happened nearly a month after the Commission on Dental Accreditation gave the Workman school its initial accreditation, a longer than anticipated process because of a pandemic backlog.
Annual tuition and fees will be $85,000 to $89,000, lower than some other private schools and less than the 2021-22 national private tuition average of $92,850. It will be higher than the public school in-state average of $55,000. Although 60 students will be selected from the 1,000-plus applicants for the inaugural year, the school eventually could accept as many as 80 students in each class, according to de Rossi.
The admissions process is touted as one that won’t require standardized tests or prerequisite courses. There also won’t be application fees, although an Acuity Insights assessment will be necessary, and applicants will have to pay its associated cost.
While the new campus building is going up, the school will be in the former chamber of commerce building, which was purchased by the university in 2022. Construction is scheduled to be completed in 2025.
“We are here for a groundbreaking, but I would like for you to reflect on the word,” de Rossi told the crowd, pointing out that the word is defined in the Cambridge Dictionary as “innovation or innovative and likely to have an effect on how things are done in the future.”
“The Workman School of Dental Medicine will be groundbreaking with its innovative care curriculum, its novel admission processes, its unprecedented oral health networks distributed across the Triad, across the state, delivering care to the citizens of North Carolina, ensuring our students receive pre-eminent clinical and didactic education in authentic environments,” de Rossi said. “We will be relentless in our pursuit of integrating medicine and dentistry to improve health outcomes. And with a state-of-the-art, 77,000-square-foot building, we will discover, develop and deliver better health.”