Meharry Medical College School of Dentistry Celebrates 125 Years
The new dean and a veteran professor reflect on the past while looking to the future of this service-based African-American institution.
Meharry Medical College in Nashville, Tennessee, is the largest private, comprehensive, historically black institution for educating health professionals and scientists in the United States. Many of its 218 full-time faculty members in its three Schools—Medicine, Dentistry, and Graduate Studies and Research—are among the most eminent in health-science education and clinical research. Meharry’s student body includes nearly 800 students from 43 states, the District of Columbia, and 22 nations. The School of Dentistry admits approximately 55 students each year into its pre-doctoral program, and has two post-doctoral programs, Oral and Maxillofacial Surgery and General Practice Residency. Additionally, it is a National Institutes of Health-designated Regional Research Center for Minority Oral Health—a recognition that only three other institutions have achieved.
As Meharry celebrates its 125th anniversary this year, Inside Dentistry sat down with one of its pediatric dentistry professors—an alum well known on campus as a Meharry history expert—to learn about the school’s rich historical roots, and its new dean, who is keeping the past firmly in mind while steering the school and its noble mission into the future.
Edwin H. Hines, DDS, MSD, a Meharry graduate who returned to his alma mater and is now a retired emeritus professor of pediatric dentistry, has a special interest in Meharry Medical College’s history. He recounts for us what he calls “the highly romanticized story” of its founding. As the story goes, in the 1820s a young white man, Samuel Meharry, sought the aid of a family of freed slaves after his salt wagon fell into a ditch near the former slaves’ home. Despite considerable risk to their own safety and freedom in the pre-Civil War South, the freedmen gave Meharry food and shelter for the night and helped lift the wagon from the mud the following morning. Upon his departure, Meharry promised to reward their assistance by doing “something for your race.” Fifty years later—long after Samuel and his brothers had become wealthy Ohio farmers—the five Meharry brothers provided a significant amount of money and land, which, along with contributions from the Freedman’s Aid Society of the Methodist Episcopal Church, led to the founding of the Meharry Medical Department of Central Tennessee College in 1876; the dental school opened 10 years later. The Meharry Medical Department was chartered separately in 1915.
Hines, who is busy putting together a museum to commemorate Meharry’s storied history, makes it clear that while the Meharrys made good on their promise, they were not even the main contributors that made the college possible. However, the institution that now bears their name addressed a critical need to provide care for an underserved population—the newly freed slaves—who, due to their isolation after the Civil War, suffered outbreaks of deadly illnesses such as typhus and cholera. “We like to describe this all-black medical school as the first public health effort, which was sorely needed to take care of the African-American population then.” This, he says, was the genesis of the school’s mission: Worship of God through Service to Mankind. “From the very earliest days to today, this institution has focused on a population that was underserved. We continue that tradition to this very day.”
The New Dean at the Helm
This mission, of course, is supported by Janet H. Southerland, DDS, MPH, PhD, who assumed the deanship of Meharry Medical College in March 2011. Although her entire education and previous academic career took place at the University of North Carolina at Chapel Hill, Southerland is proud of Meharry’s history, tradition of service, and its role in training a significant proportion of the African-American dentists now in practice and in academia throughout the United States. “Meharry is known for educating African-American dentists, who still make up about 80% of our student population. My hope is that many of our students will go into practice, but that even more will go into research and education.”
Southerland herself entered academia early in her career and says her posts at UNC—where she was Chair of Hospital Dentistry, Chief of Oral Medicine, and Director of Hospital Dental Service—as well as her education, which includes a master’s degree in public health, prepared her very well for her current position as dean. “Everything that I’ve ever done fits into this spectrum of where I’ve been and where I am now.”
Her positions at UNC, she says, were both highly administrative and highly clinical. “In addition to teaching students, I served on high-level administrative committees within the hospital and as a liaison between UNC hospitals and the dental school.” This, she says, gave her “top to bottom” exposure to the dental profession and familiarity with the many mantles she’s taken on at Meharry. “I’m comfortable in the many layers I engage in from an administrative level, from a teaching level, from a mentoring level, and from a clinical patient-care level.”
A tenured professor in the Department of Oral and Maxillofacial Surgery, Southerland still enjoys working with students and is amused by the impact her presence in the clinic has on both students and patients. “Working alongside students and residents to treat patients may be a little scary for students, but it makes the patients feel special and it’s fun for me,” she says.
The Focus on Excellence
Having just completed the first year of her deanship, Southerland says her focus is simply on achieving excellence within the three main areas within the school—dental education, scholarly research, and service. “I would like to see our faculty, students, and staff be as excellent as they possibly can in all of those areas, and that is my vision for the School of Dentistry,” she says.
Asked about the changes she’s seen in dental education since her own days as a dental student, Southerland says today there’s a greater need for students to be aware of the larger picture, a picture in which she includes the challenges surrounding disparities in oral healthcare, the rising cost of care, and the changes that are taking place in the dental landscape as oral healthcare continues to clarify and strengthen its link to systemic healthcare. What absolutely needs to be considered, she emphasizes, is the paradigm shift to overall health and well-being. “Students need to know that, as dentists, we need to be more than oral diagnosticians because the patients are coming into the clinic or practice with more than their mouth; they are coming as individuals, so we’re spending a lot more time trying to bring that to the forefront of new dentists’ training.”
Southerland also points out a welcome return to emphasizing social responsibility and accountability. “With that increased emphasis on social responsibility there has been a stronger focus on critical thinking and ethics—how we make decisions and use the trust of the public as it relates to the care we provide.”
The Changing Role of Dental Clinicians
Southerland notes that another major change in the structure of the profession appears to be on the horizon, and that is modifying the role of clinicians from “drilling and filling” to focusing on risk assessment and prevention. She points to the hot-button topic of paraprofessionals training as dental therapists, with the first class of these mid-level providers having recently graduated in Minnesota. “Right now there’s a lot of controversy about this—whether the program will be accredited, whether the graduates will be licensed, and how they could change dentistry.” That such potential new members of the dental team might someday soon be undertaking many of the technical tasks dentists now perform—including fillings, simple extractions, cleaning, and dentures—begs the question: What will the role of the dentist become?
Southerland suggests that regardless of the fate of the dental therapist, there is clearly a role for expanded-duty auxiliaries in increasing capacity and efficiency in the delivery of dental care. “The new healthcare paradigm demands looking at the whole individual and handling tasks that are more diagnostic—developing a plan for how to care for the patient, and how to prevent disease.” Whether this shift is a result of the migration from “silo” type thinking or greater success in prevention and treatment, Southerland herself would welcome the opportunity to put into practice initiatives that could improve patient health. “We want to get more and more away from treating disease to preventing it, rewarding positive steps with incentives for people to be healthy, not sick.”
Serving the Community by Engaging the Community
Southerland, whose public health background and research focused on the link between between diabetes and periodontal disease, hopes to advance a preventive oral healthcare agenda by engaging the community and the general public and doing more public awareness-type campaigns and educational programs for the adult population in Tennessee. “Based on the research I’ve done and the information I know about the impact of diabetes and periodontal disease on the cardiovascular system, it’s clear that people need to be aware of these issues.”
She explains that public education is especially important in Tennessee, which doesn’t provide adult dental Medicaid, making it difficult for those in need to obtain dental care. However, a hurdle to be overcome, she says, is connecting with these individuals. “They also need to know that you care. So any planning that goes into providing that message has to engage and involve those communities,” she says.
Like Hines, Southerland sees Meharry’s mission statement as a call to action. “All that we do or look to do in the community—locally and nationally and internationally— is to meet that mission and motto, which is instilled in our entire system.”
The Commitment to Diversity and Public Service
Southerland explains the unique features of Meharry, not only as a historically black institution, but that it is strictly a health-science campus, with a medical school, dental school, and graduate school, but no undergraduate school.
“Collaborations and partnerships are part of the Meharry mission and motto,” she says, adding that while there is not yet a formal program, students often participate in mission trips in underserved areas outside of the United States. “We are currently working on a formal program, so that students will have an opportunity to see real poverty. Although poverty does exist in this state and across all of the United States, seeing places where people are just barely surviving provides an entirely different perspective—and it reinforces what they’ve learned and why they’ve learned it,” she explains. She shares that a Meharry faculty member was among those who helped rebuild the dental school in Haiti destroyed in the 2010 earthquake, which also took the lives of half of its students. “She helped get it back up and running with donated equipment, money, and when the school graduated its first class, she was invited to attend as an honoree and commencement speaker.”
Hines says that Meharry’s history and mission factor significantly into student selection. “Before we grant acceptance to our students, we want to know why they want to be dentists, what they want to contribute to the profession, where they’re planning to go into practice, what they’re going to do. While, of course, prospective students must demonstrate the academic ability to complete our curriculum, grades are not the sole entrance criteria; a true desire to improve the common good through a demonstrated commitment to service to the underserved is equally important. And a very high percentage of our students will go to underserved areas to practice after they graduate.” He is especially pleased that his own emphasis on pediatric dentistry has borne fruit. “When I returned to Meharry, I could identify five African-American pediatric dentists; now we have 88, and according to our own study, 80% of them have gone to underserved areas to practice,” he says proudly.
The Impact of Demographics
Southerland believes the demographics of dental schools across the country are changing, noting a nationwide increase in applications and a greater interest in the dental profession. “Dentistry has become a very popular profession. People see the impact dentistry can make—not just the on the oral aspects but on lives,” she says.
She observes that diversity in the profession—once a white-male bastion—has been impacted by an enormous increase in women, but she recalls that she was one of only four African-American students admitted in her first-year class at UNC’s dental school in the 1980s. She expects the profession to become more ethnically diverse in the future, especially as the profession ages. “There are a significant number of baby boomers who are getting older, so we have an aging faculty and an aging profession.”
Meharry’s impact on diversity in the profession, she says, will continue to be significant. “I think we’ll impact education in the next decade in that we will still be providing the most minority and African-American dental professionals in the country.”
Planning for the Future
Looking to the future, Southerland says her short-term objective is to bring the school more into line with the growing trend toward being competency-based, but the longer-term goals—the 5- and 10-year marks—are more ambitious. The 5-year plan, she says will be greatly impacted by the fact that the dental school will be due for an accreditation visit in 2014. “This means most of the standards we’ll be accredited under will be new and will help to dictate the content of academic programs, although we can be as creative as we want in developing them.” However, her goals for the 10-year mark will be to make wider-reaching changes. “My hope is that we’ll be able to introduce a lot more innovation in our academic programs and a lot more interaction with our community,” she says.
This entails moving away from what she calls “the bubble,” where students still receive a significant portion of their training. “It’s important for them to spend a lot more time outside in the real world and understanding the politics and policy of what goes on, how that trickles down to them, and how they interface with their communities as oral healthcare providers and practitioners.”
For more information on Meharry Medical College School of Dentistry, “Where Excellence is Standard and Service is an Obligation,” visit www.mmc.edu/education/dentistry.
THE COMMITMENT TO COMMUNITY CONTINUES Some of the old photographs in Meharry's historical collection show how far the school has come in imparting a state-of-the-art dental education while holding true to its mission-minded core values. Today, Professor Edwin H. Hines, DDS, MSD records Meharry's storied history while Dean Janet H. Southerland, DDS, MPH, PhD, charts a new path for Meharry's future.