A brush with dentistry: Social worker at the UB School of Dental Medicine’s clinic helping patients and students meet their needs
If you look at descriptions for standard medical social worker jobs, you probably won’t see “dental clinic” listed among the more likely settings—those generally include hospitals, nursing homes, and rehab centers. But, based on the work of the C.A.R.E.S. Program, led by Julie Rockmaker MSW ’07 at the UB School of Dental Medicine’s Dental Clinic, it’s a natural (and necessary) fit.
C.A.R.E.S. (Counseling, Advocacy, Referral, Education and Service) was founded around 2001 by one of Rockmaker’s Buffalo State undergraduate professors—Rockmaker actually did her graduate field work with that professor, working on an American Dental Education Association conference poster presentation about the program. It took her a while to end up back there on staff.
Rockmaker grew up in Rochester. Her mom was a nurse—hearing stories of helping others inspired her, but she didn’t want to strictly follow in her mother’s footsteps. When she started researching majors, though, she knew that she wanted to be in a “helping profession.” “Social work was on my radar as a possible career,” said Rockmaker. Upon entering Buffalo State, she took a few classes and liked it.
She ended up earning her masters at the UB School of Social Work with a concentration in community-based work. (This was before the school shifted from curriculum concentrations to an integrated trauma-informed and human rights perspective, which was in 2009.)
“I was more interested in the idea of potentially helping communities versus engaging on the individual or family level,” she said.
When she first got out of grad school, she joined AmeriCorps for a year, and upon her return, took a job working with victims of domestic violence. “I ended up doing more one-on-one social work in that situation,” she said. “So, when the opportunity came up at the Dental School, especially because I knew about the program both from my undergraduate experience and my graduate fieldwork, I thought it might be a good fit.” She’s been in her position since 2012.
Now, her days contain a lot of variety. There can also be challenges with balancing both the Dental Clinic patients’ needs and helping ensure that the school’s dental students, who are providing the dental care, can meet their curricular requirements, which is one of the main purposes of the clinic.
She gets referrals to patients from those dental students (a.k.a. future dentists), whose curriculum includes elements to enhance their awareness beyond their patients’ teeth, gum and mouth health and treatment, to their more general health and social needs.
The Dental Clinic sees thousands of patients a year—many children and youths through their school-based programs, and adults at their clinic on UB’s South Campus. Costs for care at the clinic range from 30 to 65% lower than they would be at a private dental office. The clinic accepts all insurance, and also accepts patients with no insurance. It does not refuse care to anyone for financial reasons.
“UB dental students are learning to become aware that patients may have ‘access to care’ issues; they are also learning how to identify those needs, maybe from conversations with patients during treatment,” said Rockmaker. “When a student refers a patient to me, or if a patient asks to see me because of concerns about accessing care for financial reasons, I talk with them about their options.”
“We can help them apply for insurance, including Medicaid, if they qualify. And, I can assess them to see if they are experiencing other barriers to dental care,” she added. “I work mostly with older adults from lower income populations. They are on Social Security, with average monthly incomes of $1,500 or less. I also help with pediatric patients. Most of those patients, families with children, are on Medicaid.”
Other barriers to care could include basic needs, like food, heat, and transportation. “I also ask about their life circumstances,” noted Rockmaker. “I try to find out if they are in an abusive situation, if they have thoughts of hurting themselves, if there are any mental health or substance abuse issues.” Referrals for appropriate services are made to a variety of community partners in those cases.
When the need is strictly financial, there are also internal solutions, like school-funded grants and individual donations that can help cover or offset the cost. In the course of addressing these needs with patients, she occasionally becomes a de facto financial counselor.
“I’m working in a goal-driven way to empower clients—I review the plan for their dental needs with them,” she said. “We go over a budget, see what amount they can pay for, and what we can help with. I don’t fill out applications for them—if they need to apply for insurance, I guide them every step of the way.”
Her UB education has served her well. Earlier in her work at the Dental School, she drew on skills and knowledge from a School of Social Work grant-writing course, to find and successfully apply for grant money. And she constantly practices community-based interventions—subconsciously at this point—that she learned through her coursework. “Also, as part of the UB educational community now, I enjoy work inter-professionally at the dental school; being a social worker and working to bridge that gap,” she said.
And in a more personal way, she frequently hearkens back to a connection to her education: “In one of my UBSSW community classes, we did a project in a Buffalo neighborhood,” she explained. “The ZIP code that I picked ended up being on Jefferson Ave., which is a lower income area. As part of that grad school project, I remember going into some of the businesses and talking to people there. Between home, work, and my daughter’s school, I drive down Jefferson every day. Now I feel like I’m part of that community.”