Minnesota- Apple Tree Dental - Mounds View- AEGD

Health Center Contact: 
Chandra Stapher (cstapher@appletreedental.org). Chandra is our AEGD on-site program coordinator. 

Name of Training Site:
Apple Tree Dental Mounds View Center for Dental Health

What is the mission of your training site?
Apple Tree’s mission is to overcome barriers to oral health! Our AEGD residents are integral members of the Mounds View dental health care team: a team that works collaboratively to provide needed dental and preventive services and improve patients’ access to care.

What types of dental services can I expect to perform? 
Residents at Apple Tree Dental work with highly skilled faculty to perform a myriad of dental care services across the dental disciplines, except orthodontics. Residents can expect to enhance and expand upon their skills acquired in dental school through the provision of advanced services in pediatric dentistry, periodontics, endodontics, fixed and removable prosthodontics, operative, oral surgery, oral medicine, and implant restoration. Residents will receive experiences in the delivery of dental care services for patients undergoing IV sedation and observe care delivery to children undergoing general anesthesia. Interacting with and observing nurse anesthetists and dental anesthesiologists at the Mounds View Center for Dental Health is an experience highly valued by the residents.

The residents’ confidence in their diagnostic and restorative skills, as well as their ability to interact with others across the health care spectrum in obtaining useful medical consultations and making necessary referrals, will mature exponentially over the residency year! Equally, the residents’ self-assurance in individualizing preventive oral health plans and communicating proficiently with a wide range of patients and educating them will become second nature. They will receive experiences in assessing and managing dental trauma, and become adept and efficient at managing patients’ dental pain and infections.

What types of technologies can I expect to use? 

Apple Tree’s Mounds View Center features state-of-the-art facilities. Technologies available to the residents include:

• Cone-Beam Computed Tomography
• WaveOne® rotary endodontic system, and GuttaCore warm obturators
• Elements™ IC Obturation System (Kavo Kerr)
• SonicFill™ bulk fill composite resin system
• CariVu™ caries detection device (DEXIS)
• VELscope® Vx System - an oral cancer screening device
• Pioneer Elite™ Diode (Soft Tissue) Laser
• Piezosurgery® - ultrasonic means to perform osteotomy and osteoplasty procedures (Mectron)
• Electrosurgery unit
• Zimmer Biomet implant system
• Alginate-only impression technique for removable prosthodontic cases (residents become proficient in complete denture fabrication).
• EHR called “Open Dental” - an open source dental record system
• Patient Safe Handling Equipment:
  • DentalEz dental chair with air-glide base for easy manuevering & ergonomics
  • Liko Lift (Adaptive Specialties) and GoLift Patient Lift (Amico) Overhead Lift Systems - to facilitate safe transfers of wheelchair dependent patients to/from a dental chair
• Equipment in response to the COVID-19 Pandemic (for patient & staff safety):
  • ADS Extraoral Dental Suction System - Residents will use this extraoral suctioning unit whenever dental procedures creating aerosols are performed. It has HEPA filtration & UV light to mitigate aerosols and purify the treatment room air.
  • Needlepoint Bipolar Ionization Technology - a system added to the clinic HVAC system to improve air quality and purify the air.
  • PPE: N95 Respirators, ASTM Level 1, 2 and 3 surgical masks, face shields, insolation gowns, hair bonnets, etc.

What is the patient population? 
As a nonprofit community clinic and critical access provider, Apple Tree addresses the unmet dental care needs of underserved individuals of all ages and abilities, and provides a dental home for many low-income children and families, adults with disabilities, persons with mental health conditions, veterans, frail elders, and others with special needs.  Approximately 80% of Apple Tree’s patients are on medical assistance programs. Apple Tree has accessible treatment rooms, two oral surgery suites equipped with IV sedation & general anesthesia capabilities, along with adjacent recovery areas.

What is life like outside of the training site? 
Minnesota is affectionately known as the “North Star State” and the “Land of 10,000 Lakes.”  With a population of roughly 5.6 million residents, Minnesota has a high standard of living, a great education system and beautiful natural scenery.  Minnesota boasts a number of exciting things to do outdoors and has 66 state parks, Voyager National Park, the Boundary Waters Canoe Area, and more than 4,000 campsites. Its oldest state park was established in 1891 at Lake Itasca, the headwaters of the Mississippi River. Several scenic roadways provide breathtaking views of the river bluffs and natural habitat of the Mississippi and Minnesota rivers, the “North Shore” of Lake Superior, and beautiful vistas of Minnesota’s southern farming region, and the pine and deciduous tree forests and lakes of northern MN.

During spring, summer and fall, Minnesotans enjoy lake time and activities such as water skiing, boating, kayaking, canoeing, fishing, and more.  Hiking and biking opportunities are never scarce, particularly with a number of designated paths throughout the metropolitan area. Minneapolis is known as the “City of Lakes” and boasts miles of pathways connecting all the lakes for eager bikers and hikers. In the wintertime, Minnesotans engage in ice and snow sports, including skating, skiing, snowshoeing, snowmobiling, ice fishing, hockey, curling, and more. 

Apple Tree’s Mounds View Center for dental health is only 15 minutes north of Minneapolis and St. Paul (also referred to as the “Twin Cities”). The Twin Cities metropolitan area, with a population of 3.6 million, is a center for business, industry, education, government, art, and transportation. It has a vibrant theater scene, as well as an impressive collection of eateries, breweries, and distilleries to satisfy any palette and budget. The Twin Cities are also home to the University of Minnesota and Golden Gopher athletic teams, and several professional sport teams, including the Twins (baseball), the Vikings (football), the Timberwolves (men’s basketball), the Lynx (women’s basketball), the Wild (hockey), and Minnesota United (soccer).

Near the Mounds View Center, residents can expect to find safe, quiet residential areas and easy driving access to freeways and highways. There is a public library, movie theater, bowling alley, community center, police station, coffee shop, grocery store, pharmacy, and a number of restaurants, all within walking distance to the Mounds View Center for Dental Health.

Will residents have the opportunity to restore and/or place implants at your training site? 
Residents will definitely receive experience restoring implants. They will also learn about and gain experience with the Zimmer Biomet implant system used at Apple Tree. They will work closely with a faculty mentor who has over 20 years of implantology experience, and belongs to the International Congress of Oral Implantologists. This faculty member also provides complex oral surgery care, with which the residents will gain experience.

Will residents treat children in your training site? 
Residents will have ample experiences providing dental care to children!  They will be mentored by experienced general practice faculty as well as a board certified pediatric dentist faculty mentor. This pediatric specialist will facilitate a pediatric dentistry literature review and seminar series with the residents, and will teach and supervise the residents when treating more challenging children with behavioral issues. Indeed, the residents will complete the residency year confident in their abilities to manage the difficult pediatric dental patient!

Apple Tree’s clinical staff provides dental care services at seven Centers for Dental Health throughout Minnesota. We have two Twin Cities metro locations at Mounds View and Coon Rapids. Outside of the metro area, we have Centers in Fergus Falls, Hawley, Little Falls, Madelia, and Rochester. We also offer on-site dental care at more than 145 community oral health care sites including Head Start centers, schools, nursing facilities, assisted living residences, and group homes. Apple Tree provides a comprehensive range of oral health care services including diagnostic consultations, preventive, educational, and restorative services. We also provide advanced services including periodontics, endodontics, prosthodontics, dental implants, and oral surgery. In 2017, Apple Tree delivered 87,633 dental visits and screenings to 31,265 individual patients, resulting in more than $25.5 million worth of dental care.

In June 2014, Apple Tree opened the Mounds View Center to address, in part, low dental utilization rates among Minnesota Health Care Program (MHCP) enrollees. According to the Minnesota Department of Health Oral Health Program 2016 Association of State and Territorial Dental Directors (ASTDD) standardized survey – Older Adult Basic Screening Survey, 59% of older adults screened had impaired dental function, meaning fewer than 20 natural teeth, and 25% had lost all of their natural teeth. Two in 10 Minnesota public school third graders had untreated tooth decay in 2015. In addition, low-income adults are three times less likely than their more affluent peers to visit a dentist. These realities, coupled with the extremely low number of dentists accepting MCHP enrollees, highlight the importance of increasing access to dental services for underserved populations.