Clinical Experiences

First Year

Rotations Include

• Comprehensive Care for Children at the Pediatric Dentistry Clinic at Eastman Institute for Oral Health: First year resident pediatric dentistry clinical experiences are primarily located at Eastman’s Pediatric Dentistry Clinic. While being fully supported by pediatric dentistry faculty and mentored by second year residents, first years provide comprehensive care to our diverse patient population. Clinical experiences include: preventive care, comprehensive treatment planning, disease management, restorative and surgical care, emergency care, and nitrous oxide anxiolysis.
• Pediatric Medicine Rotation at Golisano Children’s Hospital (5 weeks): During the spring of first year, residents complete their five-week pediatric medicine rotation. During this interdisciplinary experience, our residents are integrated within the University of Rochester School of Medicine and Dentistry’s Pediatric Clerkship for fourth year medical students. The rotation includes didactic experiences with the pediatric residents and medical students, pediatric grand rounds participation, and rounding with the medical teams on the floors. Our residents round with pediatric hematology/oncology for two weeks of the rotation. Residents also round on the floors with general pediatric services and shadow at the pediatric illness clinic during the remaining three weeks. Residents come to appreciate the value of interdisciplinary care and gain experience communicating with medical teams during this rotation. Our residents reciprocate by providing education to pediatric residents, fellows, and medical students on pediatric oral health, emphasizing the impact of oral health on overall health.
• Anesthesia Rotation (4 weeks): During the spring of first year, residents complete their four-week anesthesia rotation. This rotation has several locations: Golisano Children’s Hospital, Strong Memorial Hospital, and Sawgrass Ambulatory Surgical Center. Paired with either a CRNA or anesthesia residents, residents gain experience with IV sedation, general anesthesia, and airway management including intubation. This rotation also includes simulation experiences with the department of anesthesia.
• First call for the Emergency Department at Strong Memorial Hospital: The Division of Pediatric Dentistry provides emergency dental services 24 hours a day within the Ronald McDonald House Charities Children's Emergency Department at Strong Memorial Hospital. The service mainly addresses the management of acute dental trauma along with facial infections of dental etiology. Transfer requests from area and regional hospitals are facilitated by the Strong Consult and Transfer Center.
• First call for Inpatient Consults at Golisano Children’s Hospital: The Division of Pediatric Dentistry is available 24 hours a day for in-patient consultation and treatment services to patients of Golisano Children’s Hospital. The service identifies and treats oral trauma and dental sources of infection in patients with special health care needs. Pediatric dental residents work collaboratively with pediatric health care providers from the Department of Pediatrics to ensure that oral status promotes general health for these children.

Second Year

This training year incorporates progressive supervisory responsibility as well as a more individualized curriculum including research and development time.

Rotations Include

• Comprehensive Care for Children at the Pediatric Dentistry Clinic at Eastman Institute for Oral Health: Second-year resident clinical experiences continue part-time at Eastman’s Pediatric Dentistry Clinic and they function more autonomously while also mentoring first year residents. Second year residents provide comprehensive care to our diverse patient population including: preventive care, comprehensive treatment planning, disease management, restorative and surgical care, emergency care, and nitrous oxide anxiolysis. Care is also extended to include: mild enteral sedation (minimum 25 cases as the primary provider) and early interceptive orthodontics. Two Thursdays per month are dedicated to orthodontic care in partnership with faculty from Eastman’s Division of Orthodontics. Oral sedation (midazolam as a single agent) cases are completed Monday, Tuesday, Wednesday and Thursday mornings.
• Cleft and Craniofacial Team: During second year, our residents actively participate in our hospital’s cleft and craniofacial team days. Golisano Children's Hospital offers the region's only center dedicated to the needs and treatment of children born with cleft lip, cleft palate and other craniofacial anomalies. The center consists of an interdisciplinary team of professionals, dedicated to offering a full range of services to the patient and family dealing with these types of birth defects. Second year residents actively participate in a minimum of three craniofacial team days. Residents gain hands-on experience completing comprehensive exams of children with craniofacial differences, gaining an appreciation for the vast array of dental anomalies and findings, and participate in developing comprehensive treatment plans using a team-based approach. Residents also have the option to shadow other craniofacial team specialists to better understand fields such as speech pathology, sleep medicine, plastic surgery, genetics, psychology, and audiology/ENT and their roles in craniofacial care. Residents also have the option to gain hands-on experience with Nasoalveolar Molding during development days in second at Eastman’s Pediatric Dentistry Clinic. Eastman Dental’s Pediatric Dentistry Clinic also serves as the dental home for a large proportion of the craniofacial center’s patient. 
• Hemophilia Center: Through this rotation, second year residents gain a better understanding of all factors at play when considering treatment of patients with hemophilia and other bleeding disorders. The Mary M. Gooley Hemophilia Center is an independent, federally designated Hemophilia Treatment Center (HTC) in Rochester, New York (serving people in the surrounding 12 county region) that cares for people affected by hemophilia, von Willebrand disease, other rare bleeding disorders, hemochromatosis and Gaucher’s Disease. The Center started in the late 1940s, when Rochester-area families affected by bleeding disorders came together to improve their lives and the lives of their children.
• Community Dentistry and Advocacy: (SMILEmobile dental vans and School 17): Second year residents rotate through various community dentistry sites about once a week. School #17 has a fully functioning dental clinic to help meet needs of the local community and children who attend the school. Additionally, there are three mobile dental units which visit Rochester city schools and daycares. The SMILEmobile program has been in existence since 1967. While on the SMILEmobile, our residents provide comprehensive care including preventive, restorative, and surgical treatment. These mobile units go to Rochester City Schools, day cares, Hillside Children’s Center, and Mary Cariola Center. Hillside serves children with emotional and behavior health care needs while Mary Cariola helps children with intellectual and developmental disabilities here in Rochester. With this program, our residents help to eliminate common barriers to care for the children in our community and learn the potential depth and breadth of the pediatric dentist’s role in advocacy.
  
• Emergency Medicine Rotation (2 weeks): Through this rotation, residents are immersed in the emergency department to gain an appreciation for the breadth of patients that present to the ED and various modalities for providing care. This experience allows residents to better understand their role in providing coverage for pediatric dental emergencies and working with the ED team.
• Pediatric Ambulatory Dental Surgical Services (Operating Room): During second year, residents gain extensive experience with complete oral rehabilitation under general anesthesia at both Golisano Children’s Hospital and Sawgrass Ambulatory Surgical Center. Residents are one-on-one with faculty during OR days, gaining individualized training and feedback tailored to their needs and goals, and by the end of the program residents are able to complete a full day of OR cases independently. Each resident on average sees 80 children in the OR. Faculty from the Division of Pediatric Dentistry maintain an active surgical practice within the Mildred Levine Pediatric Surgical Suite at Golisano Children’s Hospital and at Sawgrass Ambulatory Surgical Center. This practice is limited to the use of general anesthesia administered by pediatric anesthesiologists from the Department of Anesthesiology. Each year, approximately nearly 1,200 outpatient dental surgeries are performed by the division on patients, ages infant through adolescence. This service specializes in the care of young children from underserved communities with extensive dental decay. Children and teenagers with developmental disabilities and complex medical conditions also receive treatment in this setting when warranted by the child’s medical status, the invasiveness of the dental procedures, or the child’s level of cooperation. The service also receives patient referrals from community pediatric dentists to render care under general anesthesia for patients from their practices.

Operating Room Attending Faculty

• Sean McLaren, DDS
• Cynthia Wong, DMD, MS
• Erin Shope, DMD, MS
• Lisa Delucia, DDS
• Isamar Rivera-Ramos, DMD, PhD

Second call for the Emergency Department at Strong Memorial Hospital: The Division of Pediatric Dentistry provides emergency dental services 24 hours a day within the Ronald McDonald House Charities Children's Emergency Department at Strong Memorial Hospital. The service mainly addresses the management of acute dental trauma along with facial infections due to dental sources. Transfer requests from area and regional hospitals are facilitated by the Strong Consult and Transfer Center.

Second call for Inpatient Consults at Golisano Children’s Hospital: The Division of Pediatric Dentistry is available 24 hours a day for in-patient consultation and treatment services to patients of Golisano Children’s Hospital. The service identifies and treats oral trauma and dental sources of infection in patients with special health care needs. Pediatric dentists work collaboratively with pediatric health care providers from the Department of Pediatrics to ensure that oral status promotes general health for these children.

Unique Additional Experiences

• Teledentistry Program (required): We are one of the first Pediatric Dentistry programs in the country to integrate teledentistry into our curriculum and services. We collaborate with rural community health clinics to provide dental consultation and referral services through teledentistry. Residents have opportunities to provide teledentistry services at Eastman.
  
• Advocacy and Ethics (required): Residents learn first-hand about critical factors affecting overall health through community partnerships, while interacting with medical and non-medical providers at community-based organizations and programs. Our residents work closely with Eastman’s two social workers to help identify and eliminate barriers to care. Our residents learn how to build community-relationships and gain skills in advocating for the “whole” child, along with the whole family, within their community. We aim to have our residents extend advocacy into their community wherever they practice after graduation.
  
• Mini-LEND Experience (required): Second year residents are paired with a family of a child with a neurodevelopmental disability. Residents have 3 non-clinical experiences with the family – ranging from museum visits to ice-skating to home visits. This experience helps residents understand the perspectives of families from many different backgrounds, developing a greater sense of empathy in our residents.
  
• Leadership Education in Neurodevelopmental Disabilities (LEND) Program: (optional, additional application required): Collaborative interdisciplinary training focused on improving health of children with neurodevelopmental disabilities and special healthcare needs through the University of Rochester Medical Center (URMC) and Association of University Centers on Disabilities (AUCD). Upon acceptance to the program, residents can integrate this program with their second year of training.
• Nasoalveolar Molding(optional): We are the pioneers in Upstate New York in offering nasoalveolar molding (NAM), a non-surgical device to reshape the lip, nose, and gum pads, prior to cleft lip and palate surgery. We are one of the few pediatric dentistry programs in the country to offer this treatment and are the major hub for NAM treatment in Western New York. Residents have the opportunity to have hands-on experience with NAM during second year of residency, if desired.