ATLANTA, Michigan—Becky Klein sought a dentist for herself and her two teenage sons upon her return to Atlanta in northern Michigan after spending years in the southern part of the state.

She chose the Thunder Bay Community Health Service dental clinic. She felt lucky to find dental services that came highly recommended and was merely 10 minutes from her residence, a completely different scenario for numerous individuals in this region of the state.

After her sons’ first six-month dental check-up visits, she was astonished to discover that the dentists were students from the University of Michigan School of
Dentistry. They proved to be as skilled and professional as experienced practitioners, she remarked, and demonstrated exceptional communication abilities.

“I was truly impressed with the entire clinic. … The appointment proceeded like any other dental engagement. And my boys were satisfied,” Klein stated. “They interacted directly with my sons. They didn’t go through me, which was really nice.”

The three interns who undertake two two-week rotations with a month off back at the campus in Ann Arbor are essential to the clinic—seeing 18 patients daily and assisting in managing 48 new patients scheduling appointments each week, noted Dana Arnold, dental operations manager at Thunder Bay Community Health Service. Under a contract with U-M, she oversees the clinic and the interns she selects from the U-M dental school’s Community-Based Collaborative Care & Education program.

Each year, the CBCE places groups of U-M dental students in 17 federally qualified health centers throughout the state. Year-round, dozens of interns integrate into the clinics’ staff and work professionally, gaining knowledge and being challenged by intricate procedures while enhancing care options in communities that struggle with resources and access to dentists. Between 2004 and 2024, CBCE dental students completed 862,449 procedures valued at nearly $202 million.

“Without our U of M interns, we honestly would not be able to cater to the patients we do,” Arnold emphasized.

Serving the community

In Atlanta, with a population of 700 and dubbed the “Elk Capital of Michigan,” dentists are a rare sight, akin to most rural locales. The Atlanta clinic and another smaller facility in Onaway are part of the Thunder Bay Community Health Service network, which encompasses six counties—Alpena, Montmorency, Oscoda, Presque Isle, Cheboygan, and Otsego.

Lack of accessibility is a critical challenge and is deteriorating, Arnold explained. The limited number of dentists is retiring, and recently, at an accelerated pace, she mentioned. Many are shutting down their practices rather than selling them.

Adding to the accessibility concerns is the fact that numerous dentists no longer accept Medicare or Medicaid, or they require upfront payments, she noted. Approximately 50% of the clinic’s patient demographic relies on Medicare or Medicaid. Others utilize insurance or have arranged payment plans.

Many patients travel as far as two hours for their dental appointments at the Atlanta clinic, stated Arnold, who has lived and worked in the area for decades and is well-acquainted with the realm of federally funded health care.

“Part of our partnership with the University of Michigan is not only addressing our patients’ access needs, but it also serves as an opportunity for the interns to observe what we provide here in northern Michigan,” Arnold stated. “When they come here for an internship, they can experience what it’s like to be in a small community, working at a federally qualified health center. … We exist to serve the patients of our community. I think this offers a significantly different perspective.

“I believe some interns come into this experience and absolutely adore it. Others prefer private practice. However, for those who are passionate about serving the community, this is their pathway.”

Learning their profession and the community

A typical day at the Thunder Bay Community Health Services dental clinic involves Hasan Khaliq, Mitchell Selin, and Joey Wilmot—all nearing graduation from the U-M School of Dentistry—putting on scrubs and medical gear and reviewing packed schedules each morning: a surgical extraction,a dental filling, a dry socket, a pediatric case that provokes anxiety.

They invest countless hours at the chair, each managing six patients per day, offering comfort, imparting knowledge, and often facing intricate situations, swiftly transitioning from chair to X-rays, from consultations to completed procedures.

Khaliq, Selin, and Wilmot are on the verge of adding DDS to their titles. After concluding their coursework and time at the on-campus clinic, they finalized their education with internships at the Thunder Bay facility, a highly sought-after opportunity within the CBCE program.

For patients like Klein, it might be difficult to discern that these students, the newest cohort from U-M to cycle through the Thunder Bay dental clinic, aren’t yet fully licensed dentists.

What is evident, though, is how their experiences have molded them both professionally and personally—while concurrently aiding local community members who might be turned away from the bustling dental clinic if not for the interns.

Khaliq reflects on treating patients who rarely visit a dentist, whose drinking water lacks fluoridation, and who present vastly diverse backgrounds, needs, and experiences during their visits. Many come from families where going into dentures in their 20s and 30s is common, viewing it as their only choice.

“One significant aspect is that access to dental care is extremely low… one of the things that stands out to me is witnessing these 12- and 13-year-old children with severely damaged teeth,” Khaliq commented. “What resonates the most is recognizing the privileges we may possess elsewhere, contrasting it with the opportunity to assist these individuals in need.”

It’s a symbiotic arrangement. The patients receive proficient care from the recently trained professionals under the supervision of an expert and at affordable rates. The students gain exposure to patients and procedures, independent decision-making, and experiences that prepare them for their careers like never before. With the additional support from students, the clinic is capable of accommodating more patients and scheduling more appointments.

Selin described the internship as “the pinnacle of my dental school journey. It’s truly the first instance we’ve encountered real-world scenarios.”

Arnold mentioned that this is the objective: “This reflects real life. They’re encountering the challenging aspects of dentistry, and it provides them with the opportunity to make a difference, coaching them that they don’t have to lose their teeth or resort to dentures. Our aim is to instruct them to prevent that from occurring.”

Khaliq expressed that the experience exceeded his expectations.

“Certainly, this rotation at Thunder Bay has been one of the highlights of my fourth year in dental school,” he stated. “I was able to delve deeper into foundational dentistry—areas where I felt more at ease—and also try new things that were unfamiliar to me.”

On his final day of the internship rotation, Wilmot remarked on the appreciation for the personal development.

“The most significant aspect for me has been the collaborative environment. Observing how effectively a high-quality team operates, and being able to rely on your assistants, to exchange ideas with other practitioners… has greatly influenced how I envision establishing my practice in the future.”

Chase McNamara, known as “Dr. Mack,” is a past intern who completed his first and only two-week rotation in 2022, ultimately deciding to remain. He is now a licensed dentist and has recently been appointed the dental director of Thunder Bay Community Health Service, overseeing the interns alongside other retired dental professionals.

McNamara had intended to relocate out of state to pursue a private practice after graduating.

“When considering private practices, it felt like I was merely a part of a machine, unlike when I arrived here,” McNamara recalled. “I recognized that if I wasn’t the one assisting individuals, they wouldn’t be attended to. The gratitude displayed by the community was incredibly fulfilling for me.”