Richard Black

When the Woody L. Hunt School of Dental Medicine opens in South Central El Paso it will be the first dental school to open in Texas in nearly 50 years.

In charge of getting it up and running by 2021 is the school’s new dean: Dr. Richard Black, a longtime El Paso dentist who grew up only a few miles from where his office is today.

Black, who has practiced as an orthodontist for nearly 40 years, did not apply for the job but was recruited by Dr. Richard Lang, president of Texas Tech University Health Sciences Center El Paso.

“One of the things Dr. Lange said when he recruited me was that we have a new school and therefore we want to have new people with new ideas,” says Black, who was named dean in June.

It’s a big job that includes developing curriculum, a simulation laboratory and student clinic, as well as recruiting 40 to 50 faculty members, earning accreditation and winning the backing of the El Paso dentist community.

The school is supported by a $25-million gift from the Hunt Family Foundation and a grant from the Paso del Note Foundation and is aimed at alleviating the acute shortage of dentists in El Paso and West Texas.

El Paso County has one of the lowest ratios of dentists to residents in the state, according to a feasibility study recently published by Texas Tech. The nearest in-state dental program is 550 miles away, and the last dental school to open in Texas was in San Antonio in 1972.

Black grew up in Central El Paso, attending Austin High School. His father was one of the first orthodontists in El Paso.

“I grew up admiring what my dad did, and I went to college with the idea that I wanted to go to dental school,” Black says.

Black received his doctor of dental medicine degree and orthodontic specialty training from the University of Texas Health Science Center at Houston School of Dentistry.

He has served on a number of local nonprofit boards and is president of the El Paso District Dental Society and a past president of the Texas Dental Association.

Black sat down with El Paso Inc. and talked about what’s next, medical tourism in Juárez and transforming dental education.

Q: What brought you back to El Paso in 1978 after your residency?

Family. I have a large family here in El Paso. There was plenty of opportunity and places to go, but most of us in those days kind of went back home. 

That’s not the case now. Most dentists are ending up where they trained. Most of the dentists in Texas are located in Bexar County, Dallas County or Harris County. So there’s a maldistribution of dentists in Texas.

In El Paso, we send a lot of people that way but don’t get many to return.

Q: What are the most common dental health issues in the El Paso region?

Oral health is the same as it is anyplace else in Texas except that we have fewer dentists to see more people. We have the lowest ratio in the state.

Q: About 30 dentists for every 100,000 people, right?

Yes. It’s much less than other places even in Texas. So we have a lack of providers, and about 50 percent of the people in El Paso County don’t go to the dentist. If you don’t go to the dentist, you are going to have issues with oral health, and if you have issues with oral health, you are going to have issues with your total health.

Q: How many dentists here are nearing retirement age?

Statistically, we have more senior dentists. That would be the same anywhere in the West. More than 60 percent of the dentists here are over the age of 55. 

Q: Why are there so few dentists in the El Paso area?

It has to do with what I mentioned about the three major dental schools in Texas and dentists often staying where they are trained. There are about 15,000 licensed dentists in Texas, and more than 75 percent of them are in those three counties.

It’s different from medicine. You train for four years in medical school, but you really don’t start seeing patients until you have a residency. And the residency may be anywhere, and that’s where you often find physicians working – where they did their residency. 

We are producing a dental student who, after four years, is the finished product – who is able to gain licensure and practice. 

We’re not going to keep them all, but I think we are going to make a huge difference in the disparity of dentists in the West.

Q: Dental insurance is not included in all health plans. Do many people have dental insurance?

More people have dental insurance than they ever had before. Part of it is getting them to use it. One of the statistics is this benefit goes unused.

Q: Why?

You look in the mirror and you see your teeth, and you don’t see disease. Periodontal erosion is painless to you, and people don’t think they need to go and wait too long. 

Dental insurance is pretty prevalent. It is just getting people to use it. 

Q: How do you get more people to see the dentist?

Certainly, when you bring a school to an area and start talking about dentistry and the research being done at the school that begins to raise awareness. As the message gets out that we are producing competent dentists in the area, that is going to help change the dynamic.

Q: The Texas Tech Paul L. Foster School of Medicine in El Paso has been recognized for its unique curriculum. How will the dental school curriculum be different?

One of the things that’s a huge factor in dental education right now is the requirements to graduate have changed. It used to be a very traditional two-step national board process. If you passed those two tests, then you were eligible to graduate and stand for licensure.

Now they’ve taken those two tests away, and they just have one test. It is totally different, and it’s integrated medicine and dentistry and based on case studies. In order to do well on that test, your dental students are going to have to be taught in a totally different way. 

There are 66 schools in the country right now, and they are all scrambling to adapt their curriculum to this national board. 

We have a clean sheet of paper.

One of the things that we like very much about the Paul L. Foster School of Medicine is how innovative it is. The students love it and do very well on their tests because of the curriculum. 

The medical school has a unique way of teaching. It is symptom-based. A patient doesn’t come to you and go, “I’ve got temporomandibular joint dysfunction.” They go, “My jaw hurts.”

So the medical school teaches that way; the courses are tied to real life.

We think that’s terrific, and we want the faculty that is teaching at Paul Foster to teach our dental students in the same way. Our curriculum will be just as innovative and just as disruptive as the medical school’s curriculum was. 

Students will also learn Spanish like they do at the medical school. And if you’re a student here, you will participate in community health. 

This school offers such a wonderful opportunity for research on the border – research on diabetes and how that affects oral health or the impact of oral health on cancer or cardiovascular disease. You need to understand the community that you practice in.

We are going to be graduating a really confident, competent general dentist. We are going to get our students in front of patients earlier than they ever would be in other parts of the country.

Q: What is the economic impact?

When this school comes online, it will continue to promote this economic engine that is this health sciences center.

The latest estimate of what Texas Tech University Health Sciences Center El Paso brings every year was $223 million.

It’s like San Antonio. San Antonio started with a small medical school out in the middle of nowhere, and now look at what that medical center has become. That’s the vision I think (Texas Tech University Health Sciences Center El Paso President) Dr. Richard Lang has for this university.

Q: What do you expect the economic impact of the dental school to be specifically?

From what we hear, a dental school is $60 million to $90 million a year. 

Q: Do you have a sense of how many El Pasoans go to Juárez for dental care?

We live next to the largest city on the border in Mexico. They have certainly promoted what we call dental tourism. That’s nothing new. 

I don’t have a sense of how many go. I know it’s a fact. For some people, it’s a cultural thing. Some go over because of cost. 

Over my career, I’ve been asked about it many times. I say this: I think they are well-meaning people in Juárez. I have no comment on the quality of care. My comment is if you go to a Texas licensed dentist and you have a problem, you have a recourse here in the U.S. If you go to Mexico or overseas to some other country, you have no recourse. 

The United States has the best dentistry in the world, and people come here from all over to train.

It’s interesting, one of our area legislators said we want dentists in this area so people don’t feel like they have to go to Juárez – that they have someone to see.

Q: Will the dental school help fill that void and operate any clinics?

That’s very important. When you go to dental school, you don’t just learn in the classroom. You learn in a simulation laboratory and then you have to have a clinic associated with the dental school.

Until we have our new building, we are going to have a wonderful clinic that is going to be right out here.

We are also setting up opportunities for our students to practice all up and down the county – La Fe, Centro San Vicente. We are talking with folks in the Mesilla Valley area and will be talking to folks in Marfa and Presidio.

Q: Where will the dental school be housed?

Until we have our new five-story building, we are going to be housed in the Medical Science Building that’s under construction. Half of the third floor will be the dental learning center.

Q: What are the plans for the school’s permanent home?

The plans are for the building to be here on campus. If the state is willing to fund a tuition revenue bond for the school in 2021, we are talking 2025 at the earliest.

Q: How are you going to recruit the 40 to 50 faculty members needed to get up and running?

I already have people that are interested in what we are doing. Word is out nationally that we are going to be doing something totally different, and I think we are going to be able to recruit some great faculty. 

The faculty will be supported by probably three times that many staff. Easily we are talking about 200 jobs on to the payroll here.

Q: What feedback have you received from El Paso-area dentists?

We have received very positive local feedback. Dr. Lang and I have reached out with everything from private dinners at his home to town hall meetings. We have very solid support from our local colleagues. 

Q: Have you gotten any specific feedback?

The feedback we have gotten is this: Having a school for the local community of dentists provides continuing education opportunities, teaching opportunities on a part-time basis, and probably the most important thing, it provides a way maybe for them to transition their practice.

Q: Transition their practice?

Whether you are recruiting people here to buy your practice if you are retiring or recruiting to grow your practice, the dentists will be here.

I keep telling people El Paso is the best kept secret. We are a gem in Texas. A dental practice here is a very rewarding, fulfilling profession. It is rated every year as either the No. 1 or No. 2 job in America.

Q: How expensive is dental school?

Dental students, unfortunately, are graduating with the most debt – more than law students, more than medical students, more than veterinary students. Dental schools are very expensive, although the schools in Texas are ranked in the bottom quarter percentile in cost. 

Q: Will the dental school eventually have other programs – for dental hygienists or dental assistants, for example? 

Right now, we are so focused on getting the school up and running, but one of the first things that could come our way as a specialty is pediatric dentistry.

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