Working

Fred Summerfelt, RDH, AP, MEd
Assistant professor in the Dental Hygiene Department at Northern Arizona University

When Fred Summerfelt, RDH, AP, MEd, entered the oral health profession, he was simply looking for a job. Summerfelt worked in the oil fields in California and Alaska for 30 years, since he was 16, finishing high school but never attending college. He did well for himself for many years, but with oil pricing being unstable, it wasn’t long before many of the old jobs dried up. Summerfelt knew he had to find a new career.

“I didn’t know how to not work in the oil fields. So when it looked like I couldn’t work in the oil fields for much longer, it was pretty scary,” he said. “I didn’t know how to go about going to school or getting into a different occupation.”

A friend whose husband was a dentist suggested that Summerfelt look into becoming a dental hygienist. She told him it was a good job that he could do anywhere, and training was available in Anchorage. With his children getting ready for college, Summerfelt was hesitant to heed her advice. He even went to the university and looked into the program, but was afraid to do it.

“I didn’t want to walk in, quit my job and go to school,” Summerfelt said. But when he was laid off a few months later, he walked out of the oil field job and thought to himself, “I’m going to be a dental hygienist.”

Summerfelt went to see Deborah Stauffer RDH, EdD, who was the  associate dean of the College of Health and Human Sciences at the University of Alaska Anchorage (UAA) at the time.

“I said to her, ‘Hi, I worked in the oil fields for 30 years and haven’t been in school since I was in high school in the mid-’60s. I got laid off today and I want to be a dental hygienist,’” Summerfelt explained. Stauffer looked at his resume and told him he had done some great things and that, as a hygienist, he’d have to work in blood and spit. Summerfelt told her he had already been doing that his whole life. “She laughed and said to me, ‘Sit down and let’s figure out how to get you from where you are to where you want to be.’” Stauffer outlined several things Summerfelt needed to do to get into college, including taking the math placement test and talking to admissions personnel. She gave him a list of classes to take.

Summerfelt said the help and guidance of the two women played a huge role in changing his life. “One gave me the idea to go into dental hygiene, and we became good family friends. I actually went to work for her husband after earning my degree,” he said. “And this other person, who recognized I was totally lost and didn’t know how to go about going to college, laid it out for me and made it simple.”

Summerfelt earned his associate’s degree in applied science in dental hygiene from UAA in 1997, followed by a bachelor’s of science in dental hygiene and business management in 2004. In 2006, after working in private practice for 10 years—and living in Alaska for 33—Summerfelt and his wife were ready for a change. Since her family had lived in Phoenix when she was young, the couple came to Arizona in search of new opportunity. He looked at some private practices in Flagstaff and Northern Arizona University (NAU) for options and found an opportunity in teaching. Summerfelt had volunteered and done some substitute teaching at UAA and was interested in pursuing teaching. Since he needed an advanced degree for the NAU position, he went back to Anchorage to earn his master’s degree in adult education. A few days after graduating, he was back in Arizona, talking to the university about a job. Summerfelt is now an assistant professor in the Dental Hygiene Department at NAU.

In an effort to increase his autonomy as a dental hygienist, Summerfelt acquired the affiliated practice license.

“Affiliated practice gives me the freedom to practice, yet I’m part of a team. I’m practicing within the statutes and trying to set a good precedent, that dental hygienists—as licensed health care providers—are certainly capable of providing the services we’re trained to do in an independent manner, but provide our preventative services as part of a team that offers a full-service opportunity to the patient,” Summerfelt said.

Shortly after acquiring his affiliated practice licensure, Summerfelt was introduced to the concept of teledentistry, which allows an affiliated practice dental hygienist to treat patients in remote locations for preventive services, and utilizes technology to make referrals to the affiliated dentist. The dental hygienist can provide prophylaxis, fluoride varnish treatments and all the other dental hygiene services within the scope of practice. But if a patient presents with other issues that need a dentist, x-rays, photos and other digital data can be sent to an affiliated dentist electronically. This saves remotely located patients trips to the dental office, with the dental hygienist coming straight to them. It also brings patients in to the dentist, since these people otherwise might not seek treatment because of the inconvenience of travel.

Teledentistry has allowed Summerfelt to make trips to remotely located populations and, because he is a professor, he can bring his students along to learn and work. With about six hours of total training, dental hygiene students can learn how to use teledentistry tools to serve patients in remote locations. Training for teledentistry begins with the same education all practicing dental hygienists receive.

“Because [students are] trained typically, they understand what we’re trying to do [with teledentistry]. So it’s a matter of putting the equipment in their hands and familiarizing them with it,” Summerfelt said. Students learn how to use the handheld x-ray unit, operate it safely and assemble or disassemble different components of the equipment, as well as the safety aspects of the machine and its software. “Right now, about six total hours of training with people that are experienced, gets them capable of operating the equipment and setting it up in an independent manner. I can train and train, but they’ve got to go out there and do it. Six hours is enough for them to get the training to know how to safely operate the equipment and gather diagnostically efficacious digital data.”

Currently, funding for the program comes from grants either through the Arizona Department of Oral Health Enhanced Dental Teams Grant or First Things First. Summerfelt hopes that the Arizona Health Care Cost Containment System (AHCCCS)—the state’s Medicaid program—will be involved soon and provide reimbursement. All of that, of course, depends on federal funding. Summerfelt explained that dentists need to be on board and understand the significance of getting preventive treatment to people who can’t access it otherwise.

“As a hygienist, I could be jumping up and down and waving, saying, ‘I can do this, I can do this,’ but until we get the dentists liking it, we’re not going to get it done. I work with Dr. Kirk Robertson, a pediatric dentist in Flagstaff, who really gets it, and his support is making all the difference. I’ve got quite a bit of momentum now with other dentists,” he said. Summerfelt now affiliates with four dentists.
The patients whom Summerfelt and his students treat live in remote locations, often very long distances away from dentists. He gave an example of five children who would have had to make a 450-mile round-trip to the dental office just for an examination and treatment plan. After being seen by Summerfelt and his team, the digital diagnostic data were forwarded, and the children were able to go to the dentist specifically for the restorative work they needed. If the dentist found more issues than were originally diagnosed when the kids presented, they were already there and didn’t need to make another trip.

The point, Summerfelt said, is that even though the children still had to travel 450 miles, the time and effort were maximized because they were receiving restorative treatment it had already been determined they needed. “They’re not losing time away from school, and their parents aren’t losing time off work.”

Being an affiliated practice dental hygienist doesn’t just help remote populations, it allows Summerfelt to take dental hygiene students on trips and help them see new workforce models outside of clinical practice.

“What I like the most about it in relation to my students is that they come to dental hygiene school wanting to be the dental hygienist that their parents took them to for the last 20 years. Then they come in and see what we can do with teledentistry, and it changes their ideas about how we can provide service, how we can make a living, and they get very excited about the opportunity to be on the forefront of maybe capturing that mid-level practice,” Summerfelt said. He added that he enjoys watching students learn teledentistry because they’re what he calls “digitally native;” learning data collection the traditional way and then learning it digitally is easier for students than people from his generation, or what he calls “digital imports.”

“It’s awesome to see their paradigm shift,” Summerfelt said. “And the flip side is that if this gets popular all of a sudden, which I think it will, people will ask where they can find people who can do this work. The answer is we’re graduating them. We’re trying to get this to the other dental hygiene schools in Arizona so other students can be involved, too. It’s not something we’re trying to sit on here; we’d like them to all know how to do it.”

For more information about Summerfelt or his career, please email fred.summerfelt@nau.edu.

This edition of Working was prepared by Mariam Pera.