VCU news

By Mary Kate Brogan
School of Pharmacy

Sara Holston has seen the long lines, the wait patients from Southwest Virginia will endure simply to get the care they need. The dental free clinic where she has served as an assistant in rural Galax did not have running water, yet patients would sometimes drive hours just to be seen.

Soon, Holston will be one of the providers bringing critical dental care to residents in this region. After she graduates from the Virginia Commonwealth University School of Dentistry in May, she’ll join the advanced education in general dentistry residency program at Johnston Memorial Hospital in Abingdon, where she’ll be among the dentists providing care to the underserved.

“Since I’ve realized I really enjoy surgical procedures, I’m doing this residency program,” Holston said. “Afterward, I’m definitely going to stay in Southwest Virginia and practice.”

Holston is from here. She grew up raising cattle on her family’s farm in Pulaski County, south of Blacksburg. When she graduated from Virginia Tech with a B.S. in biology, she expected to pursue plans to become a large animal veterinarian but later realized it was not for her.

So, she pursued another longtime passion: rodeo.

Holston had competed in junior rodeo in middle school and earned the Miss High School Rodeo Virginia title. After college, she decided to take her competition to the next level and won, becoming Miss Rodeo Virginia 2013.

“It is speeches, interviews, written tests, modeling; our talent is horsemanship so you are put on a horse that you’ve never ridden before, and you do set patterns on it,” Holston said. After winning, she traveled around the country staying with host families, helping them on their ranches with daily chores, and doing community outreach for the Professional Rodeo Cowboys Association.

In the years after being crowned Miss Rodeo Virginia, Holston spent some time doing a bit of everything before she found her calling.

“I did random jobs: I worked driving a lumber truck, I worked at a telecommunications company and then I was working at a daycare, and that is where I kind of got steered toward dentistry,” she said. “One of the kids had really bad cavities, and he couldn’t eat the snacks that we had, and when I asked him what was wrong, he said, ‘Oh, my teeth just hurt.’ We talked to his parents about it, and they said, ‘Yeah, that’s pretty normal. Kids get cavities, and their teeth fall out. We have dentures; our parents have dentures.’ It kind of struck me that that is the kind of a mindset that a lot of people have. We have a huge lack of access to care and education when it comes to dentistry back home.”

Just the number of people and how long they are willing to wait in line in the extreme heat and the extreme cold shows how bad they do need it or how much pain they are in.

Serving underserved populations has been an undercurrent of Holston’s dental career, both as a student at the VCU School of Dentistry serving urban populations in Richmond at VCU Dental Care and as a volunteer with Remote Area Medical and Missions of Mercy serving rural populations in Smith County and other areas in Southwest Virginia. Many of these clinics serve populations that don’t have dental insurance, while others serve areas that have a lack of dental care providers available.

“Just the number of people and how long they are willing to wait in line in the extreme heat and the extreme cold shows how bad they do need it or how much pain they are in,” Holston said. “To me, it clicked like, ‘OK, if this is the most convenient way for them to go about it, then where is the disconnect between just going into an office?’ A lot of time, it is financial. But sometimes it’s just like, ‘You know, I work all week and this is on a Saturday and Sunday so it’s only time I can be off.’”

Some rural areas of Virginia have just one dentist for every 5,000 people, according to the Virginia Health Care Foundation. Of the 10 localities in Virginia designated by the National Health Service Corps and U.S. Health Resources & Services Administration as areas with the highest need for dental health professionals, six are counties in Southwest Virginia, including Holston’s home county of Pulaski.

Holston’s experience at these clinics and as a dental assistant at a free clinic in Galax, south of her hometown, underscored the need and solidified her commitment to giving back to her home community.

“At the Galax Free Dental Clinic, it’s purely extractions, but there’s actually not even running water in suction in the building that it’s done in,” Holston said. “And the patients still just line up, as long as they can get the tooth taken out that’s causing them pain, they’re ecstatic because, if not, they’re going to try to take out themselves.”

Her experience serving patients at VCU Dental Care has given her opportunities to work with similar populations that, “if it wasn’t for the school, they might not have a way to get the care that’s provided,” Holston said. The early patient interaction, hands-on clinical experience and community involvement —through outreach and health screenings — at the VCU School of Dentistry have made a difference to Holston.

“I was planning on going straight to general practice [before I realized I wanted to pursue a residency],” Holston said. “I felt comfortable treating patients. I’ve gotten comfortable with my hand skills and the things I have learned to go straight out and practice without doing a residency, and I think some other schools may not have that amount of clinical time.”

In addition, Holston, who will be the first in her family to work in dentistry, found a mentor — a dentist at the free clinic in Galax — who helped guide her before she applied to VCU. She encourages other students interested in health care to find a mentor early on.

As she heads back to Southwest Virginia, Holston will carry her clinical knowledge and skills with her, but also the experience gained from all her past careers — including her time as Miss Rodeo Virginia, building a rapport with people she’s just met all across the country. This time, though, they’ll be sitting beside her in her dental chair, getting the care they need closer to home.