From the moment I started dental school, I knew the only thing I wanted to do was specialize in pediatric dentistry, says Michael Milano, DMD. It was something I always wanted to do and couldn't imagine working in any other field.
Sometimes it just feels right. Sometimes, everything falls into place.
That’s the way it was for Michael Milano, DMD, a clinical associate professor at the University of North Carolina School of Dentistry, with a specialty in pediatric dentistry.
“From the moment I started dental school, I knew the only thing I wanted to do was specialize in pediatric dentistry,” Milano explains. “It was something I always wanted to do and couldn’t imagine working in any other field.”
And so it just seemed right that last November, during the opening ceremonies at the Special Olympics N.C. Fall Tournament, Milano was named as the recipient of the Golisano Health Leadership Award for his tireless work in bringing special smiles to those with intellectual disabilities.
“That connection, and the opportunity to change someone’s life for the better is just a wonderful thing,” Milano says.
Challenges and Rewards
But that doesn’t mean pediatric dentistry is without its challenges. Milano says that one of the main challenges is working with a population that has either no experience visiting a dentist, or worse, a negative experience. The challenge is getting those children past that initial fear.
And then there are the parents who themselves are afraid of visiting the dentist.
“Even if they try not to, they share that fear with their child,” Milano says. “So now you have not just the child’s anxiety, but the parent’s anxiety on top of that.”
The rewards, however, far outweigh the challenges. Milano says he doesn’t know anyone who went into pediatric dentistry thinking they were going to make a lot of money. They went into the field, much as he did, because they love working with children and making a difference in their lives.
“You take this child who’s incredibly fearful, and with just a few visits he suddenly is now comfortable being there, looking forward to coming to the dentist,” Milano says. “It’s an amazing impact you can have on these children. That’s sort of the ultimate goal.”
Volunteering and Recruiting
For more than 20 years, Milano has volunteered his time and his talents to Special Olympics. He has also recruited more than 1,000 dental professionals to do the same. He sees it as a natural outgrowth of pediatric dentistry, and a natural progression from the work he did with the organization as a general volunteer even before he was part of the dental profession.
“What we find is that many adult patients with intellectual developmental disabilities are not treated by general dentists,” Milano says. He explains that a general dental office isn’t really designed to see a patient over a long period of time. That staff has to see patients and turn chairs over. Pediatric dentistry, however, has the flexibility of adjusting schedules more easily. “You’ll find that many individuals with intellectual developmental disabilities are actually treated by pediatric dentists in the first place, regardless of the patient’s age.”
Milano had an opportunity early in his career to participate in a training program where he learned not only how to be a clinical director in treating patients with intellectual disabilities, but how to engage, recruit and train others as well.
“It sort of doubles your impact,” he says. “These individuals now go off to different parts of the country and start doing the same thing you are doing.”
That’s one of the reasons Milano has had significant success recruiting dental professionals to volunteer their time with Special Olympics. The other reason, he says, is learning how to ask.
“One of the basic lessons is such a simple one,” he says. “You have to ask for help. So often I think people are afraid to make that first request. In academics, dental students, pediatric dentistry residents and faculty surround me. I send one or two emails, and before you know it I’ve got 50 or 60 people wanting to help. And then you multiply that by the number of events we do each year over the course of 20 years, and it’s amazing how many people you actually end up meeting.”
Addressing a Need
Milano says the need that exists for treatment within the intellectually disabled community is no different from any other population. The challenge, however, is that so many rely on assistance from others — assistance with home care, flossing and brushing, and getting to and from the dental office.
“I don’t have a lot of difficulty finding someone to treat our athletes, because dentists are incredibly caring and they’re incredibly giving,” he says. “The difficulty sometimes is getting the athlete to the office — because they do have fear-related behaviors like everyone else, plus, they rely on someone having to transport them.”
That’s where events like the Special Olympics NC Fall Tournament last November come in. The day after receiving the leadership award, Milano and 40 volunteers he recruited provided free dental exams, oral hygiene instruction, and mouth guards to 165 Special Olympics athletes.
“The goal is to get them in as central a location as you can, and that’s exactly what the competition does for Special Olympics,” Milano says. “It allows us to be there to help them.”
Milano says the two things that stand out most from his work with Special Olympics are all the volunteers who give their time, and the connections he has made with the athletes as well as dental practitioners.
“When these volunteers leave and go back to wherever they’re going to be practicing if they’re dental students, they start doing the same thing that we’re doing here,” he says. “I just asked them for help — but they continued to do these events long after I was in contact with them.”
In addition to his time spent with Special Olympics athletes, Milano points to his role as an examiner for the American Board of Pediatric Dentistry. Years after an individual has passed his or her exam, they still come back and talk with him.
“That's probably the thing I’ll take most with me long after I’ve retired,” Milano says. “It doesn’t have to be something huge; it doesn’t have to be a major change that changes the world. You change the world for that one person, and you’ve made an incredible difference.”