Practicing dentistry in WNC
Meet Dr. Alice Jamison, DDS, MPH. Raised in Asheville, NC, she currently practices in her hometown at a general dental office that serves children up to 18 years of age.
After graduating from UNC Dental School in 2020, she completed a one-year general practice residency at Mountain Area Health Education Center while earning her master’s in public health.
Join us for a conversation with Dr. Jamison about what inspired her to pursue dentistry, her typical schedule, patient education, and more, below.
At the intersection of science and art
Dr. Jamison knew she wanted to be a dentist early on because it combined her two passions: science and art. “When I was looking around at careers, I knew I wanted to do science. My parents are artists, and I knew I wanted to do something with art or something creative,” she said.
“When I was shadowing my dentist in high school, I saw her working on a crown, and it’s just so detailed, so delicate that I was like, ‘oh, that’s beautiful.’ It’s so beautiful, and it’s beautiful to be able to create, and it’s beautiful that your creations can help people.”
Dr. Jamison sees connections between what she does in and out of the office, including her creative hobbies. “When you remove a cavity from a tooth, and then you put the filling material back in, you are essentially trying to re-create the anatomy of what you removed, so you’re re-creating the grooves and the cusps of the tooth,” she said.
“I feel like it’s similar to a very, very minute sculpture technique, and that’s also why I think I would be a jeweler and why I love jewelry (making) so much, it’s fine, detailed art. That’s why I feel like dentistry has such an art aspect to it, and that’s why I originally got into it.”
For Dr. Jamison, beauty meets function in dentistry. “I do think it’s very beautiful, and then you learn about the anatomy of the teeth, and you learn about the function and everything, and that’s where science comes in,” she said.
“Then, you’re sculpting it, knowing that this person is going to be biting on it and knowing the best ways in which what you are creating needs to function, and that’s how the intersection happens.”
A typical week at Best Bites dental office
Dr. Jamison sees an average of 40 to 60 patients daily. She said she is constantly busy, from taking notes to performing fillings and extractions, placing crowns, and checking cleanings; the work is fast-paced.
In her experience, many people have misconceptions about dentistry, “A lot of people think that the dentist is the one who just comes in and looks in their mouth after they get their cleaning, and they’re like, ‘good to go,’” she said. “And so, they’re like, what are you doing with your day? You come in for three minutes, and then you leave.”
Her week typically involves three days at the dental office and one day at the Asheville Surgery Center, handling operating room (OR) cases. On her OR days, she sees three to four patients who need “full-mouth work,” such as multiple extractions, crowns, or fillings. These patients cannot receive care at the office because they are either very young, experience high dental anxiety, or have an intellectual or developmental disability.
“They wake up and everything’s done, and it’s a very lovely service to be able to provide for the patient and for the parent because, in my mind, it decreases the trauma associated with dentistry,” she said. “The parents often hold a lot of anxiety, so, for them, it’s a little bit easier.”
Serving pediatric patients in Western North Carolina
About 75% to 80% of Dr. Jamison’s patients have Medicaid insurance. “In western North Carolina, we are one of a very few number of offices that are constantly accepting new patients on Medicaid,” she said.
Medicaid reimbursement rates in North Carolina have not seen a meaningful increase since 2008, leading many providers to avoid accepting the insurance, as it can be challenging to operate without a loss.
“We have people drive from Tennessee. We have people who drive from down the Piedmont area up,” she said. “Not as much, but sometimes down from near South Carolina. I know a family that comes two hours to us.”
Dr. Jamison’s boss and the owner of Best Bites, Dr. Paynich, started the practice about twenty years ago. “When I initially opened, the vast majority of my patients came in as Medicaid patients. I’ve never been a quote-unquote Medicaid office or limited to Medicaid only,” he said.
“Obviously, there’s essentially massive demand for dentists to treat these kids. Word very quickly got out, and I found myself to be very, very busy, quickly,” he continued. “If you can be efficient, you can get more done in a quality manner.” In addition to Medicaid, Dr. Paynich said they accept various insurance types and payment options, from cash to care credit.
The current Medicaid reimbursement rate is 34 cents on the dollar, and most private practice oral health providers do not accept a meaningful number of patients with Medicaid insurance (billing over $10,000 annually).
“So, as far as the Medicaid side of it goes, the only way that you can make it work is to be very busy. I mean, you have to do twice the work to earn the same amount of money, if not more, and that’s basically how I’ve done it,” he said.
“I have always just worked incredibly hard. I’ve trained my staff to be relatively efficient to, you know, do things like if a child comes in for a cleaning and they have a cavity to try and go ahead and set up for it and take care of it that day.”
Dr. Paynich emphasized that his goal has always been to provide a dental home for kids, rather than increase production and collection. “My practice has always been focusing on patient care, good visits for the kids, treating parents well, and providing a good service,” he said. “My primary thing has always been the dentistry, not the metrics of the practice.”
Despite the challenges posed by stagnated reimbursement rates, Dr. Paynich said the reason he continues to operate his practice this way is because he likes it. “I think encouraging providers to accept Medicaid is important. I think encouraging Medicaid to treat providers well is very important,” he said.
As a public health advocate, Dr. Jamison said, “I do wish that our field did have more compassion for acting as a safety-net for folks.” However, she recognized that everyone has their own path and said, “Everything I say is just my take on dentistry, and there’s no right way or wrong way to practice it and to be a dentist.”
Top concerns about pediatric oral health in the region
One of Dr. Jamison’s biggest concerns is misinformation or lack of information about oral health care and hygiene. “I wish that it was taught in school or combined with nutrition,” she said. “It’s not just sugars; it’s carbs that stick on your teeth and cause cavities as well.”
Along with motivating teenagers to care for their teeth, Dr. Jamison spends significant time educating parents and caregivers. “A lot of young parents don’t know how much sugar is in breast milk, and so they will just breastfeed for a very long time and may not be cleaning their kid’s teeth when they start coming in when they should,” she said.
“The teeth come in around six months; the first ones and the last baby teeth erupt around two years,” she said. “I’ll see two-year-olds or three-year-olds who have cavities on almost every tooth. These young parents, first-time parents [are] distraught because they didn’t know, and they’ll blame themselves, and they beat themselves up. It’s a conversation I have again and again of telling them it’s not your fault.”
Continue the conversation with Dr. Jamison in Part 2
Whether you work in the dental field, are considering a career in oral health, or simply want to learn more, we hope you find this provider profile insightful. In part two, Dr. Jamison will discuss Hurricane Helene’s impact on oral health, her passion for her work, the importance of patient education, and her perspective on care integration.
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