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[Ryan Jones/The Daily Pennsylvanian] Fourth-year dental student Seth Houwer performs an oral examination on his fiancee. Houwer, like many other dental students, has to treat relatives and friends to complete the requirements for graduation.

The dentist's office may seem like an odd location for a tete-a-tete between lovers, but it's precisely where Seth Houwer will be meeting his future wife -- for a little bit of oral work.

Houwer, a fourth-year Penn dental student, needs to perform a dental implant on his fiancee to achieve the points necessary for graduation.

"An implant is a lot of points," Houwer said.

The operation involves the replacement of a tooth with a prosthetic device that will resemble the original.

During the first two years of dental school a student is assessed on his academic knowledge. Dental students start seeing patients in the beginning of their third year. Over the next two years, they are assessed through the completion of certain dental procedures, such as fillings, crowns and dentures. Each procedure is assigned points and weighted accordingly.

Jeffcoat noted that these requirements stem from what she called the "must requirements." Students must be able to perform restorative work to upper and lower teeth in pediatric, adult and geriatric patients.

These basic requirements are essentially the same in all dental schools although the particular points, weighting and procedures can differ.

Fourth-year dental student and class president Barrie Matthews described the requirements as "challenging" but not impossible.

However, fourth-year dental student and student council president Brian Schwab acknowledges that the need to complete the requirements and the dependency of this on patient accessibility is what makes dental school a "weird animal."

Sometimes, patients can be referred to as "disappointments" if they fail to show up -- a situation that is not uncommon.

"Ultimately, in order to graduate, you need to be seeing patients all the time," Schwab said. "If you don't, then you are getting behind schedule."

To keep up with this demanding schedule, students occasionally resort to performing dental procedures on family or friends -- as was the case with Houwer.

"I know a lot of students who work on their mothers or fathers," Matthews said. "For me, my parents are in Montana. They are not going to fly out here to get a filling."

Though Houwer finds meeting his requirements demanding, he is currently right on schedule for graduation. However, other students are not so lucky.

"I'm a little behind," fourth-year dental student Merrill Alley said. "It causes a little anxiety."

Alley's wife refuses to be a patient, saying that it takes too long for work to be completed.

Student responsibilities also include dealing with what Matthews described as a "plethora" of paper work.

According to Matthews, students must repeatedly fill out forms that require multiple signatures. Complicating this is the fact that faculty members are often busy.

The aspect of maintaining, retaining, calling and ridding oneself of patients is also the student's responsibility.

According to Uri Hangorsky, associate dean of clinical affairs, all of this is a large part of actually being a dentist.

Third-year dental student Milan Doshi understood the policy of the Dental School: "It is an excellent way of having us as providers understand patient needs."

He noted, however, that office staff would handle the administrative work in private practices.

In the past, students who did not fulfill their requirements were allowed to graduate, but had to report to the dental clinic the very next day, often continuing to work into the fall.

Jeffcoat and Hangorsky note that most students do graduate on time, and the handful of students that still have requirements unfulfilled usually finish by mid-summer.

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