by Colleen O'Dea
Some might say Dr. Mary Ann Gataletto ('86) practices the toughest kind of dentistry: Her patients are exclusively people with developmental, emotional, and brain-injury disabilities. Many have extensive dental problems because they don't understand or practice proper dental care. Yet these patients can't or aren't willing to sit still and open wide for treatment they sometimes find frightening.
But to Dr. Gataletto, it's the most interesting and rewarding work imaginable.
"I don't say I work with people with disabilities," says Dr. Gataletto, director of the dental department at Woods Services in Langhorne, Pa., a facility for the disabled. "I say I work with people with different personalities. I just get to know them, what they like and what they don't. From there, I'm usually successful in administering treatment."
Dr. Gataletto took a less than traditional route not only to her special brand of dentistry, but also to the profession itself.
After graduating from high school in New Rochelle, N.Y., she worked for Dr. Melvyn Oppenheim as a chairside assistant in his Scarsdale, N.Y., practice. While working full time, she attended Pace University part time, earning her bachelor of science degree in 1981. Dr. Gataletto says it was Dr. Oppenheim, a clinical professor of Pediatric Dentistry at NJDS, who convinced her she should become a pediatric dentist herself.
"He felt I really had the knack," says Dr. Gataletto.
She continued to work part time for Dr. Oppenheim while attending classes full time at NJDS, where, at age 28, she felt like "the senior citizen in the class."
Dr. Gataletto was treasurer of the Student Government Association in 1985 and graduated with the Quintessence Clinical Achievement Award in Periodontics and a Certificate of Merit from the American Society of Dentistry for Children.
She completed her residency in pediatric dentistry at the Albert Einstein College of Medicine of Yeshiva University at Bronx Municipal Hospital Center. That's where she met Dr. Harold Diner, who inspired her to work with the developmentally disabled. "He was so brilliant in his field, he made it so interesting to me," Dr. Gataletto says. "It was such an easy field to him. He could convey that to me."
After earning a certificate in pediatric dentistry, Dr. Gataletto received a fellowship and earned a certificate in dentistry for the developmentally disabled. And although she does not practice "traditional" pediatric dentistry, the dentist is board certified in the specialty.
While Dr. Gataletto did a brief stint in a Manalapan, N.J., private practice, she decided that's not how she wanted to spend her career. Instead, she chose to continue working with the disabled.
She stayed on at Albert Einstein, first as educational coordinator for the fellowship program in Dentistry for the Developmentally Disabled and then as co-director of the program through 1994, when she was offered the position at Woods Services.
"I used to think I would stay at Einstein forever," says Dr. Gataletto. "It took several months for me to decide to do this. In fact, I refused it twice. But my boss here was very persuasive."
The commute wasn't much of a factor in her decision. Dr. Gataletto can make it from her home in Staten Island, N.Y., to Langhorne in little more than an hourless than the commute to the Bronx was on bad days. She lives in Staten Island because that's where her husband, Anthony DeGaetano, had a home and is the accountant for a family-owned business.
Woods Services is a private, non-profit residential facility that provides education, therapy, life skills, vocational training, job placement, senior citizens activities, and a camp for 1,200 people from ages 4 through 80-something.
Dr. Gataletto says the patients just need someone to take the time and use the right approach to provide a positive dental experience with which they'll cooperate. She can give both.
"I don't have the private practice pressure of treating a volume of patients," says Dr. Gataletto. "It may take 45 minutes to 'count teeth,' but if for that person we've never been able to do that before, then it's time well spent."
She finds the time-honored dental advice of "Tell them what you're going to do, show them what you're going to do, then do it" is all that's needed with many patients.
One of her job's major challenges has been improving the general dental hygiene of the population, for which good oral care has not been a priority. That helps make regular check-ups and cleanings easier. It's slow going, but with the help of the rest of the staff, Dr. Gataletto thinks she can change that.
"Someone responsible for the client may not feel comfortable getting in there to clean the teeth well," she says. "It's invading such a private area."
In addition to working with the disabled, Dr. Gataletto has held educational programs for the Woods staff. She also has a dental page in the facility's newsletter with a "Best Brusher of the Month" feature, trivia questions, and other items to try to make dental care more fun.
"If we can improve the daily oral care, people can feel more comfortable, have quicker appointments, and fewer invasive appointments," she says. "We're moving in that direction."
Dr. Gataletto provides most of the dental treatment at the facility. But there are community dentists who do more extensive work such as crowns and bridges and complicated extractions when necessary. There are only about a dozen clients whom she sends to the University of Pennsylvania's dentists to have work done under general anesthesia. These are patients who have multiple dental needs along with behavior problems that are so great they could hurt themselves or others.
Dr. Gataletto sees a great need for more dental students to learn to work with the disabled. She says it's something that has to be taught specifically, and even then, can't be learned by everyone.
"You can teach the technique, like how to put a child at ease, but you can't teach people to have a comfort level doing the work," she says. "My patients are great at seeing if you're insincere."
More fellowships like the one at Einstein need to be developed so there's a larger group of dentists trained to work with the disabled not just in facilities, but also in private practice, Dr. Gataletto believes. She herself teaches part time in the Department of Pediatric Dentistry at the University of Pennsylvania.
"I don't know that traditional dental school training
provides enough about working with the disabled," she says.
"More fellowship programs need to exist. It's essential
to be well-rounded in your training. People with disabilities
often have other medical problems.