UM team steps up to treat dental emergencies
Professors and instructors from the Dr. Gerald Niznick College of Dentistry are treating patients for dental emergencies at Health Sciences Centre (HSC) under a pandemic plan that went into effect this week.
A UM clinic at the hospital is accepting emergency referrals from all Manitoba dentists. The clinic is not a physical location, but an arrangement whereby the university team has access to two operating rooms, one for adults and one for children.
This allows procedures such as tooth extractions, root canals and surgeries for oral trauma to be performed with the highest level of infection control.
“These are significant cases where the patient has pain that can’t be managed with medication, or things like trauma with broken teeth and facial swelling – they clinically need to be seen,” says Dr. Trenna Reeve, associate dean (clinics) at the dental college.
Nine dentistry professors and seven dentists from the community, most of whom teach part-time at the dental college, have stepped forward to provide this frontline care. The team includes general dentists and specialists in endodontics, oral surgery and pediatric dentistry.
The community dentists are working as unpaid volunteers. All the team members are participating out of a sense of professional responsibility, Reeve says, despite the risk of virus exposure.
“Viral levels are high in the oral cavity, and some dental procedures generate aerosols (airborne particles from the patient’s mouth), so there is a risk,” she says.
“Yet you’ve got this committed group of faculty and volunteers, wanting to help where they can. They’re putting themselves potentially in harm’s way, but doing it because it’s part of their professionalism and their duty to provide access to care.”
The clinic grew out of the dental college’s search for a space where its own patients could be seen for emergencies during the COVID-19 outbreak, Reeve says. The teaching clinics in the dentistry building on the Bannatyne campus have thousands of patients who are normally treated by supervised students in dentistry, dental hygiene, and graduate programs such as orthodontics.
Students had to stop seeing patients because of the UM shutdown of in-person instruction. Faculty members couldn’t carry on because the teaching clinics lacked some of the necessary safeguards against COVID-19 transmission.
“Our building didn’t meet some of the recommendations for ventilation and air filtration in a pandemic setting,” Reeve says. “And we didn’t have an operatory that could be completely closed off and decontaminated between procedures.”
In light of these challenges, the Rady Faculty of Health Sciences, Shared Health, the Winnipeg Regional Health Authority and the Manitoba Dental Association collaborated to establish the emergency services at HSC and make them available, on a referral basis, to all Manitobans.
Support staff from the dental college are working at the emergency clinic, which is currently running about two days per week.
Any Manitoban who believes they’re having a dental emergency, such as acute pain or infection, a serious mouth injury or prolonged bleeding, should contact their own dentist (or any dentist) to be triaged, which may take place by phone.
The dentist can then follow the emergency dental referral instructions on the Dr. Gerald Niznick College of Dentistry homepage to make a referral to the HSC clinic. Faculty members evaluate the referrals. Payment and insurance coverage for treatment at the clinic work the same way as they do at one’s own dentist.
Although the provincial government has announced that treatment can resume at all dental offices, Dr. Marc Mollot, president of the Manitoba Dental Association, said in an online statement that only emergency and urgent care will be offered for the time being.
Mollot and Reeve both say there is a shortage of the personal protective equipment (PPE) that dental teams require to work safely. “Our U of M team at the hospital is fully equipped with PPE,” Reeve says. “We’re providing an option in support of all Manitoba dentists.”