October 05, 2009
An important partnership at the Arthur A. Dugoni School of Dentistry is helping to provide oral health care to patients with physical and psychosocial health issues, while also helping to train the next generation of oral health care professionals to work with these special-needs patients.
Senior-year dental students recently started annual rotations in the Special Care Clinic at the Arthur A. Dugoni School of Dentistry to boost their skills working with patients with complex needs. Attracting patients from throughout Northern California due to its unique multidisciplinary mix of dental and medical services, the Special Care Clinic's Hospital Dentistry Program offers oral health care to patients with a range of medical and psychosocial issues. The program is staffed by hospital dental faculty with advanced training who work with dental students to deliver care. Four students at a time typically rotate through a week-long experience in the program.
Formalized as a hands-on rotation last year, the Hospital Dentistry Program is meant to supplement the education of treating patients with special needs and teaching students to understand the medical and systemic interactions of the multidisciplinary team.
"Early in the rotation, students review developmental disabilities and how to treat patients with conditions such as Autism Spectrum Disorder," said Dr. Paul Subar, Assistant Professor and Director of the Special Care Clinic. "The students also learn about treatment for patients who are medically compromised, such as those undergoing transplants."
Among other topics, students learn the stages of liver disease in pre-transplant patients, and are reminded of the importance of informed consents and the emphasis on prevention through CAMBRA (Caries Management by Risk Assessment).
"Caring and treating patients with health concerns or developmental disabilities requires careful preparation and assistance," noted Subar. "The clinic is fortunate to have a hygienist who is very experienced treating patients with special health care needs and who is also an integral part of the teaching experience, as students learn to work with a dental hygienist."
Throughout the week-long rotation, other topics are covered such as the treatment of fearful patients, and patients with common illnesses such as diabetes and multiple sclerosis or less common conditions such as tuberous sclerosis. Students are briefed on hospital dentistry screening triage protocols and the use of nitrous oxide.
The Special Care Clinic provides a full range of dental services to meet patient needs, including cleanings, fillings, root canals, extractions and dentures. Where appropriate, the clinic also offers its patients alternative relaxation techniques or nitrous oxide. For those patients whose medical and/or psychosocial condition warrants general anesthesia, hospital dental services are available through one of the California Pacific Medical Center campuses and/or the Kaiser San Francisco hospital, all located near the Arthur A. Dugoni School of Dentistry's San Francisco location.
Students and faculty participating in the Hospital Dentistry Program provide pre- and post-organ transplant oral health assessment and care, and are available for in-patient dental consultations at California Pacific Medical Center.
"Patients undergoing medical transplants must be free of infection in their body, including their mouths," said Dr. Allen Wong, director of the Hospital Dentistry Program. "There are times when a patient has a fever of unknown origin which is eventually traced to infected teeth."
The dental school has had an informal relationship with local hospitals for more than 15 years, and over the last 10 years has served as an integral team player for such areas as liver and heart transplant, radiation oncology and emergency services.
In addition to Drs. Paul Subar and Allen Wong, faculty members Drs. Lynne Wong and Douglas Young are involved in the Hospital Dentistry Program.
University of the Pacific, Arthur A. Dugoni School of Dentistry is one of the nation's premier dental schools and has served the Bay Area community for 113 years. Pacific is committed to excellence in student-centered education, patient care and research. The school's clinics, located in San Francisco, Union City and Stockton, offer quality, affordable dental services to children and adults throughout Northern California.
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