By MARTY LEVINE
The need for emergency medical treatments of all varieties has not stopped during the COVID-19 pandemic, and the flow of patients from near and far to the School of Dental Medicine’s clinic hasn’t quit either, says Marnie Oakley, the school’s senior associate dean for Clinical and Faculty Affairs.
In fact, she says, “during the pandemic, that patient base has grown. The demand is very significant.” That’s because most dentists are unable to see patients today to examine, diagnose and treat developing conditions that can, eventually, turn into emergencies.
To handle the situation, the school has recruited rotating teams of staff and faculty to do telephone triage with patients, to undertake in-person examinations and diagnoses, and to perform surgeries for conditions that don’t respond to medication and can’t wait for safer times. The school has dedicated several rooms in the otherwise-closed school building to conduct the clinic daily.
Since Pennsylvania’s Department of Health put out new rules two months ago for dentistry during the COVID-19 pandemic, the school has had to add N-95 respirators to clinicians’ personal protective equipment and create negative pressure rooms to make sure potential virus particles are filtered from the air.
In the clinic’s first week under pandemic restrictions, beginning March 16, 73 patients were seen via telehealth, which aims to screen for patients who can be treated through pain medications, antibiotics or other measures available in pharmacies, bringing only the most urgent cases on site.
In one recent week, more than 130 such patients contacted the clinic for screenings and possible visits. Over its first six weeks, the clinic had more than 2,000 calls.
“Weeks of having very limited access to dentistry is really weighing on the population,” Oakley says.
The triage phones let potential patients speak with Pitt Dental faculty members, including periodontists and other specialists. Those who must eventually come to the building for an examination or procedure are first screened for temperature and history, to detect COVID-19 cases, then led to an examination room where a four-person team — two faculty dentists, a faculty dental hygienist and a staff dental assistant — conducts the exam.
If patients need an extraction, maxillofacial surgery or a cancer biopsy of a suspicious lesion, they are referred to the surgical team — a faculty oral surgeon, a resident oral surgeon and a surgical dental assistant — on another floor.
Twelve teams rotate on and off duty at the clinic, involving about 40 Pitt Dental faculty and 20 staff members so far. In the clinic’s first week, 75 patients were seen by the surgical team; now 20 to 25 patients per week need such care. “If we’re doing our telehealth right, it shouldn’t be a lot,” Oakley says.
Patients “are all appreciative,” says Larry Cunningham, the school’s associate dean for Hospital Affairs and chair of the Department of Oral and Maxillofacial Surgery, who is part of a team working in the surgical suite. “Even the ones who are treated on the phone — they understand. Many of them don’t even want to come to the building. Our strategy has been to postpone treatments as long as possible so the risk from the virus goes down, in time.”
All of the school’s oral and maxillofacial surgery faculty have participated in the clinic, he says, alongside many other departments’ faculty. “Everybody’s been happy to come in and work for a week,” he says, adding: “Our concern level is a little bit higher because of the virus. A month ago, we didn’t even know how transmissible it was.”
The procedures he has performed have been almost exclusively dental extractions, which usually require minimal follow-up care, meaning the patient won’t need to come back to the building. His team also has diagnosed one person with cancer.
“This pandemic protocol has been in place to buy us time … until our restrictions are lifted, until we can get to work more completely,” Cunningham says.
Erik D. Ziegler, chief resident in Cunningham’s department, has been part of the clinic’s surgical team as well.
“It’s an obligation to take care of your patients,” he explains about his participation. The experience has been “entirely positive with respect to being able to take care of people who are profoundly in need. Everyone’s been extremely grateful and a pleasure to take care of.
“It’s been a team effort,” he adds, “and everyone — patients, faculty, staff and residents — has been working very well together.”
Marty Levine is a staff writer for the University Times. Reach him at firstname.lastname@example.org or 412-758-4859.
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