Visiting the dentist is not an experience many people look forward to. However, for the more vulnerable patient populations in Alberta, visits can be much more than unpleasant: they border on impossible. To make treatment more bearable, the Grey Nuns Community Hospital and University of Alberta Hospital Dentistry Program have come together to provide an alternative to private dental clinics.
“[Our dental patients] are often uncomfortable and fearful—not that different from anyone going for surgery! But sometimes they’ll take it to the next level,” says Trevor Small, Senior Director of Operations of Ambulatory Services and Rehabilitation at the Grey Nuns Community Hospital.
“Some of our patients have not been able to get dental work because of their unique conditions,” Trevor says. These patients often have complex medical needs or mental health conditions. Largely, these are patients who would be intolerant of receiving the same care in a normal dental clinic setting.
Joan Janeczko’s daughter is just one of these patients. “She would not get anything done. They [can’t] do it,” says Joan. “I don’t know what her teeth would be like if they couldn’t do stuff like this program does.”
Joan’s youngest daughter, Jacquelyn, has Down syndrome and some autistic tendencies. She is also very fearful of doctors and dentists, which has made treatment in the past difficult. After turning 18 and moving to Edmonton from Hinton, she was referred to the Grey Nuns/University of Alberta Hospital clinic’s Dr. William Preshing, who took over her care as an adult patient. She has been into the clinic and the Grey Nuns for two appointments: one to fill one or two cavities, and one to remove her four wisdom teeth.
“They cross that threshold into adulthood and families just don’t know where to go. They bounce from one place to another and finally connect with us,” explains William.
Without the option for sedation or general anesthesia that’s provided by this program, Joan’s convinced that her daughter would not be able to receive any dental treatment.
The program offers a wide variety of options for patients, and general sedation is suggested when all other options have been exhausted. “Treating patients under general anesthesia is always our last resort; there are still patients with special needs and behaviours where we’re unable to avoid that.”
Joan knows this struggle well. The first procedure her daughter underwent was difficult; after an adverse reaction to a sedative, Jacquelyn woke up combative and distressed. William's team noted this in her file and changed the treatment plan for her second visit to help keep Jacquie calmer.
Once a patient’s teeth have been addressed, there’s also an opportunity to finish other medical procedures or appointments. “In some cases, it is simple things like bringing in someone to cut their hair,” says Trevor. “While they’re sedated, there’s an opportunity to get many things done that couldn’t be done in any other way."
Jacquie Janeczko also takes advantage of this benefit. She must have an echocardiogram once every five years to monitor a heart condition, and these scans are taken while she’s under general anesthetic to help ease her discomfort around doctors and medical equipment.
“They’re there for us. They’re always so calm, it’s so nice! All the staff talk to our children or young adults as young adults. They don’t talk to them like they don’t understand or that they’re not all there.”
As long as this program exists, families like the Janeczkos will be grateful. “It’s best for Jacquie. It’s just the best for her," says Joan. "She would not get anything done otherwise.” Along with the much-needed medical care, Joan is also thankful for the respect all have shown for her daughter and other patients.
The program will be increasing its capacity within the Grey Nuns Community Hospital beginning in September 2017, from one day per week to two.
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