Intermountain Healthcares Hospital-: Based Dentistry Provides Care for Special Needs Patients and Those Who Need Dental Care in the Hospital

Dr. Marc A. Collman,  DDS, FICD is the  director of special care  hospital dentistry at  Intermountain McKay  Dee Hospital in Ogden, Utah, and  is associate director of hospital  dentistry, at the University of Utah  Hospital and associate professor of  dentistry at the University of Utah School  of Dentistry. 

Intermountain Healthcare has an  innovative hospital-based oral health care  programwhich launched in 2019, called special care hospital  dentistry. The program provides dental care for patients who  have special needs or are unable to undergo dental services  in a traditional dental office setting. Examples of diagnoses  that can benefit from these servicesare autism spectrum,  Down’s syndrome, cerebral palsy, muscular dystrophy,  epilepsy, and traumatic brain injury. 

Various dental procedures can be provided for special  needs patients in the operating room, including dental  cleanings, digital dental x-rays, a comprehensive dental  examination, fillings, extractions, root canal therapy, crowns,  implants, gum surgery, and bone grafts. This environment  is very controlled because the patient is under anesthesia.  Other medical procedures can be completed during this  time. The cost of delivering care may be reduced, if needed  medical and dental procedures can be completed during the  same operating room time. 

Intermountain has recognized how hospital-based  dentists can help provide emergent dental care for other  patients in the hospital who need dental care in addition to  medical care. 

A hospital-based dentist could be available for patients  who present to the emergency department with dental  issues such as oral pain, swelling, or trauma. Emergent dental  care can be provided and often a hospital admission can be  avoided, and the patient can receive follow up care from a  community-based dentist. 

Hospital-based dentists can also address emergent dental  needs of a patient who is hospitalized. For example, a patient  in the hospital is being prepared for heart surgery and the  medical team determines the patient must have a dental  clearance prior to surgery stating that the oral cavity is not a  potential source of a bacteria in the blood stream, meaning,  no deep caries or active dental infections. Any worrisome  teeth or oral disease that could jeopardize the outcome of  the heart surgery, can be emergently treated in the operating  room, before proceeding with the heart surgery. 

Patients who are preparing to receive cancer treatments  also need to be checked to see if their teeth, gums and  supporting bones are free of any potential source of bacteria  that could get to the blood stream prior to surgical oncology  procedures or therapies. 

Hospital dentists may co-provide care with various  medical specialties including hospitalists, emergency room  physicians, oral surgeons, otolaryngologists (head and  neck surgeons), oncologists, cardiovascular surgeons and  infectious disease physicians. 

Hospital-based dentists need to have not only expert  knowledge and procedural skills, but also exceptional  listening skills and an ability to make complex decisions in  alignment with the hospital’s physician and nursing staff.