GDA Action October 2021

October 2021 • 35 OR. If the patient is in a place where an office follow up is not an option, then we usually visit the patient. This would apply to hospital inpatients, bedridden patients at home or nursing homes, or other institutions.  Other Out-of-Office Experiences Home Visits There is nothing new about home visits. In fact, in medicine, home visits historically preceded office and hospital care. This is true all over the world. What is new is how easy it has become. Once you have the skills, motivation, and supplies, the only real hard part is finding a parking spot for the visit. I have found that the most grateful patients and families are those we visit in their homes. It does take a little extra preparation. It is wise to have back up supplies such as curing light, hand-held X-ray battery, composite material, and a hard copy of the treatment plan in your car (Photos 12, 13). Nursing Homes I love going to nursing homes and assisted living facilities. Often the facility has a beautician chair and/ or dental chair and/or ENT chair. Some of our staff members compete for who gets to accompany my partners or me to the facility. Sometimes, the hygienist and dental assistant do all the clinical work, while my job is to make an entry in the chart. We take X-rays on every nursing home patient and perform cleanings and minor procedures. If they need more work, then we often schedule for them to come to our office for more definitive treatment or hospital OR for extensive care (Photos 14, 15). Hospice We happily break all the rules for hospice patients. At the base level, pain- free and infection-free is the least we can do for them. Imagine providing a service for those who want a 10-unit bridge on their only three remaining upper teeth, or to whiten their teeth so they will look good on photos, or to provide an acrylic flipper they can wear for when their family visits. It takes so little to make these people smile and happy in their final days. Our standards and guidelines of bridge length and criteria for bleaching do not apply. It takes such little effort to make someone happy (Photo 16). Institutions I have worked in different kinds of institutions. Each taught me something, and each improved my clinical skills in a non-conventional setting. The most dedicated health professionals I have ever encountered are those who worked in institutions for the mentally challenged. They work tirelessly in the company of ever- challenging clients. These are the men and women who assisted my dental team and me when we went for our biweekly or monthly all-day visits seeing their clients at the health clinic in their institutions. Their job is to sedate the patients, properly restrain them so that no one gets injured, and assist us as we perform dental X-rays, cleaning, scaling, and simple extractions. Institutions for juvenile delinquents and similar facilities also rely heavily on nursing staff, but security personal are also on hand for our safety. The situation is not much different in jails and prisons. When we go there, security is tighter than the JD facilities. When their clients come to our office for follow-up or care beyond what can be provided there, they are always shackled and accompanied by two security guards. Missions to Other States or Countries I can recall that my best days in dental school and residency were when I was studying off site. I spent many months in Portland, Maine; Edinburgh, Scotland; and London, England, then returned to my home base at Tufts in Boston, MA. Even today, my favorite day of the week is when I am in the OR. The change of routine and the quadruple production efficiency of working 6-handed with no pausing for any reason makes practicing dentistry a treat, not a chore. But leaving town on a volunteer mission is on another level (Photos 17, 18, 19). Cruise Ships Here is something you may not have thought of. I enjoyed free vacations for myself and three family guests on cruise ships. My job was to provide recall exams, cleaning, and X-rays with minor basic dental care for the crew, plus the occasional passenger dental problem and offer whitening to the guests. Vans and Vehicles Portable dental care has come a long way from disassembling the equipment and supplies into plastic or cardboard boxes and totes. Vans are now fully equipped with movable DentalEZ operatory chairs allowing for wheelchair access, portable X-rays, and almost everything you could expect in a fully equipped office. Dental schools, residency programs, community outreach programs, and private entities are now making mobile and portable dentistry easy, especially in their fully equipped vans accessible to people who cannot or will not come to the dental office (Photos 20, 21). MOM Events A wonderfully successful program is the Mission of Mercy. Dental teams of all spectrums join with students to provide this valuable service at various locations several times a year. Even if this is only initial screening and basic simple care, it gets more people into the system in a comfortable and less threatening environment. Supplies and time are usually donated (Photo 22). Dental School, Hygiene, and Dental Assistant Programs If you have never thought about this before, please think about it now. Teaching is practicing dentistry outside the office. Dental educational institutions need 23-Teaching is learning »