Month: April 2017

Emergency Dental Service Enhances Clinical, Academic Missions

The new emergency department at UConn John Dempsey Hospital has a room dedicated for dental emergencies - one that features a dental chair in place of a stretcher. (Photo by Paul Horton)
The new emergency department at UConn John Dempsey Hospital has a room dedicated for dental emergencies – one that features a dental chair in place of a stretcher. (Photo by Paul Horton)
Oral pain, bleeding and swelling can happen for any number of reasons, and they don’t restrict themselves to regular business hours.

It’s why UConn Health has had around-the-clock coverage for dental emergencies since the early 70s.

“We have the largest dental emergency service in the state,” says Dr. Steven Lepowsky, senior associate dean for education and patient care at the UConn School of Dental Medicine. “The service exists to address a significant unmet need. There are still, even in today’s world, people who do not have access to dental care and, unfortunately as a result of that, experience dental emergencies. But it’s also for patients who may be going for regular care but just have an emergent situation.”

On an average day, UConn Health sees nearly 60 dental emergencies in a 24-hour period. The most common are toothaches related to a cavity, root canal, or abscess.

The dental clinics, staffed by students and residents from the UConn School of Dental Medicine who work under faculty supervision, provide urgent dental care weekdays from 8:30 a.m. to 6 p.m. After 6, patients with dental emergencies are treated in the emergency department.

And while the hours are nothing new, the setting for the after-hours care is.

Exterior of new emergency department at UConn John Dempsey Hospital. (Photo by Janine Gelineau)
Exterior of new emergency department at UConn John Dempsey Hospital. (Photo by Janine Gelineau)

When UConn John Dempsey Hospital moved its emergency department to the new University Tower in May, it opened a new patient room dedicated for dental emergencies—one that features a dental chair in place of a stretcher.

“It replicates a full dental operatory, so it expanded the scope of what we could offer on an emergency basis after hours,” Lepowsky says. “It’s a much more pleasant environment for the patient. They don’t feel like they’re in an emergency room. Many emergency dental services are providing care on a hospital bed. This is one of the few where it’s actually a dental chair.”

From 6 to 10 p.m., a dental resident is on the premises to handle dental emergencies in the ED. After 10, patients who present with a dental emergency are assessed by medical staff with the discretion to bring in the dental resident on call when needed.

“There’s a resident and then there’s a second-year resident who provides backup, then if it’s something that they need additional assistance with, they call a faculty member,” Lepowsky says. “They’re predominantly general dentistry residents, but there are also oral surgery residents and pediatric dentistry residents on call based on what the needs of the patients are.”

That training component makes the emergency dental service a crucial piece of the dental school’s academic mission of teaching tomorrow’s dentists, just as it is to UConn Health’s clinical mission of serving all comers today.

“It’s a good educational experience for the students and residents because it helps them build skills in terms of how to diagnose a problem quickly, identify the source of the problem, and try to provide care that immediately addresses someone’s needs,” Lepowsky says.

While the dental room in the new ED enables a wider range of diagnostic and treatment options than the previous after-hours setting did, the concept has not changed.

“Our emergency dental service is not a 24/7 dental practice. It’s really to specifically address urgent needs that can’t wait,” Lepowsky says. “It’s not the correct environment for comprehensive dental care.”

Sometimes the course of action after hours is relieving the pain and sending the patient home. He or she would then return in the morning when the dental clinics are open.

“You want someone to establish a relationship with the provider and establish what we would refer to as a dental home, so there is someone who’s coordinating all their care,” Lepowsky says.

New Generation of Family Dentistry

Jeffrey Pan, student commencement speaker for the UConn School of Dental Medicine Class of 2016, with a patient in the dental clinic. (Photo by Ze Horak)
Jeffrey Pan, student commencement speaker for the UConn School of Dental Medicine Class of 2016, with a patient in the dental clinic. (Photo by Ze Horak)

Jeffrey Pan is the School of Dental Medicine Class of 2016 commencement speaker. (Photo by Janine Gelineau)
Jeffrey Pan is the School of Dental Medicine Class of 2016 commencement speaker. (Photo by Janine Gelineau)

Jeffrey Pan won’t be the first dentist in the family. Not even close.

His father is a well-known family dentist in Melrose, Mass., and his mother is a professor at the Boston University School of Dental Medicine.

And he won’t be the last. He has a younger brother who’s a first-year student at BU Dental, and a younger sister who is considering dentistry.

“I always joke with everyone that I got brainwashed when I was a kid,” Pan says. “I always wanted to be a dentist at a young age. We actually did live upstairs from the practice, and I would always come home from school and then go down and peak through the door and watch my father.”

When it came time for choosing a dental school, the UConn School of Dental Medicine was little more than a name on the list of institutions in the Northeast.

“I didn’t really know much about the program,” Pan says. “At the interview, I got a really good feeling about the program. Then I heard a lot of great things from people who were in dental school, or who had graduated and had heard about the program. It seemed like a very competitive program to get into, and it looked like it had everything that I was looking for in terms of an education and clinic experience.”

Pan chose UConn over BU, Tufts and Columbia. He describes his experience as a UConn dental student as tough and arduous.

“When they say in orientation this is not an easy program, they mean it,” Pan says. “But I think in the end it really has made us more confident in what we do, and prepared to go out as solo practitioners.”

One of the things he’ll remember most about the UConn School of Dental Medicine is the class size. Pan is one of 35 students who make up the Class of 2016. Because they got to know each other so well, he says they will have a network of people they can call on for questions and rely on as they enter the profession.

“The latter two years of clinic especially, I think it really solidified our knowledge from medical school to dental school, being able to integrate that knowledge and apply that to patients,” Pan says. “I think the workload they give us and the pressure they put on us, after a while it starts to inspire confidence.”

Pan says he’s always wanted to be like his father, and always wanted to work with his father. And that’s the plan: a year in BU’s general dental residency, and then back to the two-story building he grew up in, with Dr. Nelson Pan’s practice on the ground floor. Only this time, father and son will practice side by side.