At the Alaska Mission of Mercy (AKMOM) event, thousands of patients will be seeking dental treatment in a limited time period. During this two-day event, dentists in the dental triage unit will be asked to establish individual treatment plans with the goal of relieving pain and infection. Those plans are then reviewed with patients to ensure they understand their immediate needs and agree to what can be accomplished during that day.
In private practice, dentists can develop comprehensive and long-term treatment plans because they know that future appointments are likely. This approach is unrealistic for patients who attend events such as the AKMOM; access to dental care may continue to be a problem so the limited treatment available needs to be carefully prescribed and prioritized to yield the greatest impact on the patients’ oral and overall health. Each practitioner must consider the needs of the entire patient population as well as each individual they treat.
Patients and their families will receive one-on-one oral health counseling before dental treatment. Prior to dental triage, patients will complete a limited medical assessment. It is important for medical personnel working in medical triage to identify patients with:
- Serious medical conditions, medications, or other issues that may interfere with or prevent dental treatment
- The need for antibiotics prior to dental treatment
- The need for immediate medical treatment that cannot be provided on site
- Patients in consultation with the triage dentist will rank their top treatment priorities. Clinical dentists should focus treatment efforts on the first priority but can use their professional judgement to determine if time allows for additional procedures, for instance, within the same quadrant.
The priority guidelines for treatment are:
- Providing dental treatment to relieve pain and infection
- Providing dental treatment specific to a medical condition (e.g., prophylaxis for patients with diabetes or advanced periodontitis)
- Extracting teeth that cannot be restored in a limited amount of time (e.g., 45 minutes). Patients will receive a list of community dental care resources upon exiting the clinic.
- Restoring teeth when appropriate and time permits (e.g., pulp caps may not be appropriate treatment at this event as we do not know whether the patient will seek the recommended follow-up care.)
- Endodontic procedures on anterior teeth can be done.
- Recommending x-rays only as needed or appropriate based on the professional judgement of the triage dentist rather than for routine screening purposes.
- For extractions, restorations and endodontics, x-rays should be taken, as deemed appropriate, in the general x-ray area.
- Children should be sent to the Pediatric Department for x-ray determination.
- Providing anterior treatment partials to restore a patient’smile within the capacity of the clinic’s lab.
- Dental hygiene should focus on debridement of gross calculus.
- Routine prophylaxis for patients without immediate dental treatment needs if the hygiene department
- lead indicated availability of space and time.
Following treatment, patients will also receive:
- Post-operative care instructions with a phone number to call if they are experiencing problems with the care they receive at the clinic.
- Community resources for follow-up care or additional treatment.
- Information regarding available government programs.
- An opportunity to provide feedback about the care they received at the event.