COVID-19 Brings to Light Inextricable Connection Between Dentistry and Medical Care

In any discussion of medical careers, dentistry is not likely the first option that comes to mind. But from emergency tooth pain to reconstructive procedures, the COVID-19 pandemic has amplified the understanding that dental care and medical care are inextricably connected.

“We say at our clinic, ‘know the medical history before you decide how to treat the patient dental-wise,’ whether it pertains to the usage of blood thinners, their immune system, diabetes, or other factors,” says Cynthia L. Idzik-Starr, DDS, a Baltimore-based dentist and assistant professor at University of Maryland (UMD) School of Dentistry. “Students need to know that dentistry is not just about extracting teeth or doing fillings. We’re connected to medical science.”

Idzik-Starr notes that ERs are known to have high proportions of visitors with dental issues, often pertaining to pain associated with necrotic teeth that have infection associated with them. Often a hospital emergency room will provide a prescription for antibiotics and a medication for pain as many are not equipped to extract the teeth associated with the infection.  Those patients would be better served visiting a dental clinic that can provide treatment that can eliminate the source of the infection. Even as UMD’s School of Dentistry closed in the early stages of the pandemic’s intensification in the U.S., its oral surgery department remained open because the school did not want patients with tooth pain associated with infection to visit ERs that were overloaded with coronavirus cases.

According to Dr. Idzik-Starr, it was important to accommodate these patients because “dental infections can become life-threatening due to the possibility of it going systemic.” She conveys the story of a 24-month-old child who was referred to the UMD clinic from a rural hospital ER. The patient was suffering from a potentially life-threatening swelling that encompassed the young child’s entire upper lip past her nose and working its way up to her eyes. When Dr. Idzik-Starr removed the teeth that were causing the infection, the patient had immediate relief of the pain and began to smile. Dr. Idzik-Starr said the clinic also saw two patients that had swelling that was found not to be caused by dental issues that needed immediate medical attention and the patients were referred to the hospital ED for treatment.

Dima Ghunaim DDS, MS, FACP, a maxillofacial prosthodontist at UMD School of Dentistry, echoes Dr. Idzik-Starr’s sentiments on the little-known medical urgency of dental issues and the challenges presented by COVID-19.

“People are largely unaware of what dentists can do and don’t view dentistry as part of medicine,” Dr. Ghunaim says. “But an infected tooth with swelling is emergent and treatment can’t be put on hold. Teeth are functional and dental care is medically necessary. Infections must be treated. Knowing the importance of management of dental infection, the Dental school kept the emergency clinic in oral surgery open during the pandemic to ensure that the ERs were not overwhelmed with dental pain/infection patients due to the mandated shutdown of dental offices in the local communities. This was done to make sure that the ERs were free to manage COVID-19 along with other emergencies.”

During the pandemic, Dr. Ghunaim continued to  focus on cancer-related facial reconstruction prosthesis in partnership with the head and neck cancer surgeon at the University of Maryland. She was also part of the team of faculty managing the dental emergency clinic.

“Teeth are never the same after cancer treatment,” she says. “The treatment affects salivary flow and healing. These patients make up a highly compromised group, and not a lot of dental professionals are trained to care for them.”

Dr. Ghunaim’s comments connect to the mission of Health Professions Week (HPW), a nationwide collaboration between today’s healthcare and education organizations designed to provide reliable, accessible resources to explore careers in the health professions. For those considering a future in the health professions, HPW is a one-stop-shop to explore over 20 career options. Registrants receive access to a personalized website with curated, on-demand content introducing the participating health professions, as well as access to exclusive live events featuring opportunities for one-on-one career advice.

How will a greater number of aspiring health professionals understand that a dental career, including in a specialty like maxillofacial prosthodontics, represents a medical career? HPW raises students’ awareness about these lesser-known realities and nuances within the health professions.

“It’s great to have a week that brings to light the different aspects of health care. From dentistry, nursing, physical therapy and rehab, to all forms of medicine, there are so many aspects to health,” says Dr. Ghunaim. “Today, everybody is part of this pandemic, which gives the young generation insight that helps them make choices for their future. Along those lines, Health Professions Week helps students make the connection between dental and broader health, driving more applicants to dental programs.”

At the same time, Dr. Idzik-Starr expresses concern that dental schools and all health programs “might lose applicants because people will be scared to get into any medical field due to COVID-19. I’m afraid students will back out.”

Dr. Ghunaim believes health degree programs may see more applicants in the pandemic era because students will be inspired to help save lives. This will apply to dentistry too as most applicants express their interest in dentistry to manage patient pain and improve their quality of life. In times like these, with such an unprecedented pandemic, applicants will be motivated to help even more.

“Dentistry is still a sought-after profession, but we might see more interest in medically inclined aspects of dentistry, like oral surgery and cancer reconstruction,” she says, adding that “any applicant to dental school says, ‘I want to help people. I want to make them smile and resolve their pain.’”

One tool for driving more applicants to dental programs is Liaison’s Centralized Application Service (CAS), the cloud-based recruiting and admissions solution for higher education institutions, programs and associations looking to grow and shape enrollment, while reducing overall effort and costs. Liaison partners with the American Dental Education Association (ADEA) to offer four dentistry-related CAS Communities — AADSAS, CAAPID, DHCAS, and PASS — to dental schools, dental hygiene programs, and advanced dental education programs. CAS drives application volume through exposing programs to a broader national and international applicant pool, while allowing students to apply to multiple programs through a single, centralized application form and one set of supporting documentation.

Liaison is a sponsor of HPW, which will be held from November 14-19 this year. All prospective health professionals are welcome to register for #HPW2020, including career changers, high school, college, and graduate students, both domestic and international. For more information, visit: explorehealthcareers.org/hpw/

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