Jean-Marc Lang has not always liked going to the dentist. The 27-year-old suffers from autism, epilepsy, severe developmental delay, and ritualistic behaviors that mimic obsessive-compulsive disorder (OCD). To him, sitting down in a dentist’s chair for a cleaning seemed almost impossible.
“Jean-Marc has destructive rituals,” explains his mother Hélène. “So when things aren’t perfect, or not the same, he has a tendency to want to damage them or get rid of them altogether. He also has debilitating rituals where he tears off the skin until it is bleeds, or removes a nail.
As Jean-Marc’s behavior escalated over the past decade, Helene became increasingly concerned with keeping Jean-Marc’s teeth and gums healthy.
“He has poor communication skills and is not able to clearly say whether he is in pain or not, so this has always been a big concern for us,” she said. “It is sensitive to touch and noise, so any dental work – a dental exam, cleaning or repair – should be done very carefully to make the experience as comfortable as possible.”
When Jean-Marc was young, he first went to the CHEO dental clinic. Over time, thanks to competent and caring staff, Jean-Marc started to feel more at ease and eventually developed complete confidence in the staff. Once an adult, he was referred to another excellent clinic in the community before being referred to the dental clinic at The Ottawa Hospital.
A dental clinic like no other
The Ottawa Hospital Dental Clinic is unique in the region and provides specialized care to adult inpatients, as well as those requiring care and resources that community dental clinics are unable to provide. .
A team of highly trained oral surgeons, dentists, hygienists and support staff work closely at the clinic to provide care to up to 40 patients per day who meet eligibility criteria and are referred by their doctor.
“Think of someone who has an uncontrolled seizure disorder, someone who is recovering from a heart transplant, or someone who has had part of their jaw removed as part of their surgery. cancer treatment, ”said Siobhan Little, dental clinic supervisor at The Ottawa Hospital. “These patients need specialized care and resources that we can provide in our clinic. We can even go up to their room in the intensive care unit if they have a problem. “
Many of the patients the clinic sees are preparing for or recovering from radiation therapy for cancer.
“We see patients with head or neck cancer before and after their radiation therapy,” said Dr. Weld, who has been an associate dentist at The Ottawa Hospital Dental Clinic since 2017. “Radiation therapy kills cancer, but it also tends to damage the salivary glands. , the mouth is therefore very dry and the teeth are prone to decay. We need to make sure that all the teeth that are left in a person’s mouth are healthy and well cared for.
The clinic also receives referrals for patients undergoing heart surgery who need to rule out an infection that could compromise the results of the surgery.
“The reality is that we only have one bloodstream,” he explained. “If there’s an infection in your mouth, there’s an infection in your body. Antibiotics help, but until the source of the infection is eliminated, it can come back. “
Special resources also exist for patients with behavioral or anxiety problems. As part of their dental assistance program, hygienists are accompanied by an assistant, an additional layer of support for the patient. In some cases, patients may be gently wrapped in a “papoose” during a procedure if it makes them more comfortable. Each patient is different and each patient is treated as a unique individual.
Born of necessity and generosity
The clinic opened in 2002 thanks to generous donations from the Ottawa dental community, including dentists, dental specialists, dental laboratories, dental supply companies and dental product manufacturers.
“Part of the reason the dental community helped create the clinic was the recognition that there are patients who could not be served in a typical clinic,” said Dr. Weld.
Some team members volunteer their time at the clinic as a service to the community. The money and fees generated go into a trust fund, which helps pay for services rendered to people who cannot afford specialized dental care.
A personalized approach for each patient
With a strong sense of purpose and community support, The Ottawa Hospital Dental Clinic team strives to meet the needs of each patient.
“With each patient, we start with a consultation, and the treatment plan is built from there,” said Siobhan. “If they’re considered Hygiene Assist patients, we make sure the extra person is there for support. If sedation is required, we make sure all appropriate consents are given and paperwork is completed. “
When Jean-Marc had to go to the dental clinic to fix a chipped tooth, the clinic team met with his parents to discuss what it was like for him to go to the dentist in the past and what it was like. how he usually reacts to certain situations, so that they can better anticipate what might happen during the date.
With this knowledge, the team were ready to do what they could to make him feel as comfortable as possible.
“They spoke to her and adapted their approach as much as possible to meet her needs, making sure to build relationships and trust,” said Hélène. “They helped him understand what was being done and what was expected of him every step of the way.”
They also helped make sure Jean-Marc was comfortable.
“When I asked if there was anything we could put on his legs to keep him warm, they came back with a warm blanket,” his mother said. “Their level of kindness and compassion was so heartwarming. “
Leveraging Virtual Dental Care During the COVID-19 Pandemic
When Ontario hospitals were ordered by the provincial government to suspend non-emergency programs and services, the hospital’s dental clinic downsized to provide in-person dental care for emergency appointments uniquely. But in an effort to provide as many patients as possible with timely care, the clinic has also leveraged virtual care technology in some cases, which it plans to continue for the foreseeable future.
“Virtual care has been beneficial for our clinic and our patients,” said Siobhan. “For example, if we have a patient with developmental delay and we know that person will eventually have to go to the operating room, we don’t need the patient and their two caregivers to come to the clinic. Instead, we can call their caregiver, possibly prescribe antibiotics, and send the documents to the operating room. It is a smoother process for the patient.
As the restrictions are lifted, the clinic is once again gradually increasing the number of services.
Grateful families, dedicated staff
Anyone who has been to a dental clinic knows that staff can make the difference between a positive experience and a negative one. In addition to being at the top of their professional game, Hélène is happy to say that the hospital clinic staff show incredible compassion.
The clinic team works together to provide each patient with world-class compassionate care.
“They were so kind and patient, so open-minded and flexible as well as efficient and professional,” she said. “We could see that the whole experience was very reassuring for Jean-Marc, who meant a lot to us. We greatly appreciate the excellent service that Dr. Weld and the dental clinic team provided to our son. It’s reassuring for us to have the team here at the hospital and to know that they will do what they can to help.
And for the staff, that’s part of what makes this clinic special.
“I think because we have such a different patient population at this clinic, there is a lot of compassion on the part of the staff,” said Siobhan. “I myself went to the room to hold a patient’s hand because she was very anxious during an extraction. We try to go above and beyond to make sure they’re okay.
‘Okay, I’m ready. Let’s do this! ‘
What could have been a difficult or even dangerous date ended up being pleasant for everyone, thanks to the teamwork between the staff of the dental clinic, Jean-Marc and his family.
“This time, going to the dentist was so important for Jean-Marc,” says Hélène. “He forgot all his other behaviors and rituals. Nothing else mattered to him at the time and he was so relieved to have a tooth fixed. He just sat there with his sunglasses on and put his thumb up like he was saying, ‘Ok, I’m ready, let’s go!’ “
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