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Tuesday, March 14, 2023
Every patient admitted to OSH receives an appointment at the OSH Dental Clinic to assess their dental health and identify pain or infections that could become obstacles to a patient's recovery.
However, the OSH Dental Clinic staff go beyond preventing dental pain and infections – they build trust with patients so they can receive the care they need.
“Many of our patients are unhoused or have substance abuse issues and oral health has not been their top priority. There is severe mental illness that impacts them from getting care," said Dr. Charles Rim, one of three dentists who provides care to OSH patients. “Sometimes it may take multiple visits to gain that trust and help them understand that by providing the urgent dental care they need, we're able to remove the distractions of pain and infection so they can focus on their recovery goals."
Most patients are admitted to OSH with urgent dental issues – like abscesses or the need for dental extractions – conditions left unchecked for various reasons, including their mental health, limited access or mistrust in available support services.
Having one-on-one with the patients also helps build the needed trust to provide care, Rim said.
“We had a patient who was experiencing head pain and was convinced she had brain cancer. She couldn't believe it was an infected wisdom tooth until she trusted us to take an X-ray," he said. “When we were able to show her, it was her tooth and it came out, she never mentioned it again. She was pain free and the worry was gone."
Dental pain, swelling from an infection or missing teeth can affect a patient's appearance, diet and mental state, which all impact the patient's overall health and ability to participate fully in their treatment plan, said Dr. Tim Tanada, the OSH Dental Clinic's supervising dentist.
Tanada and Rim are part of the OSH Dental Clinic team that also includes three dental assistants, a dental hygienist, and a part-time, contracted dentist who provides services in Salem and every other week in Junction City. In addition to oral exams, the OSH Dental Clinic provides extractions, periodontal care, dental restorations, root canal treatment, fillings, adjustments to dental prosthetics as needed, and referrals to labs and other providers.
Tanada and other team members can recount stories of how important building that rapport has been in the outcomes of patients who have missing or decayed teeth and whose speech and diets improve after dentures or bridge work, as well as patients who needed extra time to trust that their head or jaw pain is being caused by dental issues and are relieved to be pain free.
Dentists and Dental Assistants at Oregon State Hospital
Because many patients come to the hospital after being unhoused without access to health or dental services, accepting care affects their recovery in other ways, too, because they feel understood by their care team, said Dr. Julia Howe, OSH chief of psychology.
“The element of knowing that you've been cared for – that people are there to help and provide you the care and support you need makes a huge difference," she said. “Our dental team's approach and skillset working with people with mental illness has a major impact because a patient has a positive opportunity to engage with people who understand them better and understand how their dental needs may be complicated by their illness."
Due to patient dental needs in Junction City, OSH partnered with
Medical Teams International, a nonprofit organization that provides mobile health services across Oregon and beyond, for access to a mobile dental clinic. Twice a month, a large red bus retrofitted with two procedure dental chairs and clinic equipment rolls onto the JC campus. On each visit to the campus, Dr. Michael Litchfield, an OSH contracted dentist, and full-time OSH dental assistant, Rosaleen K. may treat between eight to 10 patients within a seven-hour window. Their work is assisted by Medical Teams International mobile clinic manager, Kevin Abbe.
The mobile clinic enables staff to provide extractions and fillings, treatment for abscesses and other infections, as well as placement of crowns and general exams. The team also must remain flexible to take on any urgent dental needs that need to be fit into the schedule.
The dental team recognizes that teamwork across medical and therapeutic disciplines helps them achieve their dental health goals for patients.
“You see the transformation of when they're first admitted with urgent dental and mental health issues and when they're discharged, you see the change in their mental health," Rim said. “You see that transformation because all the disciplines work together with patients to help them get discharged."
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