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URMC Emergency Providers Get Training on Dental Treatment

When a patient with dental or mouth pain arrives at Strong Memorial Hospital’s emergency room or urgent care during regular hours, he or she is usually referred to the experts at Eastman Dental’s Urgent Care clinic.

But what happens during the off hours?

The University of Rochester Emergency Medicine Urgent Care Provider Group, comprised of MDs, FNPs, and PAs, recently learned ways to handle such oral health emergencies from Dr. Linda Rasubala, associate professor and assistant director of Eastman Dental’s Urgent Care.

Emergency Providers group at URMC“They had specifically requested training on oral health emergencies,” said Heidi Springer, MSN, FNP-C, CCRN, director of URMC’s Emergency Medicine/ Urgent Care APP’s and its Fellow Program. “For the most part, they know about the services provided, but we often see patients on weekends, evenings and holidays when routine services are not available. It is important that our management is evidence based and helps to bridge the patients until they are able to be evaluated by the Eastman team.”

During this interprofessional care collaboration, Dr. Rasubala gave a comprehensive presentation on managing common dental emergencies, such as trauma, infections, post-operative complications and broken dentures, or any other dental condition that requires immediate care.

“Dental emergencies are very common,” explained Dr. Rasubala. “They are rarely life threatening but usually very painful.”

Urgent Care signBecause 40 percent of the U.S. population does not attend primary dental care and relies on emergency care for dental treatments, these types of cases show up frequently in area urgent care clinics and hospital emergency departments.

Dr. Rasubala used many photos to explain the condition or technical term that is used in dentistry while educating the providers on how to properly recognize the symptoms, accurately diagnose and appropriately determine the right treatment of each case/condition.

“They were very enthusiastic to learn more so they can help their patients prior to referring them to a dentist,” Dr. Rasubala said.

“They had great questions, especially about an avulsed tooth, or when it becomes completely displaced from its socket,” Dr. Rasubala continued.  “What do you do with the tooth, how do you transport it, what to suggest to the patient and how should the patient follow up?”

Dr. Rasubala also shared with the group how to treat and reposition an intruded tooth resulting from trauma and how to stabilize the teeth with splinting.

Dr. Rasubala and Heidi Springer“A picture is worth a 1,000 words for our group,” Heidi said. “The group truly enjoyed the photos so that they could better understand what they are looking at. They also really enjoyed how open Dr. Rasubala was and for providing them with great information.  The feedback was exceptional. We really appreciated her expertise!”

Attendees also asked about what medication they should prescribe for acute dental pain.

“I strongly emphasized to the urgent care providers to consider an alternative to prescription opioids such as NSAIDs or NSAIDs combined with acetaminophen as the first-line therapy for managing acute dental pain,” Dr. Rasubala explained. “This approach has proved sufficient to manage acute dental pain.”

Dr. Rasubala continued explaining that current research evidence indicates that non-opioid analgesics, such as ibuprofen and acetaminophen, are more effective than opioid analgesics like hydrocodone, oxycodone and codeine, in controlling acute dental pain.

In an effort to curb the opioid crisis, many states implemented a mandatory Prescription Drug Monitoring Program a few years ago.  Dr. Rasubala co-authored a study published in PlosOne that showed frequencies and quantities of prescriptions for opioid analgesics, such as hydrocodone, oxycodone and codeine, decreased significantly, while those for non-opioid analgesics, such as Ibuprofen and acetaminophen, increased moderately following implementation of the mandatory Prescription Drug Monitoring Program (PDMP) at Eastman Dental’s urgent care clinic.

 

Karen Black | 6/20/2019

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