People who have complex medical needs may need to see a hospital dentist—or a dentist who treats patients in a hospital setting—instead of a general dentist. “Hospital dentistry allows patients to be in an environment where there is a communicative relationship with their medical team who can provide guidance based upon their specific needs,” says Tanaya Porter, DDS, a dentist at Henry Ford Health.
Here, Dr. Porter shares several conditions that often require a hospital dentist.
People who are diagnosed with cancer—especially head and neck cancer—need special dental consideration, as they often experience oral complications from radiation and chemotherapy. One of the most common oral complications is dry mouth, meaning you don’t produce enough saliva to lubricate your teeth. Because of this, bacteria are more likely to stick to your teeth, which increases the risk of cavities. “Dry mouth is a major cause of dental cavities in my patients,” says Dr. Porter.
Bisphosphonates, or bone-strengthening medications, are often prescribed to those who have cancer that has metastasized (spread) to the bone. But these medications can inhibit bone healing and cause oral complications. Before you start taking the medication, you’ll be referred to a hospital dentist to extract any teeth that require it—because if a tooth needs to be extracted while you’re on a bone-strengthening medication, your jawbone won’t heal correctly. This can cause osteonecrosis of the jaw, where bone cells in your jawbone die and your jawbone is left uncovered by the gums.
Dr. Porter develops dental care plans that involve seeing patients before, during and after cancer treatment to maintain their dental health.
Organ transplant recipients
Once you receive an organ transplant, you must take medication that weakens your immune system so your body doesn’t reject the foreign organ. But because of this, even small infections could become severe. “All organ transplant candidates need dental clearance exams to identify sources of oral infection,” says Dr. Porter. “Infection can cause abscess (a buildup of puss in the teeth or gums) or sepsis, which can be serious for patients who are immunocompromised. Patients are encouraged to maintain good oral hygiene and seeing a dental hygienist is very important.”
Hemophilia, a condition where your blood doesn’t clot properly, means any small cut could become life-threatening. “Those with hemophilia can’t be treated at a general dentist’s office because they need specific medication to manage bleeding before dental procedures,” says Dr. Porter. “Even something as seemingly benign as a deep cleaning or a tooth removal could be serious without the proper medication.”
Emergency tooth pain and infection
Depending upon the issue, people who come into the emergency department may need to see a hospital dentist. “Maybe they’ll have facial swelling or some type of infection that needs a dentist’s immediate attention,” says Dr. Porter. “We’ll treat the issue and then try to get them set up to continue their dentistry needs at general dentist’s office.”
“For some adults who have special needs, it’s hard for them to have dental procedures at a general dentist’s office,” says Dr. Porter. “We take them to the OR and do everything they need there under anesthesia—comprehensive dental exams, radiographs, cleanings and all restorative needs. This is part of our clinic that we’re hoping to expand upon in the future. Our goal is to improve dental health equity for our patients.”
To learn more or to make an appointment with a dentist at Henry Ford’s dentistry clinic, call 1-800-436-7936 or visit henryford.com/services/ent/oral-and-maxillofacial-surgery/hospital-dentistry.
Tanaya Porter, DDS, is a dentist at Henry Ford Health. She sees patients at Henry Ford Cancer—Detroit, Henry Ford Hospital in Detroit and Henry Ford Dentistry and Oral Surgery in Detroit.