Protocol/Guidance Regarding Oral Surgery in the Main Clinic

10 months ago
Schulich Dentistry
5 minutes

Background:

Schulich Dentistry strives to provide optimal oral health care for the patients we treat in a welcoming environment that allows for an exceptional learner experience. It is important to balance these two primary objectives. The Oral Surgery clinic is optimized to provide simple and surgical exodontia and other oral surgical procedures such as simple biopsies, and soft tissue procedures as they relate to management of acute infections with surgical drainage when appropriate.

In the Oral Surgery clinic, armamentarium and assisting staff are optimized in this clinical space for these procedures. In addition, students are assigned a pre-determined number of out-of-clinic-assignments (OCA’s) as part of their clinical rotations. The students who are assigned to the OS OCA on any given session are supposed to complete those surgical procedures as part of that rotation with the pre-booked patients. Provision of Oral Surgery procedures in the Oral Surgery clinics provides an optimal surgical setting while affording those students on the OS rotation to complete these procedures in the appropriate discipline with specialized coverage form oral surgery faculty who have been calibrated for this discipline.

Protocol/Guidance:

Patients of the school who present to Main Clinic in any discipline (in-portfolio comprehensive patients, recall patients or Urgent Care patients) requiring Oral Surgical services are booked into OS after the following protocol is completed:

  • If a referral is needed for a non-urgent Oral Surgical procedure treatment planned in the Main Clinic, the student is to complete the Oral Surgery Case Complexity Form in the patient’s EDR and the necessary paper OS slip (green slip) and present the case to the Oral Surgery Faculty Clinician. If deemed suitable for the school, the signed and approved slip is handed in to the front desk, and they will book the patient into an OS session. Students need to ensure that the patient is aware of the fees for the proposed treatment and have the treatment authorized by the OS instructor in the TX plan in Salud.
  • Please note the same is true for a patient requiring a biopsy of a hard or soft tissue lesion. We do not have an Oral Medicine Faculty member currently available in the clinic. Refer to the SOP on management of Oral Medicine referral requests for biopsy or management of hard or soft tissue lesions, TMD, facial pain, etc.

On occasion, a patient may present to the Main Clinic in any discipline in extreme pain or with an acute infection or swelling that requires immediate attention or possible surgical intervention. Where the recommended treatment is an oral surgical procedure (extraction or incision and drainage), the following protocol should be followed:

  • the student is to complete the Oral Surgery Case Complexity Form in the patient’s EDR and the necessary paper OS slip (green slip) and present the case to the Oral Surgery Faculty Clinician covering in OS clinic. If deemed suitable for the school by the OS faculty, in acute situations, the patient may be seen in OS during that OS session, providing there is an available room in OS, there is adequate time in the schedule, and at the discretion of the covering OS faculty. The admin team will book the patient into OS clinic once the green slip is signed by the OS faculty. The students in OS will complete the tx wherever possible.
  • In certain scenarios where the patient with the acute issue is in Urgent Care or in General Dentistry, but there is not adequate space in OS to treat the patient or the OS clinic is not open for that session, it may be possible to complete the extraction in Urgent Care or in General Dentistry. The following criteria should be met to allow this to happen:
    • At the discretion of the covering faculty, the patient should not be deferred to another day without serious risk of escalation of their acute situation. There is not an OS appointment available later that day (Possibly in a PM session when the patient presents in the AM session).
    • The surgical management is straightforward, simple incision/drainage or simple extraction not requiring any (or very minimal) osseous surgery.
    • The covering General Dentistry/Urgent Care faculty are comfortable with covering the procedure.
  • If the above conditions have all been met, then a Dispensary Issue Slip requesting the appropriate oral surgical instrumentation and identifying the cubicle should be signed by one of the following instructors on the clinic floor: Dr.Suljak, Dr.McDermott, Dr.Hockley, Dr.Al-fayume, Dr.Dorion, Dr.Hornyak, Dr.Polos, Dr.Troncone, Dr.DeAngelis
  • This will authorize the DA team to mobilize the appropriate armamentarium and ensure that the suction lines are properly cleaned after the extraction/procedure.

**Note: in case of a less urgent situation where treatment may be deferred to the next OS appointment and if the OS clinic is closed without any OS faculty present, the green slips may be authorized by Dr. Dorion, Dr. Suljak, Dr. Hornyak, Dr. Polos, or Dr. DeAngelis. The Oral Surgery Case Complexity Form in the patient EDR and a proper case presentation must still be completed.