Role-playing exercises sometimes make checkups easier to bear: Chloe Love Prosise Juca allows her furry friend to have his teeth cleaned before she takes her turn.
Cary Daniel, DDS, doesn’t like to get stern with his young dental patients, but some situations call for desperate measures.
For instance, when a 3-year-old refuses to obey his mother and grandmother as they coax him to sit still in the dentist’s chair, Daniel takes charge.
“What’s your name, little boy?” Daniel asks in his best Donald Duck voice. The boy, who loves Mickey Mouse Clubhouse, is startled for a second. Then he sits still.
“Will you open your mouth for me?”
It’s a voice Daniel learned when he was about the same age as his patient, a talent passed down from his father.
“Sometimes it backfires and they go running to their mom’s knee,” Daniel says, with a grin.
It may seem odd to find a dental clinic tucked into the corner of a cancer hospital with a worldwide reputation for saving children’s lives. But the St. Jude Children’s Research Hospital Dental Clinic provides services that are far from routine. This dental care may help save the lives of children who may be hundreds or thousands of miles away from their family dentists.
The clinic’s two dentists look for potential problems, such as cavities, that could lead to serious issues down the road. Staff members also educate parents and children about the critical role dental hygiene plays in the treatment of cancer, HIV infections, sickle cell disease and other disorders. Scrupulous oral hygiene is critical for St. Jude patients, because any infection can be lethal to a child with a compromised immune system. Children undergoing treatment also are at risk for a number of dental-related issues that demand the expertise of staff specially trained to deal with such rare complications.
Decked out head to toe in pink and sporting fake butterfly and rose tattoos, 5-year-old Brooklyn Chudy wiggles around in the dental chair, fascinated with an oversized set of choppers lying on the table beside her. Dental Clinic coordinator Diana Hill hands Brooklyn a toothbrush and invites her to demonstrate how she brushes her teeth. The pony-tailed girl from Missouri scrubs a little on the front of the teeth. Using humor and encouragement, Hill shows Brooklyn how to brush her teeth, gums and tongue.
Next, Daniel talks with Brooklyn—no Donald Duck voice necessary this time. He rubs numbing jelly on her gums and gives “sleepy medicine” for the tooth before filling a cavity. Soon the procedure is over, and Brooklyn is on her way to her next appointment.
Twelve years ago, when Chris Rowland, DDS, began practicing dentistry at St. Jude, most of his patients were either preparing to undergo bone marrow transplants or had encountered dental problems during therapy. Today, the service has expanded to many other St. Jude patients as part of their routine care. The Dental Clinic staff sees about 1,100 patients and performs approximately 5,160 procedures each year—a number that has increased dramatically since Rowland’s arrival in 2002. That means more opportunities to catch infections in early stages or teach proper dental hygiene. While Rowland and Daniel handle the dentistry, Hill and dental assistant Kim Willis educate patients about dental care.
Some patients, particularly from impoverished countries, may not have had regular access to dental care before coming to St. Jude. To educate families and reduce stress on patients, parents are encouraged to accompany their children to the examination area.
“We want parents to understand the importance of oral hygiene and dental care,” Rowland says. “If we don’t have the parents engaged, then the child might not keep it up.”
Rowland and Daniel also provide educational opportunities for medical professionals, including nursing staff, students, dental residents and fellows from around the world.
“This helps increase the standards of care for kids, no matter where they are being treated,” Rowland explains.
During their time at St. Jude, patients may contend with fatigue, rounds of chemotherapy, radiation or bone marrow transplants. But just like healthy children, they frequently ask one simple question all kids want to know when they visit the dentist: “Will it hurt?”
Daniel has a reassuring answer to that inquiry. “Will it hurt? You tell me! I’m going to take my water sprayer, and my assistant is going to take Mr. Thirsty, and we’re going to wash your teeth. If anything bothers you, just raise your hand, and we’ll make it comfortable.”
About half the children who visit the clinic receive fillings, extractions and other procedures, Daniel says. But inevitably, both children and parents leave the clinic with smiles on their faces.
“That’s a great thing about my job. I get the privilege of simply proving to them that it’s not painful,” Rowland says. “It’s gratifying to take a nervous kid and make them a compliant patient with minimized fear. One of the best parts of my job is walking them through it and gaining their trust in the end.”
Sometimes patients do more than just trust their St. Jude dentist—they admire him.
“One of my patients had a teddy bear named ‘Dr. Rowland,’ and she brought the bear with her during visits,” Rowland recalls.
“I’m thankful to report that he never had any cavities.”
From Promise, Autumn 2014