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Patient safety is our top priority at Special Smiles, and caregivers play a vital role as our partners in this effort. Most Special Smiles patients are medically fragile, with complex physical characteristics unique to each individual. Due to their severe intellectual and/or developmental disabilities, our patients require general anesthesia to receive dental treatment.
Treating medically fragile people under general anesthesia presents major challenges.
“General anesthesia is a medically induced, reversible state of unconsciousness that keeps patients unaware and free of pain during procedures,” explains Karen Andrews, RN, BSN, Vice President of Healthcare Services at Special Smiles. “Because it temporarily affects how the whole body functions, our medically fragile patients —who are often born with conditions that make their body systems work differently —require especially careful planning and monitoring in close partnership with our anesthesia team.”
Ensuring that treatment will be successful and safe means Special Smiles must have three things:
• A treatment facility designed and equipped for this purpose
• A medical team trained and experienced in delivering complex care
• A set of rules and procedures that prepare team and patient for success
Our treatment facility is state-of-the-art, with fully equipped operating rooms as well as private waiting rooms designed for the comfort of patients and caregivers.
Our medical team includes dentists, anesthesiologists, nurses, and support staff who specialize in treating medically fragile patients with complex special needs.
Our protocols are intentionally very strict, and our team follows them consistently to protect patient safety. When appropriate, we may carefully modify our usual procedures after the medical team thoroughly weighs the risks and benefits of treatment in our outpatient office versus a hospital setting. In these situations, each case is rigorously reviewed to ensure that receiving care in our outpatient environment remains a safe and appropriate option for that individual.
At times, caregivers find that providing the “paperwork” and preparing the patient for treatment feels burdensome. We rely on caregivers to be our partners in patient safety because it is necessary. Here’s why:
• We require an in-person consultation prior to scheduling treatment because we need to determine if we can treat this patient and to develop a treatment plan.
• We require consent for medical procedures so that patients (or guardians) can knowingly agree to or refuse treatment after understanding the purpose, risks, benefits, and alternatives, protecting their rights and autonomy.
• We require medical clearances to confirm that the patient is medically stable enough for a planned procedure, to identify and address potential risks in advance, and to ensure the safest possible setting and plan for their care.
• We require the caregiver to withhold food and drink before treatment, as directed by us, to ensure the patient will not vomit while sedated, which can be life-threatening.
With caregivers as our valued partners, Special Smiles has safely provided dental treatment to more than 20,000 patients who may be medically fragile and have complex special needs.
