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A+ runs a regional hospital dental service. The main bases are at Greenlane and Middlemore Hospitals, with other clinics at Starship, Buckland’s Rd (Mangere), Waitakere Hospital and the Mangere Refugee Center. There will also soon be a small inpatient clinic at Auckland Hospital.
Our staff include 25 full and part-time dentists/oral surgeons (and one dental therapist) covering almost all dental specialities. The two services that you are most likely to communicate with are:
Names and Contact Numbers For The Staff:
Greenlane Oral Health Unit 623-6494 or ext 3499/4894
Middlemore Dental Department 276-0145 or ext 902-8696
Starship Hospital Dental Clinic ext 6527
Oral & Maxillo-Facial (OMF) Team
Chris Sealey 025-2858661
John Edwards 025-941514
Lance West 025-923372
Neil Luyk 025-973852
Nigel Parr 021-555490
Peter Hill (Registrar) 93-5242 or 025-866748
House Surgeon On-Call. Ring switch-board
Paediatric Dentistry Team
Callum Durward 021-442051
Nina Vasan (on leave) 025-773-806
Nisreen Faris 025-469258
Wanda Gaynor 902-8696
Yaso Ramadas (Snr Dental House Surgeon) 025-2751406
One of our dentists is often working at SSH in the Dental Clinic at Level 3 Outpatients on Tuesday (pm), Wednesday (pm), Thursday (am), and Friday (am). The phone number for the SSH Dental Clinic is ext 6527. Advice can also be sought day and night from the Dental House Surgeon on-call. Only the oral surgery team provides an after-hours service.
The School Dental Service
· Enrol children from birth
· Provide free treatment up until Form 2 (limited range of treatment)
· Usually should be the first port of call for a child with a dental problem during school hours or school holidays
(some clinics remain open throughout the holidays). You can find out which clinics are open by calling 839-0565.
· Dental Therapists however:
o do not provide an after-hours or weekend service
o do not manage trauma
o do not extract permanent teeth
o do not carry out pulp therapy (soon to change)
o do not prescribe drugs
Contracting Private Practice Dentists (see list)
· Some dentists have a contract with the DHB to provide free dental services for:
o adolescents, and
o for younger children who: 1) are referred to the dentist by the School Dental Service for something beyond the training of the Dental Therapist, or, 2) turn up at the dentist with an acute problem eg trauma, infection or toothache (especially if it is after normal school dental clinic hours).
· Parents must pay for any orthodontic treatment.
· Other dentists will only provide treatment for children on a fee-for-service basis
· There are two private paediatric dentists in Auckland (Nina Vasan tel: 025-773-806) and Kahtan Yaghot tel: 570-2572) who will treat children for specialist fees. There are two other dentists with postgraduate qualifications in paediatric dentistry (Nisreen Faris: tel: 570-2572 or 025-469258 and Wanda Gaynor: tel: 576-6720 or 902-8696).
For preschool and primary school children, treatment can be sought from the local school dental therapist during work hours and school holidays. However, each dental therapist visits several schools. To find out the phone number and location of the nearest open dental clinic call the School Dental Service (Tel: 839-0565). After hours and at weekends the child can be taken to the family dentist or an Emergency Dental Clinic.
Children who for some reason cannot see their local dental therapist or dentist may attend the Relief of Pain service at the Oral Health Unit, Green Lane Hospital between 8.15am and 11am. After hours, the hospital dental service is usually not involved with simple toothache cases, unless there is an associated facial swelling or systemic signs, or unless the child is a regular patient of the department (eg medically compromised) etc. Most children with after-hours toothache can be seen at one of the private Emergency (A&E) Dental Clinics around Auckland or by their family dentist.
All dental trauma should be reviewed as soon as possible by a dentist. Some can be referred to the local family dentist or Emergency Dental Clinic. If the child presents at SSH between 8.15am and 11am they can be sent to the Oral Health Unit at Greenlane Hospital where they will be seen on the Relief of Pain clinic. At other times the dental house surgeon on-call can be contacted.
INITIAL MANAGEMENT OF SPECIFIC TYPES OF DENTAL TRAUMA
The Avulsed Tooth
Instructions on the phone
At the hospital, if tooth not yet re-implanted:
Reimplantation may not be appropriate in some situations –
· primary tooth
· where other injuries warrant preferential treatment / intensive care
· where the tooth is immature with a short root and wide open apex and the extra-oral time is long and the periodontal ligament has been allowed to dry out
· children who are medically compromised eg at risk of infectious endocarditis or on immunosuppressive therapy
Mature teeth with closed apices which have been out of the mouth for over an hour and have been allowed to dry out, need special treatment by the dentist before reimplantation. This involves: scraping the periodontal ligament off the root and soaking the tooth in a fluoride solution/gel, and possibly carrying out root canal treatment on the tooth before reimplanting it. The tooth will eventually be lost after some months or even years.
If the initial and follow-up management of the tooth is not good, in many cases the tooth root will resorb, and the tooth will eventually be lost.
Note: The pulps of immature teeth (eg in children under 10) if reimplanted quickly may survive.
The Fractured Tooth
The Luxated Tooth
Where this involves injury to the oro-facial region the paediatric dentists and/or oral surgeons are willing to be involved. Such children should also be discussed with the Paediatrician on call for child abuse (see Abuse and Neglect Guideline).
Although some oral and maxillo-facial emergencies can be treated on the Acute List at SCH, the Oral Health Service also has several elective GA lists each week. It may be possible to put a child who requires an urgent extraction or I&D etc on one of these booked lists as an extra patient. The lists are:
Monday am - GLCC
Tuesday am - SCH
Tuesday pm - GLCC
Wednesday am - GLCC
Wednesday pm - GLCC
Thursday pm - GLCC