The calls from anxious parents come into the Samuels Sinclair Dental Center all the time, and the story is often the same.
Their child needs oral surgery and the dental center in Providence is one of the few places in the state where it can be done, particularly for children with special needs.
But the wait for oral procedures at the center, which is part of Rhode Island Hospital, can be as long as nine months to a year, and twice as long for children with special needs or disabilities.
“[Parents] get frustrated,” said Dr. Elizabeth Benz, director of the center. “We are the primary, if not the only, provider for the intellectually disabled population of the state. Those patients really have no other options.”
Now, an outpatient surgical center is poised to change that.
The ENT Center of Rhode Island LLC has received permission from state health regulators to launch a dental surgery service exclusively for children. It’s scheduled to open in October at the ENT Center on Lambert Lind Highway in Warwick.
The outpatient surgical center, which primarily focuses on ear, nose, throat, head and neck treatment, is expecting to perform 800 pediatric dental surgeries a year, including teeth extraction, crowns and fillings under general anesthesia.
“There’s a huge need,” said Dr. Brian Duff, CEO of the ENT Center. “It’s just very difficult to find space and time to get it done.”
Indeed, the Samuels Sinclair Center staff and its available space are maxed out at 18,000 appointments a year, according to Benz. “We have a capacity issue,” she said.
And because of the high demand, the Samuels Sinclair Center only takes new patients who are 5 and younger. That’s because when patients turn 8 or 9, they begin transitioning to a general dental practitioner to ease the burden of overwhelmed pediatric dentists, Benz says.
Meanwhile, a long wait for dental care can lead to serious health complications ranging from infections and aspiration pneumonia to dangerous bacteria entering the bloodstream, dentists say.
“People die from dental infections all the time. We have serious cases on the adult side in the [intensive care units] all the time from dental infections,” Benz said. “I can’t stress enough the importance of taking care of your teeth and seeking regular care.”
Elsewhere in the state, Our Lady of Fatima Hospital also offers pediatric oral surgery, but the hospital will not take patients with underlying medical conditions because there is no pediatric unit to treat them if there are complications during the procedure, Benz says.
The only other option in Rhode Island would be a private dentist who can put patients under anesthesia. But these are limited, especially for patients with special needs or who rely on Medicaid to cover the cost of care, as many private dentists don’t accept public insurance.
And sometimes special needs patients, or those with disabilities, will wait months for their surgery only to have an anesthesiologist deem them “too medically complicated” to put under anesthesia days before the procedure, Benz says. In those cases, they have to start the process of getting an appointment all over again.
Usually, patients can get care quicker if they travel out of state, she says. However, if a patient relies on Medicaid, there could be complications with getting coverage across state lines.
Adding dental services at the ENT Center will certainly make a dent in the state’s backlog of pediatric oral surgery cases, according to Dr. Steven Brown, chief of dentistry and oral and maxillofacial surgery at Rhode Island Hospital. But more help is needed.
“We have to get other surgical centers involved,” Brown said.
There are several other surgical centers in Rhode Island, but none of them provide pediatric surgical care, according to the ENT Center’s certificate of need filed with the Health Services Council, an advisory panel for the R.I. Department of Health.
For the ENT Center, adding the new service was relatively simple, requiring some new dental equipment and no major renovations.
Ideally, there would be a dedicated oral surgical center in the state, Brown says. But he acknowledges that building one would require state support and approvals, as well as funding. Right now, there is only talk about creating the oral surgical center among dentists.
Also, the ENT Center doesn’t extend services to adults with special needs. The ENT Center will offer services for children with special needs. The council didn’t take a vote to approve this because some adult patients who have special needs may become combative or misunderstand doctors’ directions. In those situations, it’s best for patients to be in a hospital where more staff are available to help if something goes wrong.
“That’s a big problem,” Brown said of the council’s decision not to include special needs patients in the dental services provided by the ENT Center. “I hope they change their minds.”
Correction: An earlier version of this story gave inaccurate information on the ENT Center's special needs services. At this time, the center will offer oral surgery services for children with special needs, but not adults with special needs because of safety concerns.
