A few years ago, Bruce Fry realized his teeth were crumbling.
“I was eating a marshmallow one day and when I looked down I saw it had two teeth stuck in it.”
For Fry, it was the latest in a series of life-altering health issues he’s experienced for almost 30 years after a workplace accident. In 1989, he stepped off his machine and fell 12 feet to the ground.
“That’s all I remember,” he told me. “I guess when I fell I compressed my discs.”
He spent several months in hospital. It was two weeks before he could even stand with supports, and three months before he could walk. Then, doctors discovered he had ankylosing spondylitis – a form of arthritis that causes the bones of the spine to fuse and stiffen. When he had his accident, his vertebrae slowly began to collapse as his spine attempted to grow back.
Fry still walks, but his neck has degraded and is held up in a brace. He has undergone 11 surgeries and takes an array of pills to get through each day. He once broke four vertebrae in his neck by sneezing.
When it came time to take care of his teeth, private dental clinics would not take him on because of the risk of doing further harm to his fragile neck. “If I break my neck again, it could be fatal or it could be permanent,” Fry said.
His only option was to have the procedure performed by a dentist at a hospital. Unfortunately, there were no dental services at Queen Victoria Hospital and he was placed on a waiting list in Vernon.
After two-and-a-half years passed, Fry started to get pain in one of his teeth. Once again, he was told he would have to go to the hospital to have the tooth removed. This time, he heard Queen Victoria Hospital was investigating bringing dental services back.
“Historically, we did have a dental surgical program provided at the hospital by some of the local dentists working with our anesthetists and nurses,” explained Julie Lowes, Acute Health Services/Site Manager at Queen Victoria Hospital. “It became unsustainable for a variety of reasons so over time the service dwindled and was eventually lost.” The hospital’s Peri-operative Committee have been working over a number of years to find a way to return this service to the community.
One of the doctors spearheading its return was Dr. Kirk McCarroll, a local family physician with specialty training in anesthesiology. Dr. McCarroll moved to Revelstoke in 2015 from Golden, where dental services were routinely provided at the Golden and District Hospital.
Many of the dental patients Dr. McCarroll saw in Golden were children who were unable to tolerate procedures in the dentist’s office. Physicians and nurses there worked closely with the dental team to provide this vulnerable population the anesthetic care that allowed them to undergo the dental treatments they needed at the local hospital, rather than having to travel out of town.
Not only did this service ease the burden of travel and financial expense for an invaluable health-care service, but it also provided the physicians and nurses in the perioperative care team the opportunity to remain comfortable and up-to-date in providing anesthetic services to the pediatric population.
“Maintaining this skillset in a rural community is vital to ensure that medical teams are comfortable with the unique challenges of providing critical care to children who present to the hospital with life-threatening illness or injury. By running a hospital-based dental program, it ensures that physicians and nurses are regularly providing care to the pediatric population so that when we get a child who was injured on the ski hill or is sick with a bad infection, it’s a population we are very comfortable managing,” he explained to me.
Dental care with anaesthesia is also helpful for patients with complex care needs – patients like Bruce Fry, or to support patients who are particularly anxious about a dental surgery such as long term care residents and youth or adults with developmental concerns.
Reviving the program means that most dental patients who needed hospital treatment no longer need to leave town. It means reduced trips on dangerous highways and reduced overnight stays in motels.
“One of our priorities is to provide care closer to home,” said Dr. McCarroll. “We don’t like people being out on the highway in poor weather conditions when they really don’t have to.”
To help realize this goal, initial funding and project support was provided through the Facility Engagement Initiative, a provincial program designed to strengthen relationships between health authorities and physicians to improve the work environment and patient care.
Funds provided by this initiative go towards supporting the critical first step of planning between physicians, health administration, and dentists as well as providing a local Project Manager.
Through the partnership and collaboration with Interior Health additional funds were secured to expand the surgical program in Revelstoke which now includes dental procedures. Our success has been due to the teamwork of all parties and funding streams and is an exciting time for Revelstoke and our local surgical team said Lowes.
“When we were looking at bringing the program back to QVH, we talked to the local dentists to see how many patients went out of town for that service,” said Lowes. “We estimate that it could be about 15-22 patients per month who might benefit from this services.”
With no local dentists able to work at the hospital, Dr. McCarroll approached Dr. Shane Van Biezen, a dentist he had previously worked with in Golden. A part-owner of the Golden Dental Centre, Dr. Van Biezen was eager to assist. He helped set up the program in Golden and agreed to come to Revelstoke once a month to work here.
The next big piece was purchasing the dental tools and equipment needed for the hospital. The 2018 EZ Rock Radiothon organizers stepped up to the plate for their yearly fund raising collaboration with the Revelstoke District Health Foundation and the Revelstoke Hospital Auxiliary.
This was when Fry’s wife Cheryl kicked into high gear. As president of the Revelstoke Hospital Auxiliary, she asked her auxiliary members about raising the money. “There are a lot of people, including my husband, who need this to happen here in Revelstoke,” she said.
There was an incredible show of support and the radiothon on EZ Rock raised more than $30,000 from the community. That was enough to buy all the equipment needed to start the program, including a portable Dental X-ray machine.
In November, Fry was the first patient to be seen by Dr. Van Biezen at QVH. He doesn’t remember much thanks to the anesthesia. “I remember going in the room, but that’s it,” he said. “I went it at seven and was home around four.”
Thanks to the program, he was able to recover at home. The Frys estimate they saved $5,000 by staying in Revelstoke. Because the operation was done in a hospital, the hospital fees, including anesthesia, are covered by MSP; all they had to pay was the dental bill. In a few months, Fry plans to get a set of dentures and, hopefully, enjoy a nice steak with his new teeth.
The new QVH dental surgical clinic is currently provided once a month but increased frequency is anticipated as the dental surgical team grows with participation from local dentists. Dr. Steve Schadinger of Selkirk Dental Clinic has recently received hospital privileges and is scheduled to begin seeing patients on March 11th. Dr. Peter Stefanuto, an oral maxillofacial surgeon based in Kamloops, has also confirmed that he will begin providing dental surgical services in Revelstoke in the near future.
The program was designed so dentists can operate in the morning and consult with new patients for planning appointments in the afternoon. Local dentists or family physicians are able to refer their patients to the hospital program if they feel their patients might benefit from this new service.
Dr. Van Biezen commended the community for their support for this important program. “I think it’s a key piece of health care that’s now available in Revelstoke.”