After hours and emergency dental care

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after hours and emergency dental care
Photography: Anna Bizoń, 123RF

It’s takes commitment, but dentists who offer after-hours and emergency dental care reveal it can pay off in ways well beyond the dollars. By John Burfitt

A person in pain or at a time of crisis can be the most motivated of all dental patients, especially if that problem is an after-hours emergency. It’s an issue Dr Lesley Russell of The University of Sydney put on the agenda two years ago, when she stated in an ABC column that, “governments should consider establishing emergency dental services within hospital emergency departments, at least on weekends”.

Hospital emergency departments are often on the frontline of after-hour dental emergencies, but the reality is, few are equipped to deal with dental treatments. That’s when the availability of after-hours and emergency dental services come to the fore. 

Some practices offer specialised emergency services as a regular part of their services, while other practices offer it only to regular patients. Others don’t offer it at all.

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It’s an issue ADASA (the Australian Dental Association South Australian branch) addressed eight years ago when it relaunched the ADA emergency roster, which has dentists available on call from 5pm-9pm weekdays and 9am-9pm weekends. Treatments are offered in the rostered dentists’ clinics, incurring the prescribed treatment fee plus an additional call-out fee.

Over the 2019-20 Christmas and New Year period, the hotline received over 250 calls from people facing emergencies like broken teeth and injured mouths. This is 100 more calls than the same period last year.

“Dental emergencies should be considered in the same way as any other medical emergency,” Dr Angelo Papageorgiou, ADASA president, says. “We believe all dentists have an obligation to provide, wherever possible, after-hours care or advice to their own patients for reasonable emergencies.”

We believe all dentists have an obligation to provide, wherever possible, after-hours care or advice to their own patients for reasonable emergencies.

Dr Angelo Papageorgiou, president, ADASA

Dr Papageorgiou says the roster service directly addresses the trend for patients to attend a hospital rather than a dentist in the time of an emergency.

“Patients who present at a hospital emergency department with a dental condition can only receive cursory treatment for urgent conditions. While they may be provided with painkillers and antibiotics, it does not address the underlying dental problem,” he says.

Dr Jane Boroky of Adelaide’s St Peters Dental Clinic is one of the dentists on the ADA emergency roster, and devotes six weekends a year to being on call. She says the most common emergencies are oral pain and sporting or facial injuries.

“I might have a busy weekend where I get called in six times and other weekends where I am not called at all—it varies,” Dr Boroky says. “On a Friday afternoon, I set up a number of treatments’ trays so if I do get called in, all I need to do is flick a few switches and I’m ready when the patient arrives.”

Even so, Dr Boroky finds it troubling that in a time of crisis, many patients can’t get through to their own dentist, and instead google for an emergency dentist and hope for the best. 

“That’s something dentists need to address with their patients. If you don’t want to offer an after-hours service, then have a referral number to a dentist on your website or answering machine. It makes sense and gives the patient some confidence because it is someone you refer.”

Melbourne’s All Day Everyday Dental practice has two clinics in Brunswick and Kew, which are open seven days a week. The practice has been offering an after-hours emergency service since it was opened by Dr Barry Patel in 1982. The five staff dentists are on a roster and answer emergency calls during the night to set up appointments for first thing the next day. After the treatment, the patient is referred back to their own dentist with a treatment report. 

It can prove to be a good business decision to position yourself this way, but you really do have to be genuinely committed to it.

Dr Jane Boroky, St Peters Dental Clinic

Dr Anyda Stein has been with the practice for 11 years and says the after-hours service is one of the strongest point of differences All Day Everyday Dental has to other practices.

“People know this is how we operate, to the point that other dentists will refer after-hours cases to us or when they are on holiday,” Dr Stein explains. 

This style of operating, however, demands a full commitment from the team as well as a clearly structured roster. “You need to determine how to do this so it suits your practice, your staff and your patients, and be realistic if offering such a service is really worth your while,” she says. “We are now known for doing so and have found it’s a good way to work.”

But offering such a service does not suit every practice, nor does it suit every dentist. “If you only want to work business hours and want your weekends free, this is not for you,” she says. “You also need to think on your feet and know how to cope with a range of situations. You may well be the only person in the clinic, so you need to be able to cope.”

Where offering after-hours service can prove to be good business, Dr Jane Boroky adds, is for those dentists opening up a new practice and those looking to build up client numbers. It can also be ideal for employee dentists looking to earn some extra income.

“That can be a key advantage to working this way and while we always refer patients back to their original dentists, I know a number of dentists who have picked up new clients after treating them in a crisis,” she says.

Helping patients out at such a crucial time can make a big impact and create loyalty—both with existing clients as well as new ones. “It can prove to be a good business decision to position yourself this way, but you really do have to be genuinely committed to it,” she says. “Just be sure to deliver on what you promise.”  

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