Adapting to Coronavirus, Swinomish Indian Tribal Community Dental Therapists Provide Outdoor Dental Care

  | By Miranda Davis, DDS, Native Dental Therapy Initiative Project Director, Northwest Portland Area Indian Health Board
Adapting to Coronavirus, Swinomish Indian Tribal Community Dental Therapists Provide Outdoor Dental Care

"Why not provide dental care outside?"

That’s the idea that Dr. Ray Dailey and dental hygienist Leah Thibert brainstormed when the Swinomish Indian Tribal Community's dental clinic had to limit patient visits due to COVID-19. The staff had split into two teams, which were staying separate from each other in case one became sick. The clinic was focusing its efforts on emergency care. Dailey and Thibert realized that outdoor dental services would be a way to get both teams working at the same time while keeping them physically separated, enabling them to provide more care for the community.

All it took was purchasing two tents and a lawn chair, as they already had one portable dental chair. The outdoor services were in action by June 10. While Dailey and Thibert initiated this adapted approach to care, they soon transitioned it to their two dental therapist colleagues, Sarah Chagnon and Asiah Gonzalez. Shifting the operations to the dental therapists freed up the dentists to focus on more complex procedures inside the clinic walls.

In this outside space, Chagnon and Gonzales offer many non-aerosolizing procedures, to reduce the risk of spreading coronavirus. They also provide minimally invasive oral health services, including: dental exams (complete with x-rays); sealants; noninvasive fillings; and other topical treatments.

"We are able to provide the same quality of care at the same pace as we would inside," says Chagnon. Each provider has a patient scheduled every 30 minutes, and assistants are staffing the tents as well. Chagnon adds, "We’ve had great feedback from the community, and the kiddos love it."

Dental therapist Asiah Gonzalez agrees. "The patients love getting their care outdoors. Kids who might be apprehensive about coming into the clinic are excited to have dental appointments outside, and the environment just feels more fun. They’re not scared at all."

When asked how long they might continue the program, the consensus is that outdoor care is here to stay. "While we initially began offering this service as a response to COVID, it’s working out so well that I think we’ll be doing this every year," says Gonzalez.

The clinic is still maintaining COVID-related protocols for both indoor and outdoor patients. All patients wait in their cars until their appointment time and then receives a COVID screening at their car. The bonus for the outdoor environment, Thibert explains, is that "the tents ensure patient privacy while preventing prolonged contact within an enclosed area. And outside tents provide natural airflow proven effective in dissipating airborne viruses."

Dr. Rachael Hogan, Swinomish dental director, notes, "This has been a great example of our team collaborating to better serve the community. It’s fantastic that everyone openly shares ideas and figures out ways to make them work."