Residents treat patients with developmental disabilities including ID, CP, SD, Down Syndrome, Autism every Thursday in the outpatient clinic. Many of these patients require physical and/or pharmacologic protective stabilization due to resistant/combative behavior. Six to nine patients are treated on Thursdays with IV Sedation/GA and many more difficult/complex patients are treated under general anesthesia in the OR. Special needs and underserved patients are also treated on the two operatory fully equipped mobile vans.

Residents rotate on the van weekly and each resident will spend six weeks on this rotation. An educational goal of the dental van experience is to expose residents to the public health side of dentistry including treatment of low-income patients (adults and children), patients with intellectual and physical disabilities, and those who have difficulty in accessing oral health care.

Dental residents are assigned a one-month rotation in the Department of Anesthesia at Advocate Illinois Masonic Medical Center. While on rotation, the dental residents are supervised by faculty members of the Department of Anesthesia and rotate alongside medical and dental anesthesia residents over the rotation.

Dental resident responsibilities while on the anesthesia rotation include: attending morning education conferences conducting pre-op interviews with patients and their family; confirming patient identity and consents for procedures, reviewing a patient’s history and physical, and lab values becoming familiar with venipuncture technique, airway management, intubation with a laryngoscope and laryngeal mask airways (LMA), and bag valve masking; verifying patient positioning for surgical procedure; positioning appropriate patient monitors for anesthesia and airway management; maintaining accurate anesthetic records; administering inhalational and intravenous pharmacologic agents, becoming familiar with Department of Anesthesia sequenced protocol for anesthetic emergencies; monitoring patient recovery post-anesthesia; evaluating a patient’s level of pain.

At the conclusion of the anesthesia rotation, dental residents are expected to be familiar with the management of an anesthesia case from beginning to end under supervision and present an anesthesia topic of choice to the Department of Anesthesia faculty and residents.

The objective of this two-week rotation includes becoming familiar with assessing ED patients through intake H & P, and to assist in the treatment of acute medical, orofacial, and dental emergencies. Residents are expected to observe and assist ED staff in the assessment and management of common medical emergencies including chest and abdominal pain, asthma/respiratory distress, syncope and shock, bleeding from trauma, headache and head trauma, and pediatric emergencies. GPR residents are expected to provide initial consultation, assessment and management of patients who present to the ED with orofacial trauma, pain, and/or infection, working with the OMFS interns/residents/faculty.

Residents are expected to assist with assessment of oral and maxillofacial trauma/infection, order appropriate CT imaging and labs, and contact on call OMFS residents and faculty to arrange for consultations and admission orders. Dental residents are expected to manage dental-alveolar trauma with splinting and suturing, incision and drainage of less complex odontogenic space infections, post-op oral/dental surgical complications, and triage odontogenic pain and refer to outpatient Dental Center for definitive treatment.

Residents rotate and round with the Internal Medicine faculty and residents for two weeks in the outpatient Internal Medicine clinic. The assessments and interpreting of clinical and diagnostic data are discussed with the attendings throughout the rotation. The patient’s chief complaints, medical and social history, and review of systems are completed with the attending for all new patients. Residents are present during consultations with other services, including Cardiology, Oncology, and Infectious Diseases.

Residents attend the afternoon conferences where faculty and residents meet to discuss patient cases and their service. Faculty and residents discuss medical assessments of the patients, what consultations were done or need to be done, lab results, and the treatment plans for the patients. The GPR residents become more familiar with the management of many common medical conditions – hypertension, CHF, anti-coagulation therapy, diabetes, asthma, bleeding disorders and the implications of dental/oral surgical treatment.

Residents rotate through the oral and maxillofacial surgical outpatient clinic at John H. Stroger, Jr Hospital of Cook County for one month. During this rotation, residents are working under the supervision of Oral and Maxillofacial surgeons and building relationships with current OMFS residents and rotating dental students. The oral surgery clinic at Stroger Hospital provides care to many patients who are low income, under insured and often have a variety of medical comorbidities. Patients with specific oral surgical needs/emergencies are seen in the morning.

Afternoon sessions are scheduled for more complex cases such as IV sedations, third molar extractions and multiple tooth extractions. Tuesday afternoons are dedicated to seeing patients with oral pathology, oral and maxillofacial trauma, and fractures, and evaluating diagnostic images of patients who need advanced care. Upon completion of this rotation, residents will have participated in many oral surgical cases and developed more confidence and skill with diagnosing and managing medically and surgically complex patients.

There are several groups of patients who require admission to the hospital to receive dental/oral surgical treatments in the OR including special needs adults and children with medical complexity and/or behavior management challenges and young pediatric patients who require extensive dental rehabilitation. Patients who are admitted through the Emergency Department with orofacial trauma or serious space infections and patients who require general anesthesia for more complex oral and maxillofacial surgical procedures are also routinely treated in the OR.

Dental residents participate in patient pre-op assessment which includes patient/family interviews, reviewing history and physical exams, labs, imaging and obtaining surgical consults. Perioperatively, residents will assist attendings with developing case treatment plans, providing clinical treatment, and completing case documentation in the electronic patient record.

Residents are actively involved in the post-operative care of patients which includes accompanying patients to the Post-Anesthesia Care Unit (PACU) to debrief unit staff and family members about surgical/dental procedures. Residents discuss post-op discharge instructions with patients/families for pain management, antibiotic regimens, diet, wound care, follow up appointments and manage E-prescribing.

Residents provide dental consultation to other hospital departments, such as the emergency department, radiation oncology, trauma, cardiology, and anesthesia.