With the COVID-19 vaccination readily administered in local pharmacies, hospitals and even university campuses, the government is attempting to increase the vaccine rate to achieve herd immunity. However, what if you went to your dentist and, after discussing your treatment plan, they were able to administer the vaccine as well?
“On Sept. 27, 2019, OHSU dental students were the first in the nation to receive training to provide vaccinations,” stated Dr. Phillip Marucha during his presentation “Vaccinations by Dentists” at this year’s Mid-Atlantic Advocacy Academy. His presentation, as well as the roundtable discussions, sparked my interest in the debate on whether or not dentists should be able to administer vaccinations. Although the possibility of this is on the horizon, there are limitations to this implementation as well.
There are numerous pros to allowing dentists to administer vaccines to their patients. One primary benefit is increasing vaccine availability to the public. Dr. Marucha states in his presentation that in states such as Oregon, “the vaccination rate is about 40-45%, with some age ranges being below 20%. At most, 40% of adults who see their dentists will not see their primary care provider that year.” A patient may not see their physician for several years but may see the dentist every six months.
In addition, dentists are educated in various oral diseases, gross anatomy, and oral health behavior modification such as smoking, nutrition and medication compliance. Most oral diseases such as caries, periodontal disease, and herpes are caused by bacteria and viruses. Dentists implement soft tissue exams and screenings for systemic diseases such as blood pressure, random glucose testing, etc. Furthermore, dentists are adequately trained in giving injections and sequelae of vaccinations such as syncope and hypersensitivity. Undergoing additional vaccination training allows current dental students to volunteer at vaccination sites to administer vaccinations.
Equally important, Dr. Marucha said that allowing vaccinations in pediatric dental offices help increase vaccination rates overall. All children must have an oral health screening before kindergarten. If some children are missing vaccinations, pediatric dentists can help vaccinate them. Most children have oral health insurance. The convenience of making one less stop for patients and trusted experience with dentists providing various injections could increase the number of patients going to the dentist for vaccinations.
There are also various obstacles in providing vaccines in dental offices. For example, dentistry and medicine are viewed separately. Some people do not always view oral health as important as primary health or that dentists take care of patient needs that are not in the scope of primary care physicians. As a result, when patients go to the dentist, they may not disclose all health information because it is deemed unimportant to the clinician. Additionally, each field has different reimbursement models: one depends on cases and the other depends on procedures. Most vaccines are covered by medical insurance, but most private dental practices do not bill medical insurance. As a result, a reimbursement system needs to be developed.
Likewise, although dentists are educated in local anesthesia, they lack the continuing education on administering vaccinations. Additionally, dental offices would need to purchase equipment such as refrigerators. Vaccinations such as the COVID-19 vaccines are temperature-specific and need to be regulated on a timely basis as well.
There should not be a separation between dentistry and medicine, though, as both are responsible for the health of the patient. Dentistry is part of systemic health and can be a gateway into patients obtaining regular health care. If dentists can help identify several problems, they can refer them to specific care. There are interactions between oral health and systemic health and various opportunities for collaboration. There are known associations between oral disease and systemic diseases such as diabetes, heart disease, stroke and adverse pregnancies. Good relationships between primary care physicians and dentists would increase patient volume and create cross-relationships between fields.
Lastly, administering vaccines helps bring more into the health care system because you need to log in the information that they received a vaccination. For the dental field, better oral health leads to better systemic health, and providing vaccines may be a gateway for being more integrated with the rest of the health care system.
~Isabel Yang, Stony Brook ’22, Predental Member