Volume 7 • 2020 • Issue 2

Her work days start at 8:15 am, but, after that, nothing is predictable. Each visit is unique. “When I enter a room, I never know what to expect,” she says. “Sometimes my patients have Alzheimer’s, dementia, or Parkinson’s. Some patients don’t speak at all. Others share their memories of bygone eras.” Dr. Gagné often sees complicated clinical problems among the demographic that she serves. In addition to caries, oral ulcers, infected roots, broken fillings, and ulcerated angular cheilitis, she sometimes must replace or repair “prostheses so ill fitting that even smiling is impossible,” she says. The treatments she provides include cleaning, protheses, fillings, crowns and bridges, and treatment of dental and gingival abscesses. When she visits an LTC facility, she tries to see as many patients as possible, scheduling back-to-back appointments. As well, she offers trainings for LTC staff in daily oral health care for seniors. Dr. Gagné feels that geriatric dentistry is a calling; it isn’t for everyone and it requires passion. For her, it’s fulfilling that her treatments can drastically improve quality of life for her patients. “I can put an end to the torture of cuts to the tongue caused by a chipped tooth or cure a persistent fever in a patient who can’t communicate how they feel,” she says. How It Began Dr. Gagné graduated with a degree in dentistry from Laval University in 2005 and then practised for 9 years in general dentistry, owning her own practice for 7 years. She noticed how challenging it was for elderly patients to physically come to her office. Often, grown children had to navigate their own work agendas, the schedules of LTC facilities where their parents lived and the dental office hours. “We found that it was especially difficult in the winter when seniors don’t want to go out in bad weather,” she says. Dr. Gagné sold her practice to go into geriatric dentistry. She had experience with a mobile dental clinic at Laval University, which, at the time, was unique in the Quebec City area. In 2014, she started her mobile practice so families could call, make appointments, and then Dr. Gagné would travel to wherever her patients needed her. Her practice charges the same fees as other dentists plus a small transportation charge. In her first year, she visited 70 LTC homes and 500 patients in their own homes. The practice has only grown since. The Needs of Seniors For seniors who are dealing with physical or cognitive decline, daily oral hygiene routines often suffer. Oral health is important for the maintenance of general health, yet it is sometimes overlooked, by both patients and caregivers, when a senior has other health problems. Dr. Gagné says it is important to look out for infections and pain. “We know that chronic pain causes depression and anxiety and increases the risk of delirium and agitation,” she says. She knows first-hand how difficult it is to treat people who suffer from dementia or Alzheimer’s. She says, “even tooth-brushing is very difficult.” She suggests that visits with dental professionals should increase at the age of 75, an age when, for many people, dental visits decline. She tells caregivers and other health professionals to encourage and facilitate both daily dental hygiene routines and professional dental care for seniors. Are House Calls Coming Back? House calls were once common among physicians before hospitals became the main setting for medical care. There are predictions that with an aging population, they may become more common in the near future. Dr. Gagné enjoys her nomadic workday. “We keep moving. I’m dynamic, so it suits me well. Meeting patients where they live also allows me to get to know them. This kind of work has a beautiful human side,” she says. a Meeting patients where they live also allows me to get to know them. This kind of work has a beautiful human side. – Dr. Sarah Gagné I ssues and P eople 28 | 2020 | Issue 2 MOVING FORWARD. TOGETHER. VISIT US ONLINE AT HU-FRIEDY.COM/INFECTION-PREVENTION to view our full line of Infection Control products ©2020 Hu-Friedy Mfg. Co., LLC. All rights reserved. [735] Because Every Step Matters in Infection Prevention CASSETTES CLEANING & CARE STERILIZATION PACKAGING SURFACE DISINFECTION Take the Sterilization Self Check at Hu -friedy.com/SterilizationQuiz Not sure how your instrument reprocessing and infection prevention protocols currently stack up? Take our infection control self check to discover potential opportunities for improvement. STERILIZATION MONITORING