Char-Koosta News

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Anesthesiologist is a vital component of pediatric dental operations

By B.L. Azure
Public Information Officer

Pediatric (young children) dentist Darby Lefler (right) and dental assistant Nicole Main (left) of the THHS Dental Division operate on a youngster while Dr. Doug Smith, contracting general anesthesiologist, monitors the young patient’s vital signs. (B.L. Azure photo) Pediatric (young children) dentist Darby Lefler (right) and dental assistant Nicole Main (left) of the THHS Dental Division operate on a youngster while Dr. Doug Smith, contracting general anesthesiologist, monitors the young patient’s vital signs. (B.L. Azure photo)

POLSON — Cavities are the scourge to people’s pearly whites — a scourge that has no age limits, and just as long as person has teeth, cavities lurk on the horizon, locked and loaded, and ready to attack. Good dental hygienic practices can head the teeth-eating culprit off at the pass. The sooner the good dental hygienic practices that include annual check ups become part of a healthy lifestyle, the better.

In order to address the issue of tooth decay and other dental-related problems among children, the Confederated Salish and Kootenai Tribes Tribal Health and Human Services Dental Division welcomed aboard Dr. Darby Lefler, a pediatric or pedodontic dentist this past fall.

Dr. Garry Pitts, director of the THHS Dental Division, said that having a pedodontist on staff has always been more of a dream than reality, until Lefler was brought on staff.

The ability of the Dental Division to provide pediatric dental care at the Polson and St. Ignatius THHS clinics not only translates into a closer option instead of Kalispell and Missoula for eligible clientele to receive such care, it is also a time saver for them and a patch to the purse of the THHS Dental Division. A typical off-site two-hour dental operation requiring a dentist, dental assistant and an anesthesiologist costs approximately $10,000. Lefler said most of the operations he performs take about an hour.

The funds to pay third-party providers is subtracted from the THHS budget. However, with the ability to provide the pediatric dental services those funds remain with THHS. Tribal Health also receives payments from third-party resources such as Medicaid and Healthy Montana Kids for the services they provide at the THHS dental offices in Polson and St. Ignatius.

A key component in the provision of professional surgical dental services to young children is an anesthesiologist. Because of the cost to staff, an anesthesiologist position is somewhat prohibitive. Tribal Health contracts the services of Dr. Doug Smith of Columbia Falls to provide that service when needed.

Smith, a former dentist, said he loves his latest occupation. He is the only roving contracting anesthesiologist in Montana. The overwhelming majority of his contracts are related to Medicaid and special needs cases.

Pitts said being a dentist adds a lot to Smith’s expertise as an anesthesiologist, especially when it comes to children.

“An anesthesiologist takes out a lot of the anxiety of operating on children. We are fortunate to have the services of Doug (Smith). He is truly a specialist in anesthesiology for children,” Pitts said. “It costs a lot for these operations to be performed elsewhere. We are really fortunate to be able to do this at Tribal Health. We would like our service population to be responsive to this locally provided dental service and bring their children in.”

Pitts said the Dental Division works hard to get people to understand that preventive dental maintenance is better and cheaper than treatment after the fact. At various times through out the year the Dental Division conducts outreach and screening efforts for young children aimed at, among other things, getting their parents or guardians aware of any problems with their children’s teeth and gums. Dental infections can cause fatalities if not treated properly treated.

“When we conduct the screenings we often observe dental decay and we prescribe treatment as soon as possible,” Pitts said. “There is really no reason for a child to suffer from the pain of decaying teeth, no reason at all because of the dental services we provide, including information and education about how to maintain good dental health.”

Pitts said he has two extreme cases of pediatric tooth decay that have to be done at a hospital due to the potential complications.

“Tooth decay in children is a serious problem on the reservation. We’re here to help prevent or treat it,” Pitts said. “We establish a good personal professional relationship with our patients. We get to know them if we don’t already and we can provide them more services because we can do that a whole lot cheaper than they do in Kalispell and Missoula. That saves parents time and money — money that stays and is spent locally.”

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