Oregon dentists training to give vaccine shots

Coronavirus

'The learning curve for dentists on this stuff is minuscule'

PORTLAND, Ore. (KOIN) — With multiple COVID-19 vaccines rapidly heading toward approval, Oregon has already begun training and certifying dentists to give vaccines during routine dental cleanings.

“We teach dentists who are so adept at giving injections in the mouth how to give an injection in the deltoid in the shoulder,” said Mary Pat Califano, a registered nurse and instructor at OHSU’s dental school.

Oregon is the first state to allow dentists to administer any vaccine to any patient. Legislation allowing this first passed in May 2019. No one knew a year later we’d be entrenched in a global pandemic. Now dentists are stepping up to play a role in ending it.

So far, more than 200 dentists and dental students in Oregon have completed the training course offered by the OHSU’s School of Dentistry, with 50 others expected to finish by the end of December, according to instructors. OHSU hopes to work with the 200 members of the Dental Society in Lane County as well.

“We want to expand reach for patients to be able to get the vaccines when they want them and make it as convenient as possible,” Califano said.

Students spend around 8 to 10 hours in comprehensive online classes, with modules from the Centers for Disease Control and the Oregon Health Authority. They then go through hands-on training, practicing injections on a shoulder pad before practicing injecting a partner with saline.

They’re taught how to counsel patients about vaccines and avoid injuring patients’ shoulders when giving the shots.

Once dentists pass an exam, they can register with the Oregon Health Authority and begin getting their staff trained to handle vaccines and getting a freezer to store them. If dentists also want to become COVID-19 vaccinators there is an additional step that requires enrollment with the OHA.

“To help not only improve the immunization rates in Oregon, but potentially help in this pandemic is huge. To be front runners in this initiative is extraordinarily exciting,” Califano said. “It’s a huge opportunity for us to make a difference in something that we haven’t seen in a hundred years.”

Interested dentists can sign up for the two-part training at the OHSU Continuing Dental Education website.

Dave Johnson, healthcare system expert and CEO of 4sight HEALTH, has long advocated for investing in more primary dental medicine. Most chronic diseases first presents itself in the mouth. Therefore, if the goal is trying to diagnose and treat chronic disease earlier, then preventative dentistry is the way to do that.

“I’m not the least bit surprised that Oregon is also taking a leadership role in trying to figure out how to use frontline dentists to distribute and give vaccines,” Johnson said. “With COVID, we essentially need to make vaccines free and get them to as many people as quickly as possible. And so any and all outlets that can help in that imperative are absolutely essential. And dentists, I think, are perfectly suited to do that.”

He said that dentists are more than qualified to play a role in helping combat this global pandemic.

“They certainly give shots all the time and they’re hard shots to give,” he said. “I mean, Novocain in the mouth to knock you out when you’re pulling the tooth is a whole lot harder than putting the shot in your arm or your butt. The learning curve for dentists on this stuff is minuscule.”

Often times, he said, people see their dentists more regularly than they do their primary care physicians, making them a helpful resource.

“We’ve seen the enormous economic penalty we’ve suffered as a country because of the impact the virus has on business and on the ability of people to even do basic things like go out and eat at restaurants,” Johnson said. “So as a country, we should be willing to spend almost whatever it takes.”

He said utilizing dentists will help Oregon and the US get the vaccine to people as quickly as possible so they can reach at least 70% herd immunity, meaning the virus will no longer infect the general population by the masses.

Storage, however, may be the one logistical hurdle dentists will have to overcome, Johnson said. There is some concern that the distribution mechanics may be too complicated for dentist offices.

For instance, Pfizer and Moderna’s vaccines both need to be stored in cold temperatures. Pfizer’s vaccine goes as far as requiring an ultra-cold freezer that can keep it as cold as -70 degrees Celsius.

“So, you need dry ice to keep that,” Johnson said. “That’s probably going to get distributed in large academic medical centers or large medical centers.”

But Moderna would require more accessible refrigeration — and some vaccines that are still in trials don’t even require refrigeration.

“We just need to think through the logistics of all that,” Johnson said. “But a number of these vaccines that are in development will certainly be coming into the marketplace over the next year and will lend themselves readily to being distributed by getting the shots given in dentist offices.”

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