Like other dentists, A.J. Acierno is experienced in complex medical procedures and comfortable with oral injections.
So, he's more than capable of delivering basic COVID-19 shots to the upper arms of patients, he says.
And now that the Biden administration is letting dentists and dental students administer vaccines, Americans may now be able to get an inoculation against the deadly virus the next time they get a tooth cleaning.
“As a dentist, I will be very happy to give a shot,” says Acierno, who is also CEO of Schaumburg Illinois-based Decision One Dental, a group of dental practices with 33 locations.
In fact, the procedure will be even easier for him than oral shots because vaccine patients won't be able to fend off needles with their tongues or by clamping their mouths shut.
There’s a growing consensus that an all-hands-on-deck approach is the best way to vaccinate the nation as quickly as possible at a time when experts say that it’s the only way to put an end to the pandemic.
With that in mind, President Joe Biden's administration this month amended an emergency declaration under the Public Readiness and Emergency Preparedness Act to allow the nation's more than 151,000 dentists to join the push to deliver shots.
By comparison, the U.S. has nearly 322,000 pharmacists, many of whom are already delivering vaccines at drug stores.
"Since Biden said ... he expects everyone to be eligible, I do think that we need a lot of different outlets for people to access the vaccine," says Bunny Ellerin, director of the Healthcare and Pharmaceutical Management Program at Columbia Business School. "So if dentists are in a position where they can do it and you get your teeth cleaned too, sure, why not? I don’t really see a lot of downsides to it."
Even before Biden’s action, at least 28 states had already taken steps to allow dentists to administer vaccines. Now, the federal action supersedes any remaining state restrictions.
“That’s a game changer,” said Jane Grover, director of the Council on Advocacy for Access and Prevention at the American Dental Association, which lobbied for federal authorization. “We need to mobilize more people to get more shots in people's arms.”
The move toward delivering COVID-19 vaccines is also part of a trend of dentists expanding the services they provide to their patients, including adding clear plastic removable teeth aligners as a dentist-directed alternative to braces.
“We used to be drillers and fillers,” Acierno said. “Now we’re looking at the overall health of an individual.”
Ensuring the health of the country will make a significant effort to convince a vast majority of Americans to get the vaccine, something that experts are concerned about, given polls showing lingering reluctance or resistance in some quarters.
That’s why dentists say their personal relationships with patients may make a difference when it comes to convincing people to get their shots. They also point out that many patients see their dentist more often than their physician, meaning dentists may be able to vaccinate more people.
Jessica Gruber, a dentist who works in Germantown, Wisconsin, says her 100-year-old family practice's reputation among its longstanding patients could prove key.
“A lot of people see a dentist and stick with them for years and years and years. Having health care providers that have that strong foundation with their patients could be beneficial toward convincing people that this is something that is good,” she says.
She plans to do the requisite training and begin administering COVID-19 vaccines as soon as her practice can secure access to them.
“As health care providers, I think that dentists have a responsibility at times like this to be a part of the effort to contribute to public health,” she says.
As much as they want to help, however, not every dentist is ready to take the leap, in part due to the logistical issues, manpower and the investment involved in scheduling appointments, procuring vaccines, and setting aside time to deliver shots.
Administering COVID-19 vaccines is “the next natural step” of showing that dentists are “health care providers,” says Robert Crim, chief dental officer of Smile Brands, a dental services organization where he oversees dentists in 670 offices in 34 states.
But Crim says the challenges associated with distributing the vaccine could prove too much for his dentists – especially the concerns of whether they’ll receive enough doses on a timely basis and whether they’ll need to invest in special refrigeration.
The two-dose Pfizer vaccine, for example, is typically stored at ultra-cold temperatures, whereas the one-dose Johnson & Johnson vaccine can be stored in a regular refrigerator.
“Being allowed to do it is one thing,” Crim says, but “being able to do it is another.”
Dentists rejected the suggestion that adding COVID-19 vaccines could help bolster their foot traffic at a time when they have been struggling due to patients putting off regular appointments amid the pandemic. The extra costs of handling the vaccines will outweigh any benefits, they say.
“To be honest with you, it’s not going to help our business,” Acierno says. “We’re vaccinating people that are already coming into our business. The vaccinations are not going to be moneymakers. In fact, the vaccinations are going to be a money loser.”
But it’s still important for “the greater good,” he adds. “Right now, speed is necessary, and if we can help with that, we want to.”
The first step toward getting dentists to deliver COVID-19 shots is training them to do so. The Centers for Disease Control and Prevention are setting up training modules for dentists and hygienists to complete so that they are allowed to administer the vaccines.
Mark Miller, who practiced dentistry for nearly four decades before joining academia, led an effort to convince Oregon lawmakers to pass a bill containing protocol for dentists to get certified on vaccine administration.
As a faculty member at the Oregon Health & Science University's School of Dentistry, he is now one of the instructors in charge of training dentists on vaccines, including shots to prevent ailments like the flu and shingles.
“Who’s more at ease at handling a syringe than dentists?” Miller says. “We handle them all day long.”
After a few hours of training on various procedures, including storage and recordkeeping, his students practiced jabbing at each other.
The Oregon Health & Science University's School of Dentistry has now trained some 350 of the state’s about 3,000 dentists on vaccines.
In addition to training, dentists will need information on the differences between the vaccines available and related information so they can answer questions from their patients.
“It’s just another thing they’re trained in,” Miller says. “Our students can do any vaccination.”
Resource: “Dentists to give COVID vaccines to help Americans get vaccinated”, Article by Nathan Bomey on USA TODAY