A Yellowknife-based dentist is proposing to make Norman Wells a dental hub for the Sahtu region as an interim measure until regular dental visits to remote communities can resume.
Before Covid hit the NWT in March, Dr. Pirjo Friedman had for several years made regular dental visits to Sahtu communities like Colville Lake, Fort Good Hope, Deline and Tulita.
The pandemic ended all of her dental travel, but the strict new Covid rules introduced by the Office of the Chief Public Health Officer (OCPHO) have made dental procedures prohibitively difficult in the communities. She hasn't worked outside of her Yellowknife office of Adam Dental Clinic since March.
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While the federal Department of Indigenous Services Canada (ISC) has introduced the temporary measure of providing medical transportation for dental visits to Yellowknife through the Non-Insured Health Benefits Program, a trip to Yellowknife is considerably further than travelling inside the Sahtu.
“That's why I suggest the Norman Wells hub because that would expose people to less flying and keep them in the Sahtu area,” Friedman said.
She envisions setting it up inside the Sahtú Got'iné Regional Health and Social Services Centre.
It's a big building, she said, and it's also fairly new, having been opened in August of 2018.
She, or other dentists who would work in the building, could set up their temporary dental offices in the medical rooms using equipment they would bring themselves.
In the times she has visited Norman Wells, she found that the number of patients from the communities who made appointments with her in the oil town “just grows” and “we don't get to ever to the bottom of it.”
“When I visited Norman Wells in the past, I advertised on Facebook. People from Tulita took the winter road or (came by) boat. And it was the same for people from Fort Good Hope. When people came to Norman Wells they came with their whole family for their dental treatments.”
Mayor Frank Pope fully supports the hub idea. In fact, he thinks it should be more comprehensive. Even before Covid, Norman Wells was under-served in its dental needs, with only “sporadic dental service over the past 30 years,” he said.
“Many people who need help right away, can’t get it. Even when (people are) willing to travel, Covid made going for help difficult, if not impossible. People pay a lot to travel to Yellowknife. Air travel cost is ridiculous, hotel accommodations are expensive.
“We need this service in Sahtu, full-time and not sporadic. A resident dental service will serve all Sahtu communities. Flying to Yellowknife is not so much an inconvenience as a very expensive experience.”
Dr Roger Armstrong, President of the NWT/NU Dental Association, also supports Friedman's proposal.
“The idea of setting up Norman Wells as a Regional Dental Hub makes a lot of sense logistically. The catch is whether OCPHO guidelines can be successfully integrated into the Norman Wells facility.”
And that's where the only obstacle lies, Friedman admits.
Although the Norman Wells health centre has more advanced air filtration capabilities than other health centres in the region, its air circulation still doesn't meet the OCPHO's standards for dental care.
At issue is the set of rules on air changes per hour, a measurement of the time it takes to remove airborne bacteria or infectious aerosols from the air. It is also known as “aerosol settle time.”
“You'd have to leave the room (for two hours) to let the patient's aerosols sink. On the other hand, we don't have any Covid aerosols, it's not in the communities, it's not here, and it's not in the NWT.”
“I think it's only a question of those aerosols. If we have to wait hours between the patients, then that's not going to work.”
Friedman, and other dentists in Yellowknife has her own air purifiers that she could bring with her to Norman Wells to remove aerosols from the air faster, and possibly meet the OCPHO's standards.
“(But) I don't know if that's enough for their standards, which are probably the highest in the country,” she said.
More government support for Friedman's proposal could make a difference but there have been no commitments yet.
ISC has been discussing solutions with the GNWT that would enable regular dental services to resume in remote communities, said ISC spokesperson Rola Tfaili.
“All options are being considered including the creation of service hubs,” she said.
NNSL Media has asked the OCPHO as to whether it would support a possible dental hub in Norman Wells, and is awaiting a response.