Imagine the scene: it’s the Antarctic winter, minus 40 degrees Centigrade with a storm approaching. One of your number has broken a tooth and is writhing in agony, and you’re the doctor who has to fix it. You’re thousands of miles away from the nearest settlement, and the ‘local’ dentist is literally on another continent – with no transport out for weeks. What do you do?
Doctors with the British Antarctic Survey Medical Unit (BASMU) are well-prepared for such an eventuality, thanks to Plymouth University Peninsula Schools of Medicine and Dentistry (PU PSMD) and a team of dedicated dentists across the UK.
Medics due to visit the Antarctic as part of BASMU spend several days with the team at the Peninsula School of Dentistry as part of their preparation. There they are given advice and practice at dealing with dental emergencies and trauma, so that those in their charge with dental problems can be stabilised and made comfortable until transport is available to take them to a dental surgery – in either Cape Town, Port Stanley or Puerto Arenas in Chile, depending on where the patient is on Antarctica.
Part of this training includes the use of the simulated dental heads on display at the Natural History Museum. The heads can be fitted with a variety of dental conditions, and those undergoing training use them to hone their clinical skills in simulation before treating real patients.
As well as providing knowledge before they depart, the dental team at Plymouth University (along with other dentists elsewhere in the UK), also provides BASMU doctors with support and advice via email, videophone and Skype. This may include answering simple questions, looking at emailed photographs and x-rays or discussing the issues and giving advice.
Peter Marquis is Manager of BASMU, which is part of Plymouth Hospitals NHS Trust with connections to Plymouth University. While those visiting the Antarctic with the British Antarctic Survey must show they are ‘dentally fit’, emergencies do happen. He said: “General medical training is light on dentistry, if it is covered at all. Anyone who has had pain in the mouth can appreciate how debilitating it can be, but imagine experiencing that thousands of miles from the nearest dentist and knowing that it could be weeks before transport is available to get you to that dentist.
“By working with the dental team at Plymouth University Peninsula Schools of Medicine and Dentistry we are able to provide our medics with dental advice useful for dealing with unforeseen emergencies and trauma.”
BASMU medics spend five days with the dental team at PU PSMD. In that time they cover issues such as: cross infection; the oral cavity (which includes examining patients and each other); preventive dentistry; temporary dressings; pain assessment; diagnosis; when to refer a patient on; radiography; photography; managing spreading infections and dental trauma.
PU PSMD is in the unique position to be able to offer this support because of its Dental Education Facilities, where dental students treat NHS patients under the supervision of qualified dentists, dental nurses, hygienist and therapists, as part of their training.
Leading the work with BASMU is Professor Gill Jones, Director of Undergraduate Dental Studies at PU PSMD. She said: “We have dental training clinics which are vital to providing practical support to BASMU medics. We also use simulated dental heads as part of our students’ training, and these are immensely useful in showing BASMU doctors how to manage dental trauma such as splints. Our aim is to equip them with the knowledge necessary to deal with a dental emergency and stabilise their patient until such a time as they can be transported from their base on Antarctica to a dental surgery.”
She added: “Our help does not stop there, and BASMU medics know they can contact us in situ for our advice. It is a great project to be involved with and immensely interesting for our staff and students, and to our patients: indeed, it is often difficult to get through a whole clinic when the doctors are observing because the patients have so many questions!”
Three BASMU medics are the latest to visit PU PSMD: Dr. Julie Hunt, Dr. Sophie Carter-Ingram and Dr. Kenrick Turner.
Dr. Turner, who was most recently a surgical senior house officer at Norfolk and Norwich University Hospitals NHS Foundation Trust, said: “In six years of studying medicine we spent about two hours on dentistry, and I think that is a reflection of most medical courses. Our visit to PU PSMD has been a steep learning curve and what we have learned here will be useful not only for our roles at BASMU, but for our future careers too.”
Dr. Hunt, also originally from Norfolk and Norwich but most recently returned as a doctor on a cruise ship, agreed. She said: “Everyone at PU PSMD has been so welcoming and have given up their time and experience and this has been phenomenal, brilliant. I’m looking forward to the challenge which I am sure will bring both the worst and best of times.”
Dr. Carter-Ingram joins BASMU from St. Mary’s in West London where she was an emergency medicine trainee. She commented: “Everyone has been really supportive and it is good to know that the support will continue when we are on-base. I feel more confident about dealing with dental emergencies while I am away.”
All three left for Antarctica in the autumn where they are stationed at different bases, with anything from 90 to 120 people in their care.
Dr. Penny Granger from BASMU, who has been a key part of sessions at PU PSMD, said: “This is all about dental first aid. It is part of a six-month training programme run for medics due to visit Antarctica and is absolutely vital – very few doctors experience managing dental problems as undergraduates.”
The British Antarctic Survey is one of the world’s leading environmental research centres and is responsible for the UK’s national scientific activities in Antarctica. BASMU’s role is to determine an individual’s medical fitness to travel to and work in Antarctica, and to provide and oversee the medical personnel whose role it is to care for those working for the British Antarctic Survey in situ and to avoid needless evacuations. As well as providing support in dentistry, BASMU also covers other health care disciplines including physiotherapy, hyperbarics, nursing, radiography and basic surgical skills.